Over the years we have helped several trans-gender patients with their hair restoration. We are somewhat selective in whom we will accept for this surgery. It has to be someone who is very committed to going forward with the changing of genders, and the person has to be psychologically stable without any serious psychiatric conditions still present. Most of these patients have already or soon plan to undergo orchiectomy surgery, which removes the source of testosterone, helping to arrest their hair loss situation. They also usually are on estrogen medication, which helps in this same regard.

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The patients we have worked with we have found to be remarkably stable, very determined in this pursuit, and generally delightful people. They have in most cases already spent a good deal of money on electrolysis to remove hair, which has always been the best sign to me that they are motivated and that this is not a temporary whim for this individual. The biggest challenge faced by this group of patients is financial; not only are they often trying to arrange hair transplantation, but, usually more importantly, the tasks of hair removal, sex-change surgery, breast augmentation, etc. all add up to be a significant expense for the patient. Sometimes, the hair replacement component of their surgery has to be spread out, possibly combined with the temporary use of a hairpiece, so that they can accomplish their goals according to their priorities.

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In making the design for where the hair will be placed, the principal goals are to fill in any areas of male-pattern baldness and to create a female hairline, which is shallower and gently curved in the fronto-temporal recession. For most of these patients, three, and sometimes four, sessions are required to effect the desired density of hair.

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