Association Found Between Gender-Affirming Hair Removal and Mental Health Outcomes

BOSTON, July 21, 2021—A research letter published today in JAMA Dermatology finds that gender-affirming hair removal for transgender and gender diverse people is associated with improved mental health outcomes. It uses data from the 2015 U.S. Transgender Survey and is the latest in a series of secondary analyses of the groundbreaking survey showing that transgender and gender diverse people who receive gender-affirming health care have improved mental health outcomes.

“Association Between Gender-Affirming Hair Removal and Mental Health Outcomes” reports that gender-affirming hair removal was associated with lower odds of past-month severe psychological distress, past-year suicidal ideation, and past-year smoking. The research reinforces findings from the only other empirical investigation on the topic published in 2019 in the Journal of Dermatological Treatment.

“To date, there has been limited evidence of the mental health benefits of gender-affirming hair removal procedures, which are desired by nearly 90 percent of transgender and gender diverse people in this sample,” said study senior author Dr. Alex S. Keuroghlian, who directs the National LGBTQIA+ Health Education Center at The Fenway Institute and the Massachusetts General Hospital Psychiatry Gender Identity Program. “This is likely one of the reasons why less than five percent of health insurance plans cover procedures such as electrolysis or laser hair removal. We hope that our research study will convince health insurers of the need to cover these gender-affirming treatment recommendations by clinicians.”

Of the 11,857 survey respondents assigned male sex at birth, 4,927 had undergone hair removal whereas 5,652 desired hair removal but had not received it. After adjusting for sampling biases related to age, race, and ethnicity, gender-affirming hair removal was associated with a 38 percent reduction in past-month severe psychological distress, 28 percent reduction in past-year suicidal ideation, and 24 percent reduction in past-year tobacco smoking.

“Our findings add to the growing body of research suggesting the mental health benefits of gender-affirming health care treatment for transgender and gender diverse people,” said research study lead author Michelle Lee. “Gender-affirming hair removal is particularly important given that hormones alone are often insufficient in removing undesired hair and because hair removal is sometimes required in preparation for gender-affirming surgeries.”

The letter was authored by researchers at The Fenway Institute, Harvard Medical School, Brigham and Women’s Hospital, Harvard T.H. Chan School of Public Health, and Massachusetts General Hospital. It was based on data from the 2015 U.S. Transgender Survey conducted by the National Center for Transgender Equality which surveyed over 27,000 transgender people in all 50 states, Washington D.C., Puerto Rico, U.S. territories abroad, and U.S. military bases on a multitude of questions about their lives.

“Association Between Gender-Affirming Hair Removal and Mental Health Outcomes” is the latest in a series of papers using data from the 2015 U.S. Transgender Survey to evaluate factors affecting the mental health outcomes of transgender and gender diverse people. Prior papers include “Factors Leading to ‘Detransition’ Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis,” published in 2021 in LGBT Health, “Association Between Gender-Affirming Surgeries and Mental Health Outcomes,” published in 2021 in JAMA Surgery, “Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation,” published in 2020 in Pediatrics, and “Association Between Recalled Exposure to Gender Identity Conversion Efforts and Suicide Attempts,” published in 2019 in JAMA Psychiatry.

“Association Between Gender-Affirming Hair Removal and Mental Health Outcomes” is available online here.