PSA for trans men and trans mascs on T who are afraid of/concerned about or experiencing male pattern baldness: Talk to your endocrinologist who monitors your T about hair loss before you talk to anyone else, you have options!

When the hair in the top of my head started to thin, I talked to my regular GP. She told me it should be fine to use Rogaine topically. There were no other options, either because she was somehow not aware OR was under the impression that alternatives might interfere with HRT. If this was the case, she did not relay this info to me, and if she had, I would have made an early appointment with my endocrinologist, who specialises in HRT for trans people specifically, and asked her about my options.

But, since I only have appointments once a year with my endo now because my levels are generally super consistent, I decided to try Rogaine. I lasted about a month, because it basically meant I had to wear a lined hat at all times to make sure I wasn't getting any on my pillow/cats/child. You need to apply it two to three times a day and leave it on your scalp for a couple of hours for the best results, every day, forever, and if you stop using it, your hair goes back to whatever it was up to before that made you concerned in the first place. I quit after a month and resigned myself to eventually going bald.

I finally had a phone appointment with my endo last week (was supposed to be in person but she had an emergency and was working remotely for the day), and when I brought this up and that I had tried Rogaine but couldn't deal with all of the above + my scalp was not reacting well to the alcohol in the foam so I quit, she was like ????? what? why didn't your GP just prescribe you finasteride???

I am now on finasteride! It is a dirt cheap, tiny ass pill. I only need to take a quarter of a pill once a day (my endo also helpfully explained to me that pill cutters exist and are also dirt cheap, so perfectly cutting a pill into quarters takes about 5 seconds and I got it for a whopping $8). Just like Rogaine, I WILL need to take it every day, forever, but it's not going to get all over my pillow and make my cats sick or cause my kid to grow a beard or whatever. It isn't going to dry my scalp out, and it also the cost comparison is a joke. I take it every morning at the same time I take my adhd meds, so it's easy to remember.

I have seen so, so many trans men and mascs online lately worried about this, probably because I've seen so many conservatives and the kind of detrans people that conservatives like to parade around put a lot of emphasis about how T will make you UGLY and make all of your hair fall out. I do feel sorry for any detrans women who are dealing with wonky hairlines or male pattern baldness, but also it sure is convenient that none of them see fit to mention that if you are experiencing those things, you can literally just talk to your endocrinologist about what your options are and then take a quarter of a pill every day to fix it. Almost like making you aware of that might move you away from their end goal, which is getting you to detransition.

The drug finasteride, already used to treat hair loss and enlarged prostates, could also help to cut the risk of heart disease. In an analysis of data from both male humans and mice, the drug was shown to improve health and reduce levels of cholesterol. Too much cholesterol in the body is well known to increase heart disease risk, as it encourages atherosclerosis: fatty deposits in blood vessels, blocking the flow of blood through the arteries. Eventually, that can lead to strokes or heart attacks.

Continue Reading.

I’m tempted to go on T, but there’s one thing thats really setting me back. Both my father and his father went bald very early on in life (starting around senior year of high school). I’m absolutely terrified that I’m going to start balding if I begin taking testosterone

Finasteride will help mitigate hair loss. You can also bring up your concerns with your doctor, and they can discuss best prevention methods with you. There are lots of options (hair loss is a common dysphoria trigger for many cis men), and you can see some of the different treatments people have chosen from this reddit thread.

You can also go for a low-dose of T. It won't stop hair loss, but it will let you take a slower journey through your transition to explore if testosterone is right for you. Do know not all effects of T are reversible, though, including hair loss. But a low dose could give you time to see how being on T makes you feel, and if it's something you feel is worth pursuing even though your fears of hair loss. And if you notice the beginning of hair loss and hate it, you can stop taking T and prevent further loss from occurring.

Finally...it's hair. Hair is one of the most dynamic/least static things on our bodies. Hair loss happens. Hair thinning happens. Hair color changes happen. If you really hate it, then you might find salvation in wigs. But you might also find being bald empowering. There's nothing wrong with baldness! Especially if you're able to just own that and rock it. I think it's worth exploring...what about balding triggers fear for you? What's the underlying fear you're struggling with?

But also - you don't have to have the answers now. It's fine to take as much time as you need to consider this, weigh the pros and cons, and make your decision. It's also completely fine to make one decision now and change your mind later. Spend some time on other transition aspects that may feel more approachable right now. Those might be social, fashion, surgery oriented or anything else. See what kind of happiness you can find without T. It might help you make your decision later down the road.

It's okay. You're not alone. <3

~Mod Pluto

for anyone considering testosterone but not entirely sure they want all the effects, ask your doctor about taking finasteride with your T. it’s not for everyone and im taking it for balding, but it also limits body hair growth, which was something i was unsure about (though i mind less now). ive been on both for almost five months and my voice has dropped considerably and my period is almost gone and i feel great, but not much else has changed, so for anyone who’s looking for those things!!

microdosing HRT by taking anti-balding medications

Today’s the day!!!!! :D

March 12th!! Mark it in your calendars I’m starting horomones!! ❤️ ❤️ ❤️

Wish me luck 🥰🥰🥰

Gollum reacts well to finasteride and minoxidil, look at that hairgrowth.

And he put a ring on it~

Hey Trans Folks--Important Finasteride Fact

Finasteride causes temporary hair loss, known as Finasteride shedding, that starts roughly 2 weeks-2 months in to beginning treatment. My doctor did not mention this to me, so I googled it in a panic yesterday after running my fingers through my hair had me pulling away 20-30 hairs at a time. So if you started taking Finasteride to counteract hair loss or encourage new hair growth, please don't panic and think it's not working! Hair regrowth is a long, slow process, and you won't start to see new grown until the 3-6 month window, with full results showing up after a year. This site focuses on cis men, but does offer good information about Finasteride treatment and hair shedding. Also if you didn't know about Finasteride and are experiencing hair loss on testosterone, or experienced hair loss before starting estrogen/spiro (and spirolactane isn't helping you on that front), talk to your care team about finasteride. Finasteride blocks testosterone from turning into DHT and has shown to stop hair loss and encourage new hair growth. (On the down side, DHT is what encourages bottom growth, vocal changes, and facial hair growth if you're on T, so be aware of that and do your research. I am still getting facial hair growth and vocal changes personally, just slower and with fewer "cracks" in my voice.)

Hey! I saw you comment you were on DHT blockers, mainly to stop hair loss but keep voice/muscle changes. If you're okay to talk about it, are there other benefits/effects that you know about?

Yup! I'll write out what I've read up on for my own purposes. Standard disclaimer: I don't know what I don't know, speak to an endocrinologist if possible, get regular blood tests if you can.

The main two DHT blockers (that preventing testosterone being metabolised into DHT) are finasteride and dutasteride, with dutasteride having a stronger effect.

I used to take 1mg/day finasteride, the recommended medication and dose for hair loss prevention. However it has a short (6 hour) half-life in the body and I often forget to take it, so I switched to 1mg/3days dutasteride which remains in the body for a much longer time (several weeks half-life). This is not a recommended dosage or regimen - normal dosage is 0.5mg/day for hair loss - but is likely safe since it can be prescribed up to 5mg/day.

Potentially desirable effects of DHT blockers (compared to testosterone without DHT blockers)

Prevents head hair loss on DHT-sensitive hair follicles. For some people it can also reverse existing hair loss, though I wouldn't completely count on that.

Somewhat prevents body and facial hair from increasing. I haven't seen any evidence for reversal though.

It suppresses bottom growth.

Reduces skin oil production and thus may reduce acne.

DHT blockers likely don't affect: muscle growth, voice deepening, fat redistribution, height increase (if your bones are not fully ossified).

Side effects

DHT blockers affect fetal development, so all precautions should be taken to prevent anyone who is pregnant / trying to get pregnant from accidentally ingesting it. This means pill cutters shouldn't be shared for different medications, and you can't donate blood for as long as the DHT blocker is in your body (1 week for finasteride, 6-12 months for dutasteride).

Studies done on cis men taking DHT blockers show a potential increase in depression and lowered libido. However I don't have any information on whether the same effect applies to somebody with starting at a baseline of low testosterone and low DHT, then taking testosterone with a DHT blocker.

This systematic review is quite helpful and uses fairly understandable language.

Things I know that I don't know

The metabolism of testosterone doesn't end at DHT - DHT is then metabolised into other products, and so on. I have not looked into the downstream effects of blocking production of DHT yet, which may be significant if you are taking a near-total DHT blocker like dutasteride long-term.

I have seen many posts on bodybuilding forums (most reliable source of information /s) saying that DHT blocks the effects of estrogens by competing for estrogen receptors. As far as I can tell, DHT does not seem to bind effectively to estrogen receptors, so I somewhat doubt this claim. There is convincing evidence that DHT blockers increase the risk of gynecomastia in cis men, but I haven't yet been able to find out what the mechanism is.

I hope this long post is somewhat useful, and I'm happy to talk about other aspects of non-standard transition if you're curious.

Transition I

I had my first consult for HRT yesterday, and it went super well. I really like this doc; she knows exactly what she's doing, she has helped tons of trans folks like me before, and is able to talk through all the stuff that I simply don't know about. I'm going in for blood tests this morning, which I'm actually REALLY excited to find out the results of, because that's just the kind of person I am. I'm doing my PhD in disability ethics, I've written about bioethics before, and my mom has nurse training, so all the medical stuff is actually quite fascinating for me, even though I am NOT cut out to be a medical doctor or nurse in any way. Because of how my body is built, I'm curious to see how my hormones actually are, if I have high or low T or E, and what it all means.

Doc recommended finasteride alongside estrogen, to help with hair regrowth for the bald spot on the back of my head (one of the biggest focuses of my dysphoria) and the limiting of body hair growth. I honestly thought that it took several years to see the full effects of HRT, but she said that I'd most likely see all the bodily effects within a year, which blew my mind a bit. Part of me is like, "That's it?" But another part of me is also reeling at the fact that "Oh. I'm going to go through a STUPID amount of puberty in like, the span of a couple months. I already did that once, with the wrong equipment--what the hell is the new hormone stuff going to actually DO to me?"

Part of all this makes me nostalgic for how I got here. I only really had my gender epiphany recently, but when she asked "when was the first time I felt like I identified with a different gender," I had to answer... like, all my life. I've operated at varying levels of gender dysphoria since, well, forever. Everything kind of makes sense knowing that I was simply assigned the wrong gender at birth.

It makes sense that I wasn't any good at performing the "masculine" gender, but then again I'd argue, who is? The goalposts of gender are CONSTANTLY SHIFTING. Gender isn't a physical object, it's a role, a performance, a persona. My mom is probably more "butch" than any other straight woman I've met--short hair, wears more non-gendered clothing (polos and jeans, all day every day)--but also, does the feminine-coded stuff that she likes. She loves cooking, knitting, gardening, and generally tending to the home. She is literally a hobbit, a platonic ideal of a Tolkien-esque halfling. She loves things that grow, she loves teaching, she loves reading, learning, and making things. She rarely did anything more than the most basic makeup and jewelry, and seldom wore a dress or a skirt except for on special occasions.

In all honesty, I'm probably going to be more femme than her. I like my hair longer, and want to grow it out. I don't know how to do makeup yet, but I have a feeling once I get good at it I'll never want to take it off. I got my ears pierce, and absolutely LOVE how it makes me look, just a bit of personal sparkle to shine outwards. These are all such small things, in the end. Mentally, I'm still the same. I've always been this way. But I'm so much happier when I'm seen as a woman. My partner says I'm a completely different person, one who's happy, exuberant and vibrant. And she likes seeing me happy.

I'm not looking forward to the more turbulent aspects of puberty, but I think it will be worth it, in the end. I'm excited to transition. Now, I gotta think about changing my legal name, coming out at work... but that can wait for now. Right now, I'm excited about the future.

All transmasc people considering taking T or taking T : Finasteride can very consistently stop hairline receding and does not counteract any other aspect of your transition. Ask your doctor about, it's incredibly easy for them to prescribe.

All transfem people unable to start feminising HRT : getting a Finasteride prescription is easy from any doctor and doesn't out you. Even if you're on feminising HRT, get Finasteride as a failsafe.

Finasteride works, just do your research if you have comorbidities.

Regaine was ok, but today starts my first time taking Finasteride. Let's take a look at my ugly head and I'll get back to this in about three months and see if it's helped.

Finasteride works by stopping T turning into DHT, which is responsible for enlarging the prostate and causing hairloss. In 66% of cases, Finasteride can cause regrowth of hair as well as preventing further hairloss. It could be something to consider if you're worried that you'll lose your hair on T.

TLDR on our HRT journey (nearly 4 years now), very glad that we may be ending the chapter of our body’s life similar to how Phase 1 Arcee felt about her body lmao and moving on to feeling more euphoric with our organic frame (it is what is, we love it even though even our oldest headmate/our body desires metal, guess making shapes EVA foam will help compensate someday on occasions that would feel safe to do so):

Okay so, four days in on finasteride with estradiol (having given finasteride enough time to bond with our body tissue, takes four to five days) after switching out of spironolactone with estradiol (which we were on four almost four years) and personally;

finasteride is fucking fantastic so far:

- feel much more cogent/less brain fog (we’re told this is due to being more hydrated)

- it’s easier to plan doing things and then to do them

- body feels less unhinged/off-kilter

- sensation actually feels better/more intense, it’s easier to appreciate and immerse in touch and thus we don’t crave intimate relief as often, all of which has helped with our health a lot

Hopefully whatever “masculinizing” traits might resurface due to finasteride interfering with dihydrotestosterone instead of testosterone like spiro does won‘t be a bother, but from what we’ve seen/read/heard from folks a lot of people’s experience of it is okay. Finasteride is apparently recommended for folks who tend to get/are sensitive to side effects from medications (we definitely are).

For us personally, pre-HRT testosterone was no fun, it left us rather angsty and having difficulty with feeling a sense of composure, apart from the dysphoria, so spiro with estradiol was a remarkable improvement in all regards. Just with various psychological experiences piling up in the last three years on top of stuff from the rest of our life, spiro no longer felt tenable, so we had to switch to something else, and weren’t willing to take gender stuff by needle for personal reasons. Interestingly; a trans man we used to work with said that estrogen before HRT also left him feeling off-kilter in the head, and that taking HRT helped clear things up. This is just an experience some gender expansive folks have we suppose. :3

So yeah, here’s to the future! Whatever happens to our psyche for other reasons aside, we’ll probably be writing and doing art more consistently. We have some more thoughts about spiro and Arcee in regards to canon below:

To some degree though (this is going to be a very unhinged artist take, but more than anything it’s us processing what we went through), we’re glad we did spiro because of the effects it had we wanted that will carry over, and also because it did give our non-Arcee headmates and bodily experience personal insight into how much of a pain the aft sensory side effects and brain fog especially from something that was supposed to give euphoria is.

Given- we knew what many of the side effects could be going in, our gender affirmation providers did their best to inform us and we are deeply appreciative of how they’ve helped out all these years including by being supportive of our xenogender stuff and plurality when we finally felt comfortable talking about it. And, we know that having contracted the original strain of Covid in early 2020 could have left us with long covid which also can cause brain issues, and then there’s all the additional baggage of our psyche from how our brain is wired and living in the world, which we’ve done our best to compensate for with other medications, learning wisdom techniques from dialectical behavioral therapy and philosophy and various orgs and studies and contacts and experiences in life, seeing a therapist as needed, and so on.

So, it’s not as if it was just spiro, just as for IDW1 Arcee, it wasn’t just her surgery; it was also everything else going on in her life that was so hard, and she eventually found a way to reconstruct her life and be happy, just as we continue to attempt to do, appreciating happiness when it does come our way. This is all to say that there’s always hope; even if spiro had been the only thing in the world at the time, we would have clawed onwards, we wouldn’t be as happy but we would still try, for all the love we are lucky to have and make.

does anyone have experience with going on finasteride and testosterone at the same time? idk whether i should start fin right away or if i should be on T for a while before starting it 🤔

Why does it have to say that why does it have to say thaaaaaat