Improved mental health reported with gender-affirming hair removal

Gender-affirming hair removal is associated with improved mental health and decreased psychological distress, according to a research letter published in JAMA Dermatology.

“Gender-affirming medical care is essential for addressing the mental health burdens of transgender and gender-diverse (TGD) populations,” Michelle S. Lee, BA, of Harvard Medical School and the department of dermatology at Brigham and Women’s Hospital, and colleagues wrote. “Gender-affirming hair removal (GAHR) procedures, including electrolysis and laser hair removal, are desired by nearly 90% of TGD people. However, such services are covered by only 4.6% of insurance plans, possibly owing in part to limited evidence of their mental health benefits.”

This secondary analysis used data from the cross-sectional, nonprobability 2015 U.S. Transgender Survey, which included 27,715 TGD adults.

Participants who were assigned male sex at birth were asked if they had or wanted gender-affirming hair removal or electrolysis. Those who answered they had the procedure were included in the study group, while those who reported a desire for GAHR but had not had it were classified as the control group.

They were then asked about five mental health outcomes: severe psychological distress and binge alcohol use in the past month and tobacco smoking, suicidal ideation and suicide attempts in the past year.

Of 11,857 respondents assigned male at birth, 4,927 (41.6%) had received hair removal, while 5,652 (47.7%) desired hair removal but had not yet undergone the procedure.

The odds of past-month severe psychological distress were lower in the study group (adjusted odds ratio = 0.62; 95% CI, 0.52-0.73; P < .001). In addition, the odds were lower for past-year smoking (aOR = 0.76; 95% CI, 0.65-0.89; P < .001) and past-year suicidal ideation (aOR = 0.72; 95% CI, 0.62-0.84; P < .001).

Past-month binge alcohol use and past-year suicide attempts did not show a significant association with GAHR.

“These findings reinforce the only existing empirical investigation, to our knowledge, on this subject — a small-scale study demonstrating that GAHR is associated with improved mental health and quality of life,” the authors wrote.