I'm 35 and have been on HRT for almost six months now. I started to apply topical minoxidil shortly after coming out in February of this year, but I stopped recently and switched to oral minoxidil. I've had a big forehead and an M shaped hairline for as long as I can remember. I think I've had a bit of temple thinning in the last decade, but it's kind of hard to tell. 

The first four photos were taken just today. As far as I know, I don't have any bald spots on my scalp, but I do have two cowlicks that I've mistaken for thinning/balding in the past. The fifth photo is a comparison between January 2026 and a week ago to demonstrate how I currently style my hair. The sixth photo is from 2015, and the seventh is from 2016. 

I already know I'd like FFS at some point in the future to address certain issues I have with my face, and I've just been assuming that a hairline reduction will be a necessary part of that when the time comes. I do think I have some vellus hairs along my hairline that can maybe be salvaged, at the very least. 

I know it could be worse, but I'm very self-conscious about the length of my forehead and the shape of my hairline. I'd like to have the freedom to style my hair without having to worry about concealing the hairline/forehead coverage. 

For anyone that's been on HRT and Minoxidil/etc. longer than I have that started from a similar-ish point, how much restoration have you seen without surgical intervention? Is it naive to expect a meaningful difference in coverage or a hairline reduction/reshaping if I've been stuck with this hairline for as long as I can remember?

Is a hairline reduction necessary?