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Permanent Hair Removal for Transgender Patients in SF

Hair removal is a critical medical intervention for many trans, non-binary, and gender expansive people. Hair removal is used to remove the amount of hair on targeted parts of the body, commonly including the face, torso, arms, and legs. It is often used to prepare for bottom surgery and/or to reduce hair that causes gender dysphoria or gender incongruence related to hair growth.

Hair Removal at The Gender Confirmation Center

The Gender Confirmation Center exclusively offers laser hair removal (LHR) in our office but can provide outsider referrals for electrolysis hair removal (EHR) treatments. Although we’re unable to offer electrolysis, the information below may help inform individuals on other available treatment options.

We typically recommend laser as the initial treatment option, followed by electrolysis for any remaining hair removal after satisfactory results have been achieved with laser treatment. Laser is effective at quickly reducing the amount of hairs growing in an area and causes the hairs to grow back finer and thinner.  Electrolysis treats hairs one follicle at a time, so progress is slow and best suited for smaller areas.  Laser hair removal is FDA-approved for “permanent hair reduction” while electrolysis is FDA-approved for “permanent hair removal”.  Electrolysis is the only hair removal method that has been certified by the FDA as providing “permanent hair removal”. 

The Gender Confirmation Center specializes in facial hair removal and surgical site preparation for transfeminine and transmasculine bottom surgery procedures. Due to limited staff, we are unable to perform whole body hair removal but can provide referrals to other providers that can perform this service.

Laser Hair Removal

Our office uses the Cynosure Elite+ machine for laser hair removal, performed by a Registered Nurse. This modern technology is highly effective and commonly used by popular chains in California. The machine offers the advantage of dual wavelengths, 755nm and 1064nm, which makes it suitable for treating all skin tones. The 755nm wavelength is effective for skin tones with less melanin, while the 1064nm wavelength is effective for skin tones with more melanin. While the laser is effective at reducing black and brown hairs, it is not effective at reducing blonde, red, or white hairs.

Laser treatments typically take about 30 minutes and are most effective when scheduled at intervals of 4-6 weeks for facial and genital areas, and 6-8 weeks for other body parts (such as arms or thighs, as determined by your surgeon).  A minimum of 6 treatments is typically required to start seeing significant results with laser hair removal. However, it is common for patients to undergo 10 or more treatments to achieve very good results, which typically involves a 70% or greater reduction in hair growth.  During your consultation, our nurse or licensed provider will provide you with detailed instructions on pre and post-care, as well as review any medications or medical conditions that may delay or prevent treatment.

Electrolysis Hair Removal

Electrolysis is highly efficient in removing stubborn hairs, including upper lip, chin, and genital hairs, and can treat ALL hair colors and skin tones. The three modes available for electrolysis hair removal are Galvanic, Thermolysis, and Blend (of the two). Thermolysis delivers an electric pulse of energy to the hair in just a fraction of a second, whereas blend and galvanic methods take 6-12 seconds per hair.  Since each hair follicle is treated individually, appointments are scheduled based on the amount of hair to be treated and can range from 30 minutes to 2 hours for bottom surgery preparation. Appointments are typically scheduled once per week. The effectiveness of electrolysis for permanent hair removal depends on the stage of hair growth. The treatment is most effective on hairs in the early stage of growth. Since hairs are in different stages of growth, it may take multiple treatments to permanently remove each hair.  As a result of the gradual and targeted nature of electrolysis, the process can be slow even with weekly appointments. Depending on the specific area being treated, it may take over a year to achieve permanent hair removal. In addition, it’s important to discuss any medications or medical conditions that may affect or prevent treatment during your consultation with a licensed provider.

Considerations for Discomfort, Risks, and Benefits During Treatment

During the hair removal procedure, patients may experience discomfort or pain. Our provider can discuss different options to alleviate this discomfort, such as over-the-counter pain medication or topical lidocaine numbing cream. These pain relief methods are optional, and some patients choose not to use any. 

Although both laser hair removal and electrolysis are generally safe and effective, they carry potential risks such as hyperpigmentation, hypopigmentation, scabbing, and scarring. These risks will be thoroughly discussed during your consultation.

The effectiveness of laser and electrolysis hair removal treatments may vary based on individual factors, including the number of treatments and the hair follicles response to each treatment. Licensed providers can offer treatment recommendations for surgery preparation, but the final determination of adequate site preparation should be made by your surgeon.

Cost and Insurance

The Gender Confirmation Center works with a limited number of insurance companies that cover gender affirming hair removal.  In the event that we do not have a direct affiliation with your health insurance provider, we kindly request payment upfront. After the treatment, our team will provide you with a “superbill” that can be submitted to your insurance company to request reimbursement. Medical insurance companies typically require a referral letter from a primary care provider (PCP) stating that the hair removal is medically necessary for gender-affirming reasons (i.e., surgical preparation). Unfortunately, we’re unable to guarantee that your insurance company will reimburse you for the cost. For laser hair removal, the cost varies depending on the number of treatments required and the area of the body being treated.  For electroysis, the cost is determined by the duration of each session, which is typically performed in 30-minute increments. Costs and insurance options will be reviewed in detail during your consultation.

Summary Comparison of Hair Removal Methods