Laser hair removal in gender-affirming care: applications and barriers in transgender and gender-diverse populations.

Abstract

Purpose: Laser hair removal (LHR) plays a significant role in gender-affirming care of transgender and gender-diverse patients. This systematic review aims to synthesize and critically evaluate the current literature on the utility of LHR in these populations, while addressing limitations and barriers.

Methods: A search of the PubMed, EMBASE and Web of Science databases was conducted according to PRISMA guidelines. Studies were included if they directly discussed the topic, were of the appropriate study type and were published in peer-reviewed journals in English. Our search yielded 10 studies that met our inclusion criteria. From the included studies, data was individually extracted and scrutinized, following formal quality assessment.

Results: In transwomen receiving vaginoplasty, LHR has been established as an effective method for preprocedural hair removal, with preliminary studies comparing its efficacy to electrolysis. In transmen undergoing phalloplasty, early findings suggest LHR as satisfactory in decreasing hair density in the neourethra. While limited, available evidence indicates that adequate hair removal may contribute to improved psychosocial outcomes. Efficacy of LHR prior to gender-affirming surgery may differ based on treatment protocols and patient demographics, potentially contributing to the variability in results included within our review. Moreover, cost, lack of provider expertise, and overall fear and anxiety remain recognized barriers to care for LHR and electrolysis.

Conclusion: These results highlight the significant role of LHR in the gender-affirming care of transgender individuals, by aiding in surgical readiness and facilitating gender congruence. Our review is subject to several limitations including limited sample sizes, underscoring the need for future research.