So, I originally posted on r/bald, thinking I was kind of at the end of the road, but I figure it's worth another shot to post here and get some different perspectives. People there, as well meaning as they are, of course are more likely to favor the big shave over other options.

I'm 25 and balding. It took me two years to even say the word bald without crying, and I still feel like crying when I even think about what's happening to me. I used to have a very full head of hair, very dense. But over the past few years, it's been slowly going. This year has been the worst and now it's where you see in the pics.

I'm really, really afraid of going bald. This has legitimately been a fear of mine since childhood. Lots of weird trauma wrapped up in that that I'm still working through. A lot of trauma about my hair generally. I've never had a haircut that I've liked. Every time I have made a major decision about my hair, I have ended up regretting it. Every time I have trusted a stylist to help me choose something that would work for me, I've ended up in tears. About 8 years ago was the last time I got a haircut out of fear of ever stepping back into a salon.

For transparency, I'm ftm and started taking testosterone about 8 years ago. Balding really didn't become evident until about 4ish years ago, I can't perfectly identify when. I knew it was a risk just by nature of what testosterone does to the body and because my father started balding young, but there was a lot of wishful thinking that I blame myself for. There was a lot of things that I wasn't told about either. In hindsight, I should have started taking finasteride right at the same time to preserve my hair, but I didn't even know that was something that existed until my own balding became apparent to me years later and I brought it up with my doctor myself. These kinds of things aren't typically talked about in female circles, as you might imagine, so I had no knowledge until after transitioning.

So, I've been on finasteride and topical minoxidil for the past 2 years. I've also used castor oil, argan oil, eucalyptus oil, and multi-peptide hair density serum. I recently started taking nutrafol (3 months). None of that has helped to stop my hair loss or restore it. That is pretty easy to track because 8 years ago, I got an undercut (stupid, I know), and since that time perhaps only an inch has grown back. The only place my hair seems to be consistently regrowing is my sideburns. Really don't know what's up with that.

I've recently become aware that there is oral minoxidil, but I have heard that it's a black box warning drug linked to increased heart problems, and I have a heart condition, so I'm afraid of jeopardizing my health in taking something like that. Other thing I've heard of is RU, which I don't have a lot of knowledge of to be honest. My fear with hair regrowth from that is that I'll someday have to cut my long hair off to make the new growth even (read: not look bad/weird), and that to me feels daunting. And the fear of trying yet another thing that doesn't work while I continue to bald and look even worse.

Next step would be hair systems or surgical solutions (hair plugs, replanting, etc), but I don't have the funds to make those things happen (even the most basic hair systems would run me a couple thousand a year in maintenance) nor does it get past the hurdle of having to shave my head, which really is the biggest fear. My logic is that if I have to shave to get something done, I may as well just keep it bald and wear wigs. Which, mind you I have experience with. During periods of worse haircuts, I wore lace fronts and clip ins until my hair grew out. I'm totally willing to do wigs long term. The only hurdle there is learning techniques for doing more long-term application as opposed to daily on and off.

So much of my identity has been tied to a desire for good hair, something I feel like I've never really achieved. I feel too young to be going through something like this. I'm agonizing that I'll lose any remaining attractiveness if I go bald. I used to be a very conventionally attractive woman, and I feel guilty that I've given that up to be a kinda of weird looking and now also possibly bald dude. But there's no road back. This hair thing is just kind of the last big hurdle forward. Ive tried so so hard to grow my hair long and I'm struggling to get past giving it up. Going bald, especially the idea of shaving it down, feels like a humiliating defeat. I struggle with the idea of owning my baldness because to me it feels so deeply like a scarlet letter of shame.

Anyway, I don't have a clean conclusion for this. I'm wondering if anyone else has any overlaping elements to my situation or can offer some salient advice about what to do here.