NEWS Mental Health News Transgender People Gain Mental Health Boost from Gender-Affirming Hair Removal By Sarah Fielding Sarah Fielding LinkedIn Twitter Sarah Fielding is a freelance writer covering a range of topics with a focus on mental health and women's issues. Learn about our editorial process Updated on August 11, 2021 Fact checked Verywell Mind content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Nicholas Blackmer Fact checked by Nicholas Blackmer LinkedIn Nick Blackmer is a librarian, fact-checker, and researcher with more than 20 years’ experience in consumer-oriented health and wellness content. He keeps a DSM-5 on hand just in case. Learn about our editorial process Share Tweet Email Print Getty Images Key Takeaways A new research letter found that gender-affirming hair removal can improve a person's risk of severe psychological distress.Hair removal is one of many procedures individuals can undergo to diminish body dysmorphia.Currently, legislators across the country are working to limit access to gender-affirming care for youth and adults. For transgender and gender-diverse individuals, gender-affirming procedures can be a huge step towards feeling comfortable in their own bodies. These medical undertakings can involve anything from chest reduction to silicone injections. A recent research letter published in JAMA Dermatology looked explicitly at the mental health impact of gender-affirming hair removal. Author Michelle S. Lee and her colleagues used data from the 2015 U.S. Transgender Survey. Researchers had asked 27,715 individuals surveyed in the extensive report about everything from harassment to employment. In the “Transition-Related Health Care” section, researchers inquired about points such as therapy, puberty-blockers, and procedures. The latter, which served as Lee’s source, dove into the different procedures transgender men, women, and non-binary people may consider undergoing. People assigned female on their original birth certificate gravitated towards chest surgery reduction or reconstruction, and hysterectomies. In contrast, gender-affirming hair removal (GAHR), such as electrolysis, was the most common among participants who were assigned male on their original birth certificate. In fact, 41% of people in this group had had GAHR, and 49% wanted it someday. Non-binary participants were less likely to have already had GAHR compared to transgender women, 13% to 48%, but more likely to want it, 54% to 47%. What Does Gender Expression Mean? The Mental Health Benefits of Gender-Affirming Procedures Given those numbers, it's no surprise that Lee reports GAHR has immense mental health benefits. The researchers linked it to a decreased risk of severe psychological distress in the past month and smoking or suicidal intent in the past year. These results can be attributed, at least in part, to gender-affirming care’s role in diminishing gender dysphoria—a condition people may experience when the sex they were assigned at birth is not the same as their gender identity. It can create depression, anxiety, and low self-esteem, among other mental health conditions, says Ernesto Lira de la Rosa, PhD, a psychologist and an advisor for the Hope for Depression Research Foundation. Ernesto Lira de la Rosa, PhD It is imperative that we continue to change the system that often engages in discriminatory practices. — Ernesto Lira de la Rosa, PhD “The various medical procedures, legal steps, such as legally changing name and gender, and treatments like voice therapy and laser hair removal are performed to reduce gender dysphoria,” says KT Hiestand, PhD, a psychologist at Hiestand Psychological Services. “It is common to experience gender dysphoria for transgender women related to the absence of or small breasts, genitalia, the presence of facial or body hair, a deeper voice, masculine facial structure, broad shoulders, lack of hip to waist ratio, large hands and feet, and height.” Hiestand explains that facial hair can be particularly problematic as it is easily visible and may identify the individual as transgender rather than passing as a female. While shaving can help with this, the continual appearance of hair can “continue to cause gender dysphoria until completely removed,” he explains. In the U.S. Transgender Survey, for other procedures, such as voice therapy, vaginoplasty, and facial feminization surgery, almost the same percentage of people—or even more among transgender women—say they wanted these, but much lower numbers who had had these procedures. While hair removal may be more common to undergo due to its less invasive nature and potentially lower cost, it is far from accessible. What Is Gender Dysphoria? Insurance Rarely Covers Hair Removal The research letter reports that only 4.6% of insurance providers cover GAHR. This can be attributed, in part, to these companies declaring hair removal medically unnecessary. “If hair removal procedures are deemed not medically necessary, then insurance companies may deny coverage for these procedures,” says Lira de la Rosa. Not only can this negatively impact someone’s mental health, but it may prevent them from undergoing gender confirmation surgery. As Hiestand explains, some surgeons require people to have genital hair removed first. KT Hiestand, PhD It is common to experience gender dysphoria for transgender women related to the absence of or small breasts, genitalia, the presence of facial or body hair, a deeper voice, masculine facial structure, broad shoulders, lack of hip to waist ratio, large hands and feet, and height. — KT Hiestand, PhD There is no replacement for hair removal, but Lira de la Rosa and Hiestand have a few ideas for managing gender dysphoria if a procedure is not currently available to you: Give yourself or get a professional wax, as it removes hair considerably longer than shavingWear a face mask—as the pandemic continues, this keeps you safe and hides unwanted facial hairLean on understanding loved ones, and people with similar lived experiences for supportIf possible, seek out a transgender-affirming mental health provider—many professionals offer low-cost or sliding scale servicesCheck-in on your mental and physical health regularly GAHR on its own is far from a total solution, but it was associated with lower rates of past-month severe psychological distress, past-year smoking, and past-year suicidal ideation. Lee’s team didn’t find a significant link between GAHR and the risk of alcohol binging in the past month or a suicide attempt in the past year. A push for widely accessible gender-affirming care is necessary as policies continue to threaten and make it unavailable for many people. “It is imperative that we continue to change the system that often engages in discriminatory practices,” says Lira de la Rosa. “There are also many states currently writing legislation that increases barriers for trans individuals. Some states have already passed legislation that outlaws providers from providing gender-affirming treatment to minors. These laws and bills are not based on science and facts, rather on discrimination and transphobia.” A lack of transgender-affirming providers provides another barrier with transgender individuals worried about seeking medical care out of fear of mistreatment or judgment, adds Lira de la Rosa. What This Means For You Gender-affirming care is critical for many people, but it is currently not easily accessible. If you would like to pursue it, and feel comfortable doing so, reach out to loved ones and trusted providers who can provide support as you navigate this challenging, but potentially incredibly worthwhile, path. The Mental Health Impact of Delays to Gender-Affirming Surgery 2 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lee MS, Almazan AN, Nambudiri VE, Keuroghlian AS. Association between gender-affirming hair removal and mental health outcomes. JAMA Dermatol. Published online July 21, 2021. doi:10.1001/jamadermatol.2021.2551 National Center for Transgender Equality. The report of the 2015 U.S. transgender survey. 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