For transgender and gender-diverse (TGD) adults assigned male at birth, gender-affirming hair removal (GAHR) is associated with improved mental health, according to a research letter published online July 21 in JAMA Dermatology.

Michelle S. Lee, from Harvard Medical School in Boston, and colleagues conducted a secondary analysis of the 2015 U.S. Transgender Survey of 27,715 U.S. TGD adults. The respondents assigned male sex at birth were asked whether they had or wanted any of the health care listed for gender transition, including hair removal/electrolysis. Respondents who reported undergoing GAHR were included as the exposure group; controls reported a desire for but had not had GAHR. Five binary mental health outcomes were examined among participants.

Overall, 42.8 percent of respondents reported being assigned male sex at birth. Of these, 41.6 and 47.7 percent had undergone hair removal and desired, but had not yet received, hair removal, respectively. The researchers found that GAHR correlated with reduced odds of past-month severe psychological distress, past-year smoking, and past-year suicidal intent after adjustment for sociodemographic factors and other gender-affirming care (adjusted odds ratios, 0.62, 0.76, and 0.72, respectively). No significant correlation was seen between GAHR and past-month binge alcohol use or past-year suicide attempts.

"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 write.

One author disclosed future royalties from a forthcoming textbook.

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