When in my transition should I start hair removal?

After reading my overview on prioritizing transition, you need to figure out where hair removal fits in.

  1. Start as early as possible in your transition. At the very least, try to get your face to where it's cleared in one weekly session prior to going full-time.
  2. Do your face first.
  3. Dealing with facial hair while full-time is one more stress in your life, since it is one of the strongest male gender cues.
  4. Trying to live full-time before starting hair removal can adversely affect your employment, your ability to function in everyday public situations, your personal and intimate relationships, and your mental well-being.
  5. Some people have been denied SRS because they had not completed enough facial hair removal.
  6. Hormones will have little or no effect on existing TS facial hair.
  7. Anti-androgens may help reduce the amount of hair removal you'll need, although they may worsen your pain threshold.
  8. Some electrologists advocate thinning facial hair over several sessions because it's easier on the skin. For those already full-time, clearing is usually the only option. While clearing, it's usually best to clear an area and keep it clear, then using any leftover time in subsequent sessions to extend the cleared area.
  9. Schedule hair removal so you'll be hair-free at optimal times, whether that's workdays or weekends.
  10. Schedule enough time to get done in each session.
  11. Missing sessions /arriving late is the most common and preventable way people waste money on hair removal.

The following section reflects the general opinion that it's best to get it done early. While some TSs have had happy and successful transitions (even SRS) before starting hair removal, I would urge you to save yourself a lot of trouble and get as far as you can with hair removal before going full-time.

I would contend that after coming to terms with your own feelings and deciding how to handle telling those you care about, hair removal should be your next priority. I started electrolysis while I was working through things in a long-term relationship. I found it very satisfying to be doing something toward my goal while redefining my relationship. The sooner you start after you come to terms with your feelings, the better. The great thing about hair removal is that it requires no approval by a physician or psychiatrist, unlike hormones and other medical procedures.

I will discuss the dangers of rushing through transition in detail in another piece, but I will say that almost all those I know who have had the easiest transitions and were able to keep their jobs were the ones who did a gradual transition. As Susan says, "we are compelled to complete transition in some six months in spite of the fact that most (if not all) transitions will, in one way or another, take about five years." Anything sooner can sink those who rush into a "hell that is their own making."

Rosalind writes:

I find it especially annoying to still be busy with electrolysis after every other aspect of the SRS process has long been done (I'm more than three years post-op). Also, facial hair is so masculine a trait that I feel uncomfortable about having a relationship and waking up in company with a five o'clock in the morning shadow ...

Another friend wrote asking about ways to conceal facial hair. She was three years full-time and just starting hair removal. Her comment "Oh, to do it all over again!"

Where you situate hair removal in your transition is up to you, but I will reiterate that almost all TSs agree that the sooner you start, the happier you'll be. Like transition itself, everyone wishes they'd started sooner. You won't have to tolerate a constant reminder of your masculinity, in the mirror, when people look at or touch your face. You'll need less makeup. The only reason to wait is because of financial concerns, or because it will jeopardize an intimate or familial relationship. If you are working through things with a spouse or family member, try to negotiate doing hair removal. Point out that plenty of men have little or no facial hair and that it's something you could complete and still remain male (if that's their or your concern). At any rate, start as soon as you can. You'll thank me later.

Five plans from easiest to hardest

Below are five plans or scenarios which I've ordered from the easiest way to the most difficult.

1. Complete hair removal, then go full-time

I think most people would agree that this is the ideal. Unfortunately, this is rarely possible. For some, this is not an option because of money issues. For some, they cannot stand the thought of waiting that long to go full-time. However, the closer you are to completion when you go full-time means it's one less stressful thing to worry about, and one less masculine trait to contend with.

2. Get face to where it's cleared in a weekly session, then go full-time

This is probably the next easiest option. By the time you are clearing your face in one weekly session, you will look like you have no facial hair. However, anyone who gets very close, sees you in direct sunlight, or touches your face will probably notice hairs as you get closer to your weekly session. Most of the week will be fine, but you will have to deal with concealing hair toward the end of the week. The good thing about this method is that if you time your weekly treatment right, you can either be totally clear over the weekend or for most of the work week, whichever is more important to you.

3. Clear entire face once, then go full-time

If you can wait to go full-time until you have cleared your entire face once, you will at least be a little ahead of the game. You won't have the outline of a beard or pronounced five o'clock shadow, but you will need to conceal that hair, shave, or go in several times a week tobe accepted as female, especially if you have dark hair. Some people think, "Well, I'll just zip down to E2000 or to the laser place, get my face cleared once, then transition." Keep in mind a place like E2000 books months in advance. Even they usually estimate around 6 treatments spaced six weeks apart. In the interim you will have growth to be dealt with.

4. Go full-time, then start hair removal

This is a difficult way to do it. It's not impossible, but it's certainly more stressful. In the event of financial necessity or other reasons that keep you from doing hair removal prior to going full-time, you will need to pay a lot of attention to how you conceal your facial hair, if being accepted as female is your goal. I don't know much about concealing facial hair, since I've never had to deal with it.

Crossdressers typically take hours to ready themselves for public outings. Most of this time is spent in trying, with varying degrees of success, to conceal facial hair. Until hair removal has her facial hair under control, the transsexual woman must undergo the same sort of rigorous preparation for even the most simple errand, or risk being perceived as a man.

Several crossdresser pages have more advice on makeup tips and other ways to conceal facial hair, and as I come across this information, I'll include links to it in later versions.

Diane Wilson adds:

People who are considering transition before having their face cleared should talk to their electrologists. Mine will work with less than 24 hours growth--it slows her down a bit, but she can get her work done. I can do a light shave (still close enough for makeup, although it may show a bit at times) on the morning of electrolysis, and be ready for her to work on in the late afternoon. But this is something that *has* to be worked out with your electrologist! Also, depending on how much makeup you wear, a significant thinning may be sufficient for transition, rather than waiting for clearing.

Dallas Denny has this to add:

The differential in salaries between males and females can make it difficult for the transsexual woman to afford electrolysis in the new role. Discrimination frequently forces talented and qualified individuals out of their pre-transition careers, and makes it difficult for them to find new jobs. The individual whose facial hair or other characteristics makes it difficult to "pass" frequently faces even more discrimination than those who do "pass." Finding themselves unable to get any job whatsoever and unable to afford electrolysis, even talented and well-educated individuals sometimes find themselves in a downward financial spiral which leaves only sex work as an alternative to homelessness.

[Quick aside here: Occasionally I see or hear someone casually state they'll just do sex work if they're fired. While sex work is an option some choose to survive, those who think sex work is a fun, viable alternative to their current jobs are likely living in a fantasy world. You need only to talk to one TS street prostitute to get an idea of just how dangerous and degrading this can be.]

Do whatever you can to have a smooth transition and keep your job. That means getting as presentable as possible before transitioning at work.

5. Complete SRS, then start hair removal

There are people who feel SRS is more important than anything else. Instead of getting hair removal, they save all their money to get SRS as soon as possible. Usually they say they needed to do it because they wanted to feel like a woman, or they had a strong aversion to their genitals.

Generally, it can be very helpful to step back and think about why you feel genital configuration is the defining characteristic of femininity. When you are out in public, no one will know what your genitals look like, but everyone will see your face and use it to identify you as male or female. If you are interested in SRS in order to pursue intimate or sexual relationships in a female role, coarse facial hair would be a major difficulty in most intimate encounters where you hope to be treated as a woman.

People who opt for SRS to the exclusion of everything else may be setting themselves up for a lot of hassle they could avoid otherwise. The Standards of Care guidelines are in place to make certain that people aren't rushing into something they haven't thought through. Some people have showed up on the date of their scheduled surgery with all the papers and been turned away because they hadn't completed hair removal. Pretty harsh, huh? Pretty unfair, right? Well, all reputable plastic surgeons screen out patients they feel have unrealistic expectations, questionable motivations, are poor candidates physically or psychologically, or whose lives they feel will not be improved through surgery. SRS surgeons have standards like weight requirements and HIV screening because they do not want to endanger the patient. Some feel that socialization in your chosen gender, or hair removal, are other requirements they must uphold in the same way. That may be arbitrary, sexist, insulting, and so on and so forth. However, that's the way it is, and this is just fair warning.

Dallas Denny writes:

When one is living full-time, it's difficult to take time off from one's busy life to grow hair long enough for the electrologist to grasp it for treatment. Vanity or circumstances will likely not permit you to have a hairy face in public. Also, it requires one to do a lot of preparation to go out for even the most causal purposes-- to buy a newspaper, or to have breakfast. One must wear lots of beard cover, which looks unusual unless one complements it with lots of eye makeup, blush, and lipstick-- and that just cries for dress-up clothes. It's difficult to achieve the casual style of most post-ops until electrolysis is done. If I had to choose between having a beard and having a penis, I would rather have the penis. It was much easier to get rid of than the facial hair.

Until electrolysis is complete, or nearly so, you are only a day or so away from being bearded. The SRS clinics in Brussels and Montreal are full of people who for all practical purposes look like unshaven men.

I suppose if you've made it full-time through SRS without hair removal, there's not that big a rush to do it. And some have gotten SRS performed without having started hair removal, so it's not out of the question. If you plan to do it this way, I would strongly recommend a consultation with your SRS surgeon before the surgery date to ensure that he or she will perform the procedure despite your facial hair.

This document is designed to make the transition process as easy as possible. Holding off on hair removal makes transition harder than it has to be. That's my advice, but you must come to your own conclusions about what is right for you.

Hormones or not

As mentioned earlier, you do not need to be on hormones for hair removal to work, but the general consensus is that it will help the process.

If you plan to take hormones, you should start around the same time you begin hair removal. The estrogens are not as important as the testosterone blockers as far as hair goes. Testosterone nourishes male facial and body hair. Taking spironolactone or its equivalent will help retard new beard growth (it will not get rid of existing facial hair, however). Spironolactone does reduce body hair, though. Also, keep in mind that one of the side effects of the hormone progesterone can be increased facial and body hair. Talk to your physician about your goals.

My belief is that hormones are overhyped, particularly in their ability to help you be accepted as female. They affect body shape, emotional state, and sexuality. These things can easily be concealed from others. I had been on hormones for 18 months and still worked as a male. In fact, if I wanted, I could have worked as a male indefinitely. Many pin their hopes for being accepted as female on hormones rather than on facial hair removal, which would usually be more helpful in allowing them to blend in as women than a year or two on hormones.

A published study from 2000 corroborates anecdotal evidence that HRT has almost no effect on MTF TS facial hair. In the study, 21 male-to-female transsexuals had their hair evaluated at baseline and after 4, 8, and 12 months after starting HRT. The authors conclude it had some effect on body hair, but not on facial hair: "Though all parameters of hair growth and sebum production declined, facial hair growth continued." [1]

The question remains whether HRT can help increase effectiveness of laser or electrolysis, but based on these findings, the best one can probably hope for is the halting of potential follicles from converting to hair-bearing follicles.

[1] Giltay EJ, Gooren LJ. Effects of sex steroid deprivation/administration on hair growth and skin sebum production in transsexual males and females. Journal of Clinical Endocrinology and Metabolism 2000 Aug;85(8):2913-21

Changes in hair growth patterns are extraordinarily difficult to judge qualitatively and objectively, due to the the many variables that can affect hair growth over a few months. For instance, hair grows at a different rate in the summer, which is one of dozens of reasons your hair growth may seem to change. These variables make it difficult to link observed changes to any one factor, such as HRT.

There is also a very high level of placebo effect when assessing hair loss. The Vaniqa clinical trials found that about one in three control subjects using ordinary cream were judged by physicians to be "improved" or "marked improvement" with their facial hair.

Even more difficult is to make an accurate assessment based on personal observation after a short amount of time. It's the same with any effects of HRT on the skin.

The Giltay study was pretty rigorous (standardized measurements, precise protocol), but they had a pretty small sample size (15), so there's certainly room for more study on this topic. They do state, "In the virtual absence of androgens, hair growth continues but at a slower rate." However, they noted that facial hair was the only place where their measurements did not decline.

There have been a lot of anecdotal reports that HRT slows facial hair growth, but I urge caution in drawing conclusions from these anecdotal observations.

Bottom line: don't count on HRT to affect facial hair, but it certainly can't hurt.

Shaving or not

Some feel that shaving is important in the early stages of treatment (and it doesn't make hair grow in thicker). Electrolysis and laser are most effective on actively growing hairs. Treating your resting hairs is a waste of time and money, it can hurt more (they're closer to the surface) and increases the potential for skin damage.

Try to avoid shaving if at all possible until your redness and swelling have completely subsided. However, it can be good to shave a couple of days before your next appointment. Any hairs that grow out will be in anagen phase, and they will be in more effectively treated. If you can get in often enough to keep up with this new growth, you'll save yourself time in the long run. The longer a hair is allowed to grow after it surfaces through the skin, the stronger the root gets. For me that meant going in 2-3 times a week for a while. This is another reason to try to get done before you go full-time.

If you absolutely must shave immediately after treatment, you may find an electric foil razor such as Braun's less irritating on inflamed skin (a blade razor will probably tear the small 'pimples' which often appear when such coarse hairs are epilated).

If you shave between sessions, you may again find an electric foil razor less irritating. If you use a regular razor, make sure it's sharp, and avoid any shaving creams with menthol and other irritants. Some find a non-spirit-based aftershave like Clinique's Post-Shave Healer helps. You will need 18 to 48 hours' growth for treatment so your electrologist has enough hair to see the angle and to grasp with tweezers.

Having said all that, others feel that if you don't need to shave between sessions, it's best to avoid it. Once you're to the point you don't need to shave between sessions, you can start letting your fine vellus hairs grow. Shaving removes them, and this can make your face look waxy and unnatural. The sooner you can let this fine down cover your cheeks the better (yet another reason to start before full-time).

One of the best feelings about getting electrolysis is looking at dust-covered shaving equipment in a closet. Everyone I know was thrilled that they no longer had to shave, as not having to do so reinforced their private views of themselves as women. Several stated that the morning shaving routine had always reminded them of their maleness.


Two strategies for removing hair

Clearing

This method involves removing every hair from an area during a session. This has the advantage of leaving an area totally hair-free. Some electrologists feel that treating too many hairs near each other is hard on the skin and can cause excessive swelling and drying in the treated area.

Thinning

This is a more gradual process of clearing an area of visible hair over several sessions. It's easier on the skin and allows for quicker recovery. This method may not be ideal if you are already full-time, although it's possible for those full time to do it this way.

Once you've decided on thinning versus clearing, the following methods are usually used. Most people need several sessions to clear their face for the first time. For instance, I had 48 hours of treatment before my face was cleared the first time. The basic strategy is to start in an area and keeping that area clear. Any leftover time is used to expand the cleared area.

The most common way is to work toward the jaw either from the cheeks down, from the throat up, or from both directions. For instance, I had extremely coarse hair just under my jawline, so I started on the throat and worked up to the jawline. I think that this approach is somewhat less noticeable to others, too, since the work is being done in an non-prominent area. Once the area under the jaw was staying cleared, I started down from the cheeks, leaving a thinner and thinner strip of hair along the jaw.

I had that Abe Lincoln/Captain Nemo/Judge Ito look going for a couple of weeks. Eventually the strip of hair was thin enough that we started moving down from the ears toward the chin. This was a tricky part for me-- I had to book several sessions that week, because I wanted to get the strips gone and leave me with a goatee. I think it took three two-hour sessions to get to the goatee look. Once I was there, I didn't have to worry about comments from people at work about my weird facial hair pattern.

A less common method is to do the upper lip first. I don't recommend this, because it's the most difficult part. You're probably better off experimenting with pain management techniques, and tackling the upper lip once you've found an effective strategy.

No matter what, you should do your face before you spend time and money on other areas. The face will be where most people decide your gender, and it's the area hardest to conceal with temporary methods.


Other tips

Day of week for treatment

At first you may be going several times a week for electrolysis. Once you're down to one weekly session, it's good to go the same day and time each week. Setting a regular appointment can be easier to remember and schedule and budget for.

The day you choose depends on your schedule and what you want as your optimal hair free night. I was in a self-imposed hermit mode, spending my weekends doing fun things like writing about hair removal. Because I'm not out at work, I want things not to be noticeable Monday through Friday. A friend of mine likes to do hers on Thursday so she can enjoy Saturday without redness or hair. However, I should point out that I've gone back to work right after sessions and not had anyone say anything. The best thing to do is experiment a bit till you find a good routine, then stick with that as best you can.

If you don't get done during your session

One of the most depressing things to have happen is not getting done before your session is over. This is especially difficult if you're already full-time (another reason to start NOW!). Keep in mind a session is not wall-to-wall hair removal. There are usually a few minutes of prep time up front, as well as cleanup time at the end. This can add up to a significant percentage of your total time, especially if you are only getting a half hour or 15 minutes. The shorter the session, the less actual zapping. Ask your electrologist throughout the session if it looks like you'll be able to get it all. If he or she doesn't think so, have them either get the coarsest ones, skip the area below the jaw or chin, or see if you can get additional time. Ask the next person if you can finish things up. Any cool transsexual who has been in the same position will probably help you out, unless they have their own time concerns or need to get back to work or something. Perhaps you can wait until an opening later. Your best bet is prevention, though. Try not to book just enough time to get done. If you give yourself an extra half an hour, the session won't feel as stressful (see pain management), and there are always hairs you can get somewhere else if you get your face done. Some weeks you will have more growth than others, so if it looks like it's going to be a bad week, call in advance and arrange extra time.

Plan for busy times

Most people are concerned about having their face clear during the work week, whether they're out or not. That means Friday evenings and Saturdays are the busiest times for most electrologists. There are also seasonal and holiday fluctuations. Christmastime and before Valentine's Day can be tricky, and there's usually a surge in the spring as people prepare for shorts and swimsuits. My electrologist also has a huge surge before Labor Day because of a huge local drag pageant. If you need work done around those times, try to book it earlier than usual, or better yet, keep a standing appointment.

Absences/missing sessions

Ask if your electrologist plans to be out of town. If so, try to book time as close as possible to his or her departure and return. Do the same if you plan to be out of town. If you will be gone for an extended period, you may want to find an electrologist where you're going. Do that the same way as you found your main one-- ask other TG women in that area, or get a referral from your electrologist or a professional association.