Excess hair, hair removal methods, and barriers to care in gender minority patients: A survey study. (25th September 2019)

• Record Type: Journal Article
• Authors: Marks, Dustin H.; Hagigeorges, Dina; Manatis‐Lornell, Athena J.; Dommasch, Erica; Senna, Maryanne M.
• Is Part Of: Journal of cosmetic dermatology. Volume 19:Number 6(2020)
• Page Start: 1494
• Page End: 1498
• Publication Date: 2019-09-25
• Subjects: electrolysis -- gender minority -- gender nonbinary -- hair removal -- laser hair removal -- transgender -- transmen -- transwomen; Skin -- Diseases -- Treatment -- Periodicals; Lasers in surgery -- Periodicals; Skin -- Pathophysiology -- Periodicals; Surgery, Plastic -- Periodicals; 616.5
• DOI: 10.1111/jocd.13164
• Languages: English
• ISSNs: 1473-2130

Abstract

Abstract: Background: In gender minority patients, electrolysis and laser hair removal may be necessary to reduce facial and body hair in individuals seeking a more feminine appearance and/or modified gender expression. These procedures may also be required preoperatively for some gender‐affirming surgeries. Aims: To identify (a) the frequency of unwanted facial and body hair, (b) the use of various hair removal methods, and (c) associated barriers to care in gender minority patients. Methods: An online‐based patient survey was distributed via social media on Facebook ®, YouTube ®, and Instagram ® in fall 2018. Respondents were at least 18 years old and self‐identified as a gender minority. Results: In total, 991 responses were recorded with a completion rate of 77%. Considering excess hair, 84% of transwomen on feminizing hormone therapy (FHT: estrogen and anti‐androgen therapy), 100% of transwomen not on FHT, and 100% of nonbinary individuals on FHT reported excess facial/body hair. Laser hair removal (18%) and electrolysis (17%) had similar rates of use in this cohort and were more commonly reported for nonsurgical gender‐affirming purposes than preoperative preparation. Cost was the most frequently cited barrier to care. Conclusion: As the majority of transwomen and nonbinary people on feminizing hormone therapy had persistent excess facial/body hair, routine use of gender‐affirming hormones is not sufficient to fully eliminate unwanted hair. There remains a critical need to advocate for more comprehensive insurance coverage for laser hair removal and electrolysis in gender minority patients.