Question about T & Male Pattern Baldness

[Rhye]

I was reading the MTF forum and noted an old thread in which a transwoman was worrying about male-pattern baldness after she was already transitioned.

That got me to thinking. Do transmen have to worry about male-pattern baldness? Is it genetic, or hormone-linked? Or both?

Just curious, and I couldn't find the answer elsewhere here!

[sarahb]

I have read that FTMs do in some cases develop male-pattern baldness. I would say it's both since the hormones induce the genetic predisposition to baldness just like in other guys.

[Rhye]

That makes sense, in which case I could say goodbye to my hair if I transitioned. I have two cousins who are balding at 24 & 26, my maternal grandfather was bald by 20, and my father's been bald since he was 30.

Interesting though, thanks Sarah!

[icontact]

Yeah, Sarah's right, I've read that in various places.

Similar question: So if without T, you already have a faint happy trail, does that mean you will have an absurd amount of chest hair when getting on T?

[gravitysrainbow]

I hope not, Sam. I definitely have a happy trail already. Not faint either. If I get too much chest hair from T (or any, really), it's going to be shaving or waxing time. Head hair, though, I would rather keep. But yeah, male pattern baldness is a possible side effect of T, and based on my family members, I'm at risk.

[Rhye]

I have a feeling I would be a relatively hairless male.. I can already get away with never shaving my legs, and that's dark hair. It's just really fine and sparse. Same with the "happy trail" hair. It's there, but not very significantly..

Oh well, Gravity, maybe we can be bald together.

[noxdraconis]

For those who want to know, here is the break-down.

Male pattern baldness is a trait mainly carried on the X-chromosome and triggered by androgens (mainly Dihydrotestosterone DHT), so that is why bio men have a 50% chance of looking like their maternal grandfather in terms of balding (since bio guys have one X that they get from their mother who has 2 X's, one from her mother and one from her father, meaning there is a 50% chance that the one her son gets is from her father).  An FTM on the otherhand have a 50% chance of following the balding pattern of his father and a 25% chance of following his maternal grandfather's, since he has one X from his father (the only one he has, meaning that is the only one he can give and that can be expressed in his phenotype) and one X from his mother (who can give an X from either side of her family).  Which X gets expressed all depends on X deactivation and Barr bodies, but all in all, an FTM has a 50% chance of mimicing his father's balding pattern.

[icontact]

Bah, I really hope T doesn't increase hair. I like the amount of hair I have, my happy trail's perfect, the hair on my legs is enough to be determined as male, but not a forest like some guys I've seen, ech.

Hm. Interesting Nox, thanks for the info.

[noxdraconis]

Hm. Interesting Nox, thanks for the info.

As a biology nerd, its my job .

[Aiden]

LOL... yeh well I guess mine is unknown, but least glad to know that I have a chance of having hair LOL   My mom's father has full head of hair, just grey's early.  My father's mother, I never met or seen her father, but so far my father hasn't shown any balding so maybe am good.  I was worried because his father went bald lol but if it's the x chromosome then that shouldn;t mater right?

Posted on: August 15, 2008, 09:01:24 PMThough I do wonder, what genes determine beard growth? 

[noxdraconis]

LOL... yeh well I guess mine is unknown, but least glad to know that I have a chance of having hair LOL   My mom's father has full head of hair, just grey's early.  My father's mother, I never met or seen her father, but so far my father hasn't shown any balding so maybe am good.  I was worried because his father went bald lol but if it's the x chromosome then that shouldn;t mater right?

Right, because your paternal grandfather's X can never be passed to you since the X your father gives you is from his mother.  So if your father has yet to start balding, you most likely will not either if you get to his age so no worries .

[Christo]

Its different 4 everybody but if ur old man & the men in ur family are bald, ur gonna be bald to & thats all theres to it.  Look at James green.  he's losin his hair but he looks good.
James Green
James Green
I dont wanna lose my hair now but its gonna be cool when I'm old.  its part of bein a dude

[trannyboy]

Lindsey, male pattern baldness (MPB) is a poorly understood subject but in short all those factors and more play in. Normally the gene for in on the x chromosome and men are told to look to their mother's family to determine genetic risk. Since FTMs have 2 X from mom and dad you need to look at both sides of your family and theoretically your risk is higher then a bio boy. Even if you carry the gene doesn't mean you will go bald but your risks are higher.

Other risk factors include hormone levels, diet, stress and cosmetics. Doctors and researchers don't understand the hormonal keys. For instance we have seen that people with high follicle Dihydrotestosterone (DHT) levels will likely go bald but merely having high serum DHT doesn't convene a higher risk of MPB. We have likewise seen high DHT levels shrink prostate tumors and Benign Prostate Hyperplasia (BPH) even though studies linked DHT to BPH and prostate cancer. More studies have shown that the balance of these hormones is more critical then first thought and what we assume to be caused by a single hormone isn't caused that way.

We alter our hormones levels beyond the knowledge of medical science and that is much more of an unknown then you might first think. You simply can't predict what changes and effects putting these drugs in your body will have. We can be somewhat sure that the benefits outweigh the risk but we don't know. Going bald is a minor risk compared to the other unknowns. You need to be ready to accept these risks to go on testosterone. It isn't the thought that you are going to be safe on these drugs that gives informed consent. It is knowing you don't know but are prepared to take it one step at a time and deal with problems as they arise.

Finally baldness isn't the end of the world anymore then pimples and such. Many people are bald, it is a totally normal physiological response in their bodies. Many men have been injured trying to not be bald. Check out forums for guys who took DHT blockers and have been suffering since. I could be biased though as no one in my family goes bald except my mom and thats stress related. I will be a nice dignified white head or at least thats what my genes say. I know that given the risks of medications to treat baldness I would much rather be bald.

->-bleeped-<-boy

[Aiden]

Well was willing to risk going bald before found out lies in X chromosome lol, doubt that would change knowing that still a chance lol.

Can only hope get the greying gene rather than the balding lol.   Have no problems with grey lol

[Keira]

The "injury" men suffer by taking DHT blockers is infrequent (less than 1%) and
slight in most case.

The most frequent is temporary gynomastia (enlarged breast).
Thiis occurs because the DHT that normally binds to T receptors cannot and
thus is free. Free T is then available for conversion by aromatisation to E, increase of
E leads in some people more susceptible to E in slight breast budding. After awhile,
the pituary detects the excess T and decreases output from the testes and thus
free T goes down and in almost all case, the breast increase goes away.

Another, less frequent happening is a decrease in libido.
Same reason, Free T converts to E, which upsets the E to T balance, thus
decrease in libido.

What's crazier for a guy is taking spiro to keep their hair. That would have a much
bigger impact on breast tissue and libido.

Taking a DHT inhibitor for a FTM is much more benign than for a bio male since
if you've had a mastectomy and they removed EVERYTHING, breasts cannot regrow
no matter what the T to E ratio is.

If a FTM is afraid of losing their hair, I see nothing bad about them taking dutasteride or
finesteride, plenty of men do it. If you take it BEFORE losing your hair, you'll probably wont
lose any.

[Elwood]

Yeah, Sarah's right, I've read that in various places.

Similar question: So if without T, you already have a faint happy trail, does that mean you will have an absurd amount of chest hair when getting on T?

Not necessarily. Best way to know is to look at your dad/brothers. They represent your POTENTIAL. You will be as hairy as them or less.

[trannyboy]

Kiera- A few points to consider.

Yes, after a mastectomy you won't regrow your breast but not all FTMs have a mastectomy, with the peri or more commonly with just lipo, FTMs have regrown breast and adipose tissue. That isn't the risk I am talking about though. Recently I have spent a lot of time haunting the DHT blocker boards and the complaints about them aren't simple as libido or breast developement. I am talking about symptoms ranging depression to extreme hormonal imbalances that aren't stopped by removing the drug. I know there are other effects but off hand I can't remember. 

It worries me that for pure vanity we are using a drug that wasn't meant to be used in our population and has patients in the intended population reporting negative responses that aren't resolved by ceasing treatment and aren't understood.

The problem with blocking DHT is it is needed in other areas of your body and taking systematic blocker like finesteride etc doesn't resolve the actual issue. Serum DHT and follicle DHT are both lowered by those drugs and it isn't high serum DHT that is the problem in baldness it is the follicle levels. I have seen people with high and low serum DHT go bald. There are good shampoos that can be used and they don't effect your global hormonal levels. Even with a systematic DHT blocker in place you can still lose your hair.

So for all of this an FTM would need to take the drug concurrent with their testosterone for their lifetime or at least as long as they don't want to be bald, they would see a lesser physical transition over a longer period of time, might suffer unknown ill effects and still go bald.

->-bleeped-<-boy

[Keira]

Women live with very very low DHT levels, so its obviously not a big issue...
Even with dutasteride, I'm betting the DHT levels to the folicle is still higher
than that at the hair folicle of most women.

I can understand that a FTM, wouldn't want to take a feminizing hormone
while their taking T. But, as with anything, there are tradeofs, more hair on your
head VS more hair on the rest of your body.

But, like any man, losing their hair severely can be very
traumatic. I'm not talking about slow creaping balding that occurs over
40-50 years, I'm talking losing most of your hair inside 15 years.


Only those with EXTREME sensitivity to DHT usually continue losing their hair
if they take dutasteride.

Obviously, there are other reasons than DHT for losing hair.
If someone loses some hair for metabolic reasons, it must be investigated.

I just hate blanket statements about risks, we take risks every time we cross the streets.
If someone knows the very small risks of a DHT conversion inhibitor and is ready to live with them,
its their own decision and I'm not going to stop them