Facial hair treatment in transgender and gender diverse adults: a survey of barriers and satisfaction

Facial hair treatment in transgender and gender diverse adults: a survey of barriers and satisfaction | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Facial hair treatment in transgender and gender diverse adults: a survey of barriers and satisfaction Manas Ranpariya, Sylvia Hsu, Jules B. Lipoff This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7935766/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract This study explores facial hair–related practices, satisfaction, and barriers among transgender and gender diverse adults. A cross-sectional survey of participants (N = 24) recruited from dermatology and gender-affirming care clinics was analyzed. Respondents completed a brief questionnaire assessing the importance of facial hair for gender affirmation, use and perceived effectiveness of growth or removal interventions, satisfaction with current facial hair, and financial or systemic barriers. Most participants (N = 19, 79%) rated facial hair as at least moderately important to gender affirmation, while satisfaction with current facial hair was limited for the majority (N = 19, 79%). The most common growth treatments were topical minoxidil and biotin, while shaving and laser hair removal were the most frequently reported removal methods. Nearly all respondents (N = 23, 96%) reported financial or insurance-related barriers. These findings suggest that facial hair significantly contributes to gender affirmation but remains a source of dissatisfaction and financial strain. Increased awareness and coverage for gender-affirming hair care may improve equity and support in dermatologic practice. facial hair gender affirmation transgender health dermatology hair removal treatment satisfaction Main text Facial hair plays a meaningful role in gender affirmation for many transgender and gender diverse (TGD) individuals, influencing both physical presentation and psychosocial well-being. Prior research on facial hair in gender-affirming care has typically focused on binary identities or on isolated aspects of hair management, with little exploration of the comparative use and satisfaction with both facial hair growth and removal interventions in TGD populations. In a national survey of transmasculine adults, over 85% reported facial hair as important to transition, though dissatisfaction with density was common and 44% had pursued enhancement methods, most often topical minoxidil. 1 In a prospective cohort study, 36% of transmasculine individuals initiating testosterone also used minoxidil, with most noting improved upper lip and chin hair density. 2 Conversely, transfeminine and nonbinary patients often seek facial hair reduction, as estrogen rarely eliminates growth. 3 Laser hair removal and electrolysis are frequently required prior to gender-affirming surgeries and may reduce dysphoria, though cost and insurance coverage remain barriers. 4 , 5 We sought to address these gaps by surveying a broader TGD population. This study was approved by the Temple University institutional review board. A brief, anonymous survey was administered between September 2024 and January 2025 using QR code flyers placed in dermatology and gender-affirming care clinics. Eligible participants were TGD-identifying adults aged 18 or older. Respondents were asked questions regarding the importance of facial hair for gender affirmation, history of hair growth or removal interventions, perceived effectiveness, satisfaction with current facial hair, insurance or financial burden, and adequacy of support. The survey instrument was validated by peers, although no formal validity assessment was performed. Among 24 respondents, 79% (19/24) rated facial hair as moderately to extremely important for gender affirmation. Effectiveness and satisfaction were originally assessed using 5-point Likert scales (none, slight, moderate, very, extremely). For analysis, responses of none to moderate were categorized as “limited,” while very or extremely were categorized as “high.” Minoxidil (topical or oral) and biotin were the most used growth methods. However, only one respondent rated any growth method as highly effective. Hair removal was more common and often multimodal, with shaving (92%) and laser hair removal (83%) being the most frequently reported [Table 1]. Four respondents rated the effectiveness of removal methods as high, while eight rated it as limited. The majority (79%) of respondents reported limited satisfaction with their current facial hair status in relation to their gender identity. Financial and systemic barriers were common. Nearly all (96%) of respondents reported having at least some degree of difficulty managing facial hair–related costs. When asked whether they felt adequately supported in managing facial hair in relation to their gender identity, responses were mixed: nine (38%) said yes, five (21%) said no, and ten (42%) were unsure [Table II]. These findings highlight the importance of facial hair in gender affirmation and the use of both growth and removal methods across TGD populations. Satisfaction with current facial hair was generally limited and was further compounded by cost and insurance barriers that affected most respondents. These patterns emphasize the need for increased awareness of gender-affirming hair care, better clinical guidance, and broader insurance support for both facial hair growth and removal services. Dermatologists, increasingly recognized as key members of gender-affirming care teams, may encounter facial hair related challenges in practice but often lack structured guidance or education on TGD patient experiences. 6 This study is limited by self-reported data and small sample size. Nonetheless, future research should include larger samples and further examine the comparative effectiveness of interventions and systemic barriers limiting dermatologic access for TGD individuals. Declarations Funding information : None Conflicts of Interest : Dr. Lipoff reports receiving a grant from Pfizer, royalties from Springer Science and Business Media and UpToDate, and consulting fees from Alphasights, Amgen, Boehringer Ingelheim, Guidepoint Global, and RBC Consultants Ethical Approval: Reviewed and approved by Temple University IRB; protocol #31636. Ethics statement: The patients in this manuscript have given written informed consent to the publication of their case details. Data availability statement : The data that support the findings of this study are available from the corresponding author upon reasonable request. References Pathoulas JT, Flanagan KE, Walker CJ, Pupo Wiss IM, Marks D, Senna MM. Characterizing the role of facial hair in gender identity and expression among transgender men. J Am Acad Dermatol. 2022 Jul;87(1):228–30. doi:10.1016/j.jaad.2021.07.060. Marinelli L, Bichiri A, Cagnina S, Castella L, Ghigo E, Motta G. Efficacy of topical minoxidil in enhancing beard growth in a group of transgender assigned female at birth individuals on gender affirming hormone therapy. J Endocrinol Invest. 2024 Nov;47(11):2843–50. doi:10.1007/s40618-024-02373-8. Gao Y, Maurer T, Mirmirani P. Understanding and addressing hair disorders in transgender individuals. Am J Clin Dermatol. 2018 Aug;19(4):517–27. doi:10.1007/s40257-018-0343-z. Marks DH, Peebles JK, Dommasch E. Hair reduction for transgender persons: what dermatologists should know and how they can help. JAMA Dermatol. 2019 May 1;155(5):525–6. doi:10.1001/jamadermatol.2019.0149. Bradford NJ, Rider GN, Spencer KG. Hair removal and psychological well-being in transfeminine adults: associations with gender dysphoria and gender euphoria. J Dermatolog Treat. 2021 Sep;32(6):635–42. doi:10.1080/09546634.2019.1687823. Frasier K, Li V, Vinagolu-Baur J, Chapman O, Baptiste C, Sobotka M. Advancing inclusivity in dermatological healthcare for transgender individuals: a narrative review. Dermis. 2024;4(4):10024. doi:10.35702/Derm.10024. Tables Table I. Reported Facial Hair Modification Methods Category Treatment # of respondents who used it a (%) b Growth Treatment Biotin 3 (38%) Topical minoxidil / Rogaine 2 (25%) Oral minoxidil 1 (13%) Other natural remedies 2 (25%) Rosemary oil 1 (13%) Hair transplantation 1 (13%) Removal Treatment Shaving 11 (92%) Laser hair removal 10 (83%) Plucking / tweezing 7 (58%) Waxing 5 (42%) Electrolysis 3 (25%) Depilatory creams (e.g., Nair) 1 (8%) a Respondents could select multiple methods b Percentages for growth treatments are calculated out of those who pursued growth treatments (n=8). Percentages for removal treatments are calculated out of those who pursued removal treatments (n=12). Table II. Participant Characteristics and Survey Outcomes Survey field Response n = 24 (%) a Gender identity Trans male 9 (38%) Trans female 10 (42%) Non-binary 4 (17%) Gender-queer 1 (4%) Importance of addressing facial hair Extremely 12 (50%) Very 4 (17%) Moderately 3 (13%) Slightly 4 (17%) Not important at all 1 (4%) Have you pursued facial hair growth treatments? Yes 8 (33%) No 16 (67%) How would you rate the effectiveness of these growth methods? b High 1 (13%) Limited 7 (88%) Have you pursued facial-hair removal treatments? Yes 12 (50%) No 12 (50%) How would you rate the effectiveness of these removal methods? b High 4 (33%) Limited 8 (67%) Overall satisfaction with current facial hair a High 5 (21%) Limited 19 (79%) Difficulty with out-of-pocket cost / insurance barrier? Yes 23 (96%) No 1 (4%) Do you feel you have adequate support and resources for managing facial hair in relation to your gender identity? Yes 9 (38%) No 5 (21%) Unsure 10 (42%) a Percentages for growth effectiveness are calculated out of those who pursued growth treatments (n=8). Percentages for removal effectiveness are calculated out of those who pursued removal treatments (n=12). All other percentages calculated out of total respondents (n=24). b Likert-style survey items (none, slight, moderate, very, extremely) for effectiveness and satisfaction were collapsed into two categories: limited (none–moderate) and high (very–extremely). Additional Declarations Competing interest reported. Dr. Jules B. Lipoff reports receiving a grant from Pfizer, royalties from Springer Science and Business Media and UpToDate, and consulting fees from Alphasights, Amgen, Boehringer Ingelheim, Guidepoint Global, and RBC Consultants Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 23 Nov, 2025 Reviewers invited by journal 23 Nov, 2025 Editor assigned by journal 25 Oct, 2025 Submission checks completed at journal 25 Oct, 2025 First submitted to journal 23 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7935766","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":550893554,"identity":"4f9b7881-e83d-4771-b544-8d019680f1ac","order_by":0,"name":"Manas Ranpariya","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIiWNgGAWjYBADHgYG5gNAWkKGFC1sCSAtPCRZZADVSwDozj787HFBzT0Zg+NnPr+6UWPBw8B++OgGfFrMzqWZG884VsxjcCZ3m3XOMaDDeNLSbuDVcobBTJqHLYHH4EDuNuMcNqAWCR4zAlrYv0nz/ANqOf/mmXHOP6K08JhJ87YBtdzIYX6c20acljLpmX0JPJI3npkx5/ZJ8LAR9gv7NumCbwn2fOeTH3/O+VYnx89++BheLSDADCIUDjCwSYAYbISUw7XINzAwfyBG9SgYBaNgFIw8AADvWEP1PyWn6gAAAABJRU5ErkJggg==","orcid":"","institution":"Rutgers Robert Wood Johnson Medical School","correspondingAuthor":true,"prefix":"","firstName":"Manas","middleName":"","lastName":"Ranpariya","suffix":""},{"id":550893555,"identity":"578f9665-84f5-43e6-b052-af5be3ed6b6a","order_by":1,"name":"Sylvia Hsu","email":"","orcid":"","institution":"Temple University Lewis Katz School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Sylvia","middleName":"","lastName":"Hsu","suffix":""},{"id":550893556,"identity":"2a6d6570-c945-4d1c-9fbc-03da614f0b7f","order_by":2,"name":"Jules B. 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Dr. Jules B. Lipoff reports receiving a grant from Pfizer, royalties from Springer Science and Business Media and UpToDate, and consulting fees from Alphasights, Amgen, Boehringer Ingelheim, Guidepoint Global, and RBC Consultants","formattedTitle":"Facial hair treatment in transgender and gender diverse adults: a survey of barriers and satisfaction","fulltext":[{"header":"Main text","content":"\u003cp\u003eFacial hair plays a meaningful role in gender affirmation for many transgender and gender diverse (TGD) individuals, influencing both physical presentation and psychosocial well-being. Prior research on facial hair in gender-affirming care has typically focused on binary identities or on isolated aspects of hair management, with little exploration of the comparative use and satisfaction with both facial hair growth and removal interventions in TGD populations.\u003c/p\u003e\u003cp\u003eIn a national survey of transmasculine adults, over 85% reported facial hair as important to transition, though dissatisfaction with density was common and 44% had pursued enhancement methods, most often topical minoxidil.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e In a prospective cohort study, 36% of transmasculine individuals initiating testosterone also used minoxidil, with most noting improved upper lip and chin hair density.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e Conversely, transfeminine and nonbinary patients often seek facial hair reduction, as estrogen rarely eliminates growth.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Laser hair removal and electrolysis are frequently required prior to gender-affirming surgeries and may reduce dysphoria, though cost and insurance coverage remain barriers.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eWe sought to address these gaps by surveying a broader TGD population. This study was approved by the Temple University institutional review board. A brief, anonymous survey was administered between September 2024 and January 2025 using QR code flyers placed in dermatology and gender-affirming care clinics. Eligible participants were TGD-identifying adults aged 18 or older. Respondents were asked questions regarding the importance of facial hair for gender affirmation, history of hair growth or removal interventions, perceived effectiveness, satisfaction with current facial hair, insurance or financial burden, and adequacy of support. The survey instrument was validated by peers, although no formal validity assessment was performed.\u003c/p\u003e\u003cp\u003eAmong 24 respondents, 79% (19/24) rated facial hair as moderately to extremely important for gender affirmation. Effectiveness and satisfaction were originally assessed using 5-point Likert scales (none, slight, moderate, very, extremely). For analysis, responses of none to moderate were categorized as \u0026ldquo;limited,\u0026rdquo; while very or extremely were categorized as \u0026ldquo;high.\u0026rdquo; Minoxidil (topical or oral) and biotin were the most used growth methods. However, only one respondent rated any growth method as highly effective. Hair removal was more common and often multimodal, with shaving (92%) and laser hair removal (83%) being the most frequently reported [Table\u0026nbsp;1]. Four respondents rated the effectiveness of removal methods as high, while eight rated it as limited. The majority (79%) of respondents reported limited satisfaction with their current facial hair status in relation to their gender identity.\u003c/p\u003e\u003cp\u003eFinancial and systemic barriers were common. Nearly all (96%) of respondents reported having at least some degree of difficulty managing facial hair\u0026ndash;related costs. When asked whether they felt adequately supported in managing facial hair in relation to their gender identity, responses were mixed: nine (38%) said yes, five (21%) said no, and ten (42%) were unsure [Table II].\u003c/p\u003e\u003cp\u003eThese findings highlight the importance of facial hair in gender affirmation and the use of both growth and removal methods across TGD populations. Satisfaction with current facial hair was generally limited and was further compounded by cost and insurance barriers that affected most respondents. These patterns emphasize the need for increased awareness of gender-affirming hair care, better clinical guidance, and broader insurance support for both facial hair growth and removal services. Dermatologists, increasingly recognized as key members of gender-affirming care teams, may encounter facial hair related challenges in practice but often lack structured guidance or education on TGD patient experiences.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e This study is limited by self-reported data and small sample size. Nonetheless, future research should include larger samples and further examine the comparative effectiveness of interventions and systemic barriers limiting dermatologic access for TGD individuals.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding information\u003c/strong\u003e: None\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u003c/strong\u003e:\u0026nbsp;Dr. Lipoff reports receiving a grant from Pfizer, royalties from Springer Science and Business Media and UpToDate, and consulting fees from Alphasights, Amgen, Boehringer Ingelheim, Guidepoint Global, and RBC Consultants\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e Reviewed and approved by Temple University IRB; protocol #31636.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics statement:\u0026nbsp;\u003c/strong\u003eThe patients in this manuscript have given written informed consent to the publication of their case details.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e: The data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003ePathoulas JT, Flanagan KE, Walker CJ, Pupo Wiss IM, Marks D, Senna MM. Characterizing the role of facial hair in gender identity and expression among transgender men. J Am Acad Dermatol. 2022 Jul;87(1):228–30. doi:10.1016/j.jaad.2021.07.060.\u003c/li\u003e\n \u003cli\u003eMarinelli L, Bichiri A, Cagnina S, Castella L, Ghigo E, Motta G. Efficacy of topical minoxidil in enhancing beard growth in a group of transgender assigned female at birth individuals on gender affirming hormone therapy. J Endocrinol Invest. 2024 Nov;47(11):2843–50. doi:10.1007/s40618-024-02373-8.\u003c/li\u003e\n \u003cli\u003eGao Y, Maurer T, Mirmirani P. Understanding and addressing hair disorders in transgender individuals. Am J Clin Dermatol. 2018 Aug;19(4):517–27. doi:10.1007/s40257-018-0343-z.\u003c/li\u003e\n \u003cli\u003eMarks DH, Peebles JK, Dommasch E. Hair reduction for transgender persons: what dermatologists should know and how they can help. JAMA Dermatol. 2019 May 1;155(5):525–6. doi:10.1001/jamadermatol.2019.0149.\u003c/li\u003e\n \u003cli\u003eBradford NJ, Rider GN, Spencer KG. Hair removal and psychological well-being in transfeminine adults: associations with gender dysphoria and gender euphoria. J Dermatolog Treat. 2021 Sep;32(6):635–42. doi:10.1080/09546634.2019.1687823.\u003c/li\u003e\n \u003cli\u003eFrasier K, Li V, Vinagolu-Baur J, Chapman O, Baptiste C, Sobotka M. Advancing inclusivity in dermatological healthcare for transgender individuals: a narrative review. Dermis. 2024;4(4):10024. doi:10.35702/Derm.10024.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable I. Reported Facial Hair Modification Methods\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"664\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e# of respondents who used it\u003csup\u003ea\u0026nbsp;\u003c/sup\u003e(%)\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003eGrowth Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eBiotin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e3 (38%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eTopical minoxidil / Rogaine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e2 (25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eOral minoxidil\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e1 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eOther natural remedies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e2 (25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eRosemary oil\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e1 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eHair transplantation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e1 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003eRemoval Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eShaving\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e11 (92%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eLaser hair removal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e10 (83%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003ePlucking / tweezing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e7 (58%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eWaxing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e5 (42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eElectrolysis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e3 (25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 419px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125px;\"\u003e\n \u003cp\u003eDepilatory creams (e.g., Nair)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e1 (8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eRespondents could select multiple methods\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003ePercentages for growth treatments are calculated out of those who pursued growth treatments (n=8). Percentages for removal treatments are calculated out of those who pursued removal treatments (n=12).\u003c/p\u003e\n\u003cp\u003eTable II. \u0026nbsp; Participant Characteristics and Survey Outcomes\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"664\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSurvey field\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en = 24 (%)\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eGender identity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eTrans male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e9 (38%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eTrans female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e10 (42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eNon-binary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4 (17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eGender-queer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1 (4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eImportance of addressing facial hair\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eExtremely\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e12 (50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eVery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4 (17%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eModerately\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e3 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eSlightly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4 (17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eNot important at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1 (4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eHave you pursued facial hair growth treatments?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e8 (33%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e16 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eHow would you rate the effectiveness of these growth methods?\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1 (13%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eLimited\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e7 (88%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eHave you pursued facial-hair removal treatments?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e12 (50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e12 (50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eHow would you rate the effectiveness of these removal methods?\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4 (33%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eLimited\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e8 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eOverall satisfaction with current facial hair \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e5 (21%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eLimited\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e19 (79%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eDifficulty with out-of-pocket cost / insurance barrier?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23 (96%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1 (4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003eDo you feel you have adequate support and resources for managing facial hair in relation to your gender identity?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e9 (38%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e5 (21%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 478px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eUnsure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e10 (42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003ePercentages for growth effectiveness are calculated out of those who pursued growth treatments (n=8). Percentages for removal effectiveness are calculated out of those who pursued removal treatments (n=12). All other percentages calculated out of total respondents (n=24).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003eLikert-style survey items (none, slight, moderate, very, extremely) for effectiveness and satisfaction were collapsed into two categories: limited (none\u0026ndash;moderate) and high (very\u0026ndash;extremely).\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"facial hair, gender affirmation, transgender health, dermatology, hair removal, treatment satisfaction ","lastPublishedDoi":"10.21203/rs.3.rs-7935766/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7935766/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study explores facial hair–related practices, satisfaction, and barriers among transgender and gender diverse adults. A cross-sectional survey of participants (N = 24) recruited from dermatology and gender-affirming care clinics was analyzed. Respondents completed a brief questionnaire assessing the importance of facial hair for gender affirmation, use and perceived effectiveness of growth or removal interventions, satisfaction with current facial hair, and financial or systemic barriers. Most participants (N = 19, 79%) rated facial hair as at least moderately important to gender affirmation, while satisfaction with current facial hair was limited for the majority (N = 19, 79%). The most common growth treatments were topical minoxidil and biotin, while shaving and laser hair removal were the most frequently reported removal methods. Nearly all respondents (N = 23, 96%) reported financial or insurance-related barriers. These findings suggest that facial hair significantly contributes to gender affirmation but remains a source of dissatisfaction and financial strain. Increased awareness and coverage for gender-affirming hair care may improve equity and support in dermatologic practice.\u003c/p\u003e","manuscriptTitle":"Facial hair treatment in transgender and gender diverse adults: a survey of barriers and satisfaction","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-28 05:18:42","doi":"10.21203/rs.3.rs-7935766/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"132033374140982204743198532070135517372","date":"2025-11-24T02:57:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-24T02:29:29+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-25T14:31:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-25T14:31:04+00:00","index":"","fulltext":""},{"type":"submitted","content":"Archives of Dermatological Research","date":"2025-10-24T01:22:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"archives-of-dermatological-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Archives of Dermatological Research](https://www.springer.com/journal/403)","snPcode":"403","submissionUrl":"https://submission.nature.com/new-submission/403/3","title":"Archives of Dermatological Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"1e8c931b-111d-48d1-8e3b-e7bbb0aa8e1b","owner":[],"postedDate":"November 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-28T05:18:42+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-28 05:18:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7935766","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7935766","identity":"rs-7935766","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}