Transgender and gender diverse (TGD) patients who receive masculinizing gender affirming hormone therapy (GAHT) are 2.5 times more likely to develop androgenetic alopecia (AGA) than cisgender women, according to a poster presented at the 2023 AAD Annual Meeting.

Researchers reviewed the electronic health records of 37 826 patients receiving care at a single health care organization between August 1, 2014, and August 1, 2020, in a retrospective comparative cohort study, which included 1098 adult TGD patients who received feminizing GAHT, 1137 adult TGD patients who received masculinizing GAHT, 13 505 adult cisgender women, 21 279 adult cisgender men, and 432 adult TGD patients who did not receive GAHT. International Statistical Classification of Diseases, 9th/10th Revisions, Clinical-Modification codes were used to identified outcomes, and clinical factors, such as age, body mass index, smoking, hyperlipidemia, hypertension, diabetes, and alcohol use, were accounted for while comparing incidence rates.

TGD patients who received masculinizing GAHT had an adjusted incidence rate ratio (aIRR) of 2.50 (95% CI: 1.71-3.65) compared with cisgender women and 4.46 (95% CI: 1.56-12.73) compared with cisgender men. TGD patients who received feminizing GAHT had a significantly higher rate of AGA than cisgender women, with an aIRR of 1.91 (95% CI: 1.25-2.92); however, these patients did not experience a significantly different rate of AGA compared with cisgender men.

AGA may pose a significant challenge for TGD patients. The results of this study can help clinicians better understand AGA incidence rates in TGD patients receiving masculinizing or feminizing GAHT.

Reference

Gao J, Sanz J, Tan N, Dommasch E. Androgenetic alopecia incidence in transgender and gender diverse patients on hormone therapy compared to cisgender patients. Poster presented at: AAD Annual Meeting; March 17-21, 2023; New Orleans, LA.