Unfortunately, unwanted hair is extremely distressing and a very sensitive subject for transsexuals, and permanent hair removal is an absolute necessity, but is also life-changing. Happily, much of this excess hair around the body is significantly reduced upon hormone therapy, however there are two main problem areas which will always remain, and this will take many hours of work over a long period of time to remove. Initially the beard is the most important area to tackle, but also important will probably be genital hair removal prior to Gender Reassignment Surgery, and also possibly needing attention is body hair removal, although many find the need for this to be greatly reduced or even completely unnecessary after a few months of hormone therapy.
Probably the most significant area of hair removal for the TG/TS client is the beard. Significant because it has such a major time and cost implication, but also, and probably most importantly, the huge impact it can have on the quality of living. It can quite literally be life-changing. Complete removal of the beard requires many hours of treatment over many months. Typically 100-150 hours of treatment will be required. This can be spread over wide-ranging periods depending on budget, with weekly treatment times of typically between 1 and 4 hours. Weekly appointments are not necessarily vital and if they are inconvenient, fortnightly will be just as effective, however the majority of clients tend to opt for one hour weekly appointments. It is usually better, if possible, and it isn’t always, to start beard removal as early on in transition as possible. There are a couple of reasons for this, not the least of which being that it will be necessary to have not shaved usually for at least 36 hours prior to each appointment, meaning that there will be an embarrassing stubble during this period. If the worst of this can be done prior to actually starting the real life test, the embarrassment will hopefully be minimised. Also, this initial stage of transition can be the most traumatic anyway, with you going through several different emotions of excitement, worry and nerves, and just about every other emotion, with everyone else around you having to get used to the ‘new’ you. What you want is minimal distress for you and confusion for others from unsightly stubble at this emotional and difficult time! If you start early enough, hopefully, if you do find you have to pay for your own genital electrolysis, the financial implications of having to pay for both, won’t affect treatment, or ultimately delay surgery.
Male to Female Patients - Genital Hair Removal
Female to Male Patients
For a female to male patient seeking a phalloplasty, a skin graft will be required. In order to harvest the skin graft, electrolysis will be required on the donor site to carefully remove all hair prior to the operation. This donor site is likely to be on the forearm, although other areas could be required depending on the operation required.
Although Hormone therapy is very effective at considerably reducing body hair to the extent that it no longer becomes a problem, there are often some areas for which some electrolysis can be of benefit in enabling a Trans woman to live with confidence and not having to worry about superfluous hair. Typical areas that might need some treatment would be around the nipples and lower down on the tummy. These areas can usually be treated quickly and easily with minimum time and cost implications.
Assuming your intention is to proceed with Gender reassignment Surgery, genital hair removal is the next to be considered. Hopefully, all things being well, you will be referred to see Iffy Middleton, the Clinical Nurse Specialist, approximately 12 months into your real life test with a view to determine if electrolysis will be required prior to surgery. There are two surgical procedures performed, the Penile Inversion technique, and the Peno Scrotal Flap. Hair removal may be required prior to surgery to avoid hair growing in the neo-vagina, which cannot be removed post-operatively and is likely to cause problems for the patient later on with inflammation and infection. Hair is also undesirable under the clitoral hood, but can be treated later if necessary.
If the Penile Inversion is to be performed you may benefit from a small area around the base of the penis being cleared of hair, as well as the shaft of the penis being cleared if necessary. If a Peno Scrotal Flap is to be performed, the shaft of the penis, as well as the small area at the base of the penis, the area that will be used to form the clitoral hood, and also a section of the scrotum right back to the perineum will need to be cleared. This will definitely be required if a patient has been circumcised. If it decided that hair removal will be required prior to surgery, the electrolysis should be covered by the NHS. This is definitely the case if you live within a London Primary Care Trust (PCT) area, however if not you can still have your treatment paid for by the NHS, but currently you will have to be referred by your GP to a dermatologist who will then hopefully recommend treatment to the PCT. I can confirm that I have had recent clients with their treatments paid for by Surrey and Berkshire PCT’s.
For effective removal of the hair you will need to allow a minimum of 9 months prior to surgery. Actual treatment times may vary considerably within that 9 month period, depending on the density and strength of the hair growth. In all cases, electrolysis must be completed at least 2 weeks before surgery.