Hair transplant surgery and gender dysphoria: Ask an expert

Written by: Dr Greg Williams
Published: | Updated: 08/03/2022
Edited by: Sophie Kennedy

People within the gender diversity community may experience gender dysphoria as a result of hair growth patterns which are not in keeping with their gender identity. For trans men, the introduction of male hormone therapy will often result in the development of masculine features including facial hair growth and male pattern hairlines. For trans women, however, who already have masculine hairlines, a hair transplant procedure which reshapes the hairline in a more feminine way can have a significantly positive impact on their quality of life. In this article, leading hair restoration surgeon Dr Greg Williams discusses the subject.




How can hair transplant surgery help trans women?

Hair transplant surgery can literally be life changing for trans women by removing the stigma of a male hairline shape or balding crown. It can entail a small procedure to just round off mild temporal recessions or a big procedure that may need to be repeated if there has been extensive male pattern hair loss. The degree of hair loss that has developed in a trans woman will depend on their genetic potential, age, topical and oral treatments used to slow down hair loss pre-transition, and when hormone therapy was started along with what is being used.


Gender affirmation surgery, by removing the production of testosterone by the testes, usually results in a cessation of androgenetic alopecia. Hair transplant surgery is helpful as it allows trans women to better present as themselves, not only in terms of hair but in the fundamental aspect of gender.



How is hair transplant surgery performed?


Follicular units (small naturally occurring groups of 1-5 hairs) are removed from the back and/or sides of the head and implanted into individual incisions in the recipient site. There are two donor harvesting methods - follicular unit excision (FUE) and linear strip excision (also known as strip follicular unit transplantation or strip FUT).


In the FUE technique, the individual groups of hairs are cored out leaving small round scars about a millimetre in diameter. In the strip technique, an ellipse of scalp skin is excised and then this is dissected into the same individual groups of hairs. The wound is stitched or stapled closed and heals with a linear surgical scar. Whilst the FUE technique is less invasive, less painful and heals more quickly, it usually entails shaving the donor area so my preferred harvesting method for women is the linear strip excision.



How long does it take to see results?


Transplanted hairs generally fall out after a few weeks and then take three to four months to start growing. Initially, the new hairs are fine and take another three to four months to develop enough to make an initial assessment feasible. No more hairs would be expected to grow after 8 months post-op but each individual hair should continue to improve in diameter for several months so the final result can take up to eighteen months to mature.


As hairs generally grow at about a centimetre a month, it will take a long time to grow long hair. It often takes a few years before a trans woman will decide on what hair length, hairstyle and hair colour suits them best. In addition, there is a hair density limitation that can be achieved per procedure so some trans women will choose to repeat the procedure in order to increase the thickness of their transplant.



Why choose Dr Greg Williams?


Dr Williams is a qualified plastic surgeon and, as part of his training, worked at the gender identity service at Charing Cross Hospital so he has first-hand experience in the surgical and non-surgical needs of trans women. He has delivered academic lectures on hair transplant surgery for trans women and has published an article on the ethics of treating LGBTQ+.  There are few hair transplant surgeons in the UK, or around the world, who can demonstrate this level of experience and qualification.



If you are considering a hair transplant procedure, don’t hesitate to visit Dr Greg Williams’ Top Doctors profile to book a consultation to discuss your options.

By Dr Greg Williams
Aesthetic medicine

Dr Greg Williams is a leading hair restoration surgeon based at the renowned Farjo Hair Institute in London and Manchester. He uses the latest techniques and technologies available in the field and is an expert in hair loss treatments, FUE hair transplants and follicular unit hair transplant surgery

Dr Williams, who is committed to giving patients the highest level of care on their hair restoration journey, is a fully-qualified plastic surgeon who is highly respected in the field of hair transplantation. 

He is a fellow of the International Society of Hair Restoration Surgery, possesses a diploma from the American Board of Hair Restoration Surgery and a Fellow of the Royal College of Surgeons of England in Plastic Surgery (FRCS & FRCS Plast). He also has an MBBS from the University of the West Indies

Dr Williams, who is the current president of the British Association of Hair Restoration Surgery (BAHRS), has esteemed presentation experience. He has spoken at the Royal Society of Medicine (RSM) and the European Society of Plastic, Reconstructive and Aesthetic Surgery (ESPRAS). He also gave the first talk on hair restoration in the then 30-year history of the British Association of Aesthetic Plastic Surgeons (BAAPS). 

He has been a lecturer since 2003, educating plastic surgery trainees on hair restoration and was appointed to the MSc faculty at University College London. There, he lectures on hair anatomy, physiology and biology alongside embryology, genetics, as well as the causes of hair loss and hair transplant surgery. Furthermore, Dr Williams passes on his expertise via workshops. He has taught doctors from around the globe at pioneering events including the world's first ARTAS robotic-assisted live surgery workshop held at the Farjo Hair Institute.

Dr Williams, who has been involved in numerous radio and television appearances, has had his research into hair restoration published in respected peer-reviewed publications including Trends in Urology and Men's Health, Body Language Journal and the International Journal of Aesthetic and Anti-Ageing Medicine. He has also written the professional standards and codes of conduct for both hair transport surgeons and hair transplant surgical assistants, published in the International Society of Hair Restoration Surgery's (ISHRS) journal Hair Transplant Forum International, as part of his presidential role at BAHRS.

Previous to his impressive hair restorative career, Dr Williams lead the burns service at London's Chelsea and Westminster NHS Foundation. He was also clinical director for the London and South East of England Burns Network, was involved in the contingency planning for the London 2012 Olympics and co-authored NHS Emergency Planning Guidance regarding the management of burn-injured patients in the event of a major incident. 


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