Who are we?.....
This survey is being carried out by The South East Gender Initiative (SEGI) / Medway Gender and Sexual Diversity Centre (MGSD), who are a constituted Not For Profit Community Group based in Rochester, Medway, Kent. SEGI/MGSD have direct experience of working with Transgender* people, people with gender dysphoria, people who have or are undergoing gender reassignment. SEGI/MGSD promotes awareness of and provides support services for Transgender people in Medway and Kent through counselling, peer support, mentoring and advice.
Permanent removal of facial hair for Transgender people
Methods of hair removal have long been discussed on internet forums and within the Transgender community. In particular, facial hair removal for Male to Female (MtF) transitions, which is a vital part of transition. Recently the NHS has recognised this issue describing it as “essential treatment for MtF patients. Removal of facial hair relates directly to confidence and safety whilst undertaking the RLE (Real Life Experience)” .
As part of the NHS Transgender care pathway for MtF transgender patients they now include facial hair removal. The NHS have recommended the use of electroepilation (electrolysis) and light based treatments (Laser/IPL) as methods to reduce facial hair growth.
The most recent NHS consultation 2017 advises :-
‘The Lead Clinician may refer the individual for a time-
when referring an individual for facial hair reduction:
The two modalities that will be used for hair reduction are laser epilation (Alexandrite, Diode or, for darker skin types, Long Pulse Nd:YAG lasers only) and electrolysis. Electrolysis should only be recommended when laser hair removal is expected to be ineffective or is inappropriate due to the number and colours of hairs present.
Current Intrim care path 2013/14
There are limits to the amount of treatments the NHS will provide. They have based these limits on the available research of these methods of hair removal.
There has been limited research into the effectiveness of light based treatments for the permanent removal of facial hair for transgender people. Electroepilation has been used since 1875 and has therefore proven its ability to permanently prevent hair growth.
Due to the limited information available on the amount of treatment necessary to provide acceptable hair removal results for the transgender community and the limits applied by the NHS to the treatments they will fund, it would be useful for the transgender community to have more information about the effectiveness of the various treatments to allow them to make an informed choice on the treatment they receive.
This survey is intended to gather information with regards to the type and amount of treatment required to obtain satisfactory hair removal for MtF transgender people. The information gathered will be based on the individual’s personal assessment of the treatment they have received.
The survey should take no longer than 5 to 10 minutes to complete. But we would ask that you provide as much detail as possible to help build the evidence on the effectiveness of each type of treatment.
We will not be collecting any details that can identify participants and ensure absolute confidentiality of individual responses to the survey. We will need to ask questions about ethnicity, age and hair colour as this is important in assessing the results of the treatment.
Results of the survey, once completed, will be posted by the MGSD Centre on their website, www.mgsd-
Who should participate in this survey?
We are particularly interested in the treatment of facial hair removal for Non Binary and MtF Transgender people and the results of permanent hair removal from the individual’s perspective.
We will provide respondents access to detailed information about the various methods of hair removal treatment. This will help individuals with their knowledge of the types of treatment available.
It is important, to enable the best advice to be given in the results of the survey that we collect as much information about the treatment you have received. If you are unsure about some of the detail of the treatment please complete as much information as possible.
Currently the NHS interim guidelines provide 1 test session and 8 sessions of hair removal, for laser, IPL and electrolysis. This number of sessions will not provide satisfactory hair removal for the majority of people.
The NHS Specialist Clinical Commissioning Groups are aware of this and proposals to increase the amount of treatments has been included in the NHS England Draft Clinical Commissioning Policy 2014 but todate this has not been approved by NHS England.
The amount of treatment the NHS proposing to provide for facial hair removal in its 2014 draft is as follows:
Light based treatment up to 2 blocks of 8 sessions, reassessed after each block;
Electrolysis, 3 blocks of 80 hours, reassessed after each block.
Or one block of laser for 8 sessions plus one block of electrolysis of 80 hours, reassessed after each block.
The amount of treatment provided by the NHS is to reduce the hair growth to an acceptable appearance, not to necessarily permanently remove all hair. The current NHS consultation for the GIC care pathway dose not define the amount of treatment other that it will be time limited.
The Encyclopedia of Hair Removal argues Light based treatments are not proven to permanently remove hair growth, just permanently reduce some types of hair growth. Electrolysis has been used since 1875 and is proven to permanently remove hair growth, of all types. Typically, permanent facial hair removal for all hair colour and skin types by electrolysis is on average between 300 and 500 hours.
We have no information for the average number of hours for Laser and IPL treatment, due to the limited research of the number of sessions required for permanent hair removal of facial hair for Transgender people. Only evidence for permanent reduction on cisgender people.
It is clear that there are too many variables between client skin and hair types, types of laser and IPL machines and modes of electrolysis to carry out a quantitative study. Therefore, a qualitative study, from Transgender people’s opinions on the outcomes of their hair removal, is appropriate.
To provide feedback on which method of facial hair removal worked best for Transgender people, to enable others to make an informed choice on the treatment options available to them.
The research approach is based on the following main components:
Type of treatment, whether one type or more were used,
The number of sessions undertaken and the time period over which the treatment took place.
We need to gather some information (that will not identify the individual) to allow detailed analysis of the variables from person to person, with regard to the effectiveness of the treatment. For example;
Density of hair growth
Age range at time of treatment
Adverse reactions (e.g. pigment change, scarring / marks)
Effectiveness of treatment
Side effects & discomfort.
* For the purposes of this document, Transgender is an umbrella term that includes all diverse gender identities and expression, including those who don’t conform to common binary ideas of gender.