Incidence and Factors Associated With Androgenetic Alopecia Among Transgender and Gender-Diverse Patients Treated With Masculinizing Hormone Therapy

In a retrospective cohort study of 988 transgender and gender-diverse patients undergoing masculinizing hormone therapy (MHT) at Fenway Health, the incidence of androgenetic alopecia (AGA) increased from 0.4% before MHT to 3.1% after MHT initiation. The median duration before AGA diagnosis was 2.8 years, with the highest incidence in the fourth year of MHT. The study found that 71% of AGA patients were prescribed finasteride, while 9.7% received topical minoxidil. The study's findings were consistent with previous research indicating delayed AGA development in transgender patients on MHT, though the proportion affected was lower, possibly due to reliance on ICD-10 diagnoses and the young age of participants. Limitations included a short median follow-up duration of 3.4 years and a predominantly White cohort, which may not represent diverse populations. Treatment success could not be assessed due to insufficient follow-up data.