FTM Transgender Alopecia?

This is the history of a ftm transgendered man with relatively early androgenetic alopecia.  In spite of his exogenous testosterone, the frontal hairline is preserved.  Most of the alopecia is in parietal and vertex areas.  There is only one PubMed reference that is pertinent, and that is not available full text.(1)

I am a ftm Transman. I started my transition December 2013 and have been on testosterone for about 1 year and  4 months. My resources are limited. I have been a queer female all my life, and as a result of this, economically marginal. I am very serious about my transition to male,. I realize that gender is a fluid spectrum and that I am not yet sure how I will finally present as male.

I have just turned 60 years old, though I look about 20 years younger. I have been very athletic and have always eaten healthfully and have taken care of myself.  Perhaps this is because, subconsciously, I knew that I would have to venture into gender transition at some point, and thus prepared myself.

I am a musician and performer with disabling social anxieties and gender dysphoria. This has severely hampered my ability to perform. My appearance, as an artist, and someone who must go before the public, is a critical issue for me. My biggest problem with transition at present is that I am beginning to bald on the vertex of my head. If this continues unabated, I will wind up with the typical horseshoe pate of male pattern balding.

None of the men in my family, on either side, have this type of balding. Yes they have receding hairlines on my father's side. Thus, I do think my particular balding (and its rapidity) is impacted greatly by the effect of the testosterone. This is a very disturbing and unwanted consequence of testosterone injections. In general, I want to use testosterone for my transition,  but I do not want to be used by testosterone. I don't accept the assessment, “well at your age, men bald.” That does not fly with me. I want to know what my options are proactively.  I have done extensive research on the Internet in regards to balding. I have spent a lot of money trying a number of natural DHT blockers. The problem with this, as with Propecia, is that they work by consequence of increasing female hormones, which is unwanted in ftm transition, and also, block facial hair, a secondary sexual characteristic very important for most trans guys. Secondly, it is not even clear that they work to prevent balding.

Presently, I have started to use Rogaine 5% foam (just this week, so the jury is out).  Currently, I am switching my health care to a clinic that specializes in transgenders individuals. That way, I can also evaluate my balding in terms of testosterone levels. The endocrinologist I see presently is not skilled enough in this regard.

I am extremely interested in any research or techniques that can be offered to me to prevent my balding and turn it around. I am doing all I can on my own at present, but feel there are other options and knowledge out there to which I haven't access.

I am not out to my family yet regarding my transition to male. My appearance, and the quality of my appearance is very personally important to my journey as a man and to my profession as a public performer. I need to continue to be healthy, and to look good.  I want to cure my gender dysphoria so that I can have a life. I do not want to create more obstacles blocking my success in life.

It has been a difficult journey! And, I am willing to do all I can. Unfortunately, I am not in an economic position to do all I could otherwise. I do not want this to be a limitation to my successful transition.  Thus, I am seeking all the support and help I can possibly get in relation to a truly successful transition, unlimited by my financial circumstances. I cannot adequately express my gratitude for any help on this challenging crossing.  Any benefit I receive in these ways are not only for myself, but will be knowledge freely disseminated, for the use of all transmen now and in the future.

Reference:
1) Short- and long-term clinical skin effects of testosterone treatment in trans men. Wierckx K, et al.  J Sex Med. 2014 Jan;11(1):222-9.

Testosterone (T) treatment increased facial and body hair in a time-dependent manner. The prevalence and severity of acne in the majority of trans men peaked 6 months after beginning T therapy. Severe skin problems were absent after short- and long-term T treatment. PubMed.