Gender-affirming hormone therapy reduces depression, anxiety in trans and non-binary youth

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Gender-affirming hormone therapy has been shown to significantly improve the mental health of LGBTQ+ youth. Daisy-Daisy/Getty Images
  • Depression and anxiety often affect transgender and non-binary youth, a group that also experiences higher rates of suicidal ideation and suicide.
  • A major new study confirms that gender-affirming hormone therapy reduces this depression and anxiety.
  • Such therapy also helps individuals align their physical characteristics with their gender identity, helping them avoid psychologically painful gender dysphoria.

Two years after starting gender-affirming hormone treatment, transgender and non-binary youth experienced lasting reductions in depression and anxiety and achieved significantly improved congruence between their gender and physical characteristics, a major new study reports.

The study shows that gender-affirming hormone treatment is valuable for transgender and non-binary adolescents, a group at increased risk for suicidality, depression and anxiety.

The study, from July 2016 to June 2019, included 315 transgender and non-binary young people aged 12 to 20.

They were treated by clinics at Ann and Robert H. Lurie Children’s Hospital in Chicago, Children’s Hospital in Boston, UCSF Benioff Children’s Hospital in the San Francisco area and Children’s Hospital in Los Angeles. The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The study was published in New England Journal of Medicine.

According to a 2022 study by the Trevor Project, about three-quarters of transgender and non-binary youth had experienced anxiety symptoms in the previous year compared to cisgender youth. More than half had depression.

The same study found that approximately half of transgender and non-binary youth had considered suicide and that one in five had attempted suicide.

The new study “further validates the struggles that so many trans youth face on a daily basis, which in part revolve around fitting in, being comfortable in their own skin and being happy in their everyday lives,” said Dr. Zishan Khan , a psychiatrist at Mindpath Health in Texas who was not involved in the study, spoke with Medical News Today.

Dr. Megan Gandy of the West Virginia University School of Social Work, who was also not involved in the study, said the results were consistent with previous research.

“Studies like this contradict the wrong thoughts and perceptions that many people have about such treatment,” added Dr Khan.

When a person’s body and appearance are in conflict with their gender identity, they may experience “gender dysphoria.”

“It is well documented that such dysphoria is associated with higher rates of adverse psychological outcomes such as suicide, depression, anxiety, substance use, emotional dysregulation, and others,” Dr. Gandhi said.

Matching a person’s physical characteristics to their gender identity is called “gender matching.”

The new study found that achieving gender conformity was associated with reduced symptoms of depression and anxiety.

Dr. Luke R. Allen, a psychologist at Student Psychological and Counseling Services at the University of Nevada, Las Vegas, who was not involved in the study, pointed out that Medical News Today that the way we see ourselves — and the way others perceive us — strongly influences our “anxiety, anxiety, and willingness to put ourselves out there, make friends, and pursue other important relationships and activities.”

“The constant fear of being judged and the associated dysphoria can be debilitating for many,” he said.

Dysphoria can be especially challenging for young transgender and non-binary teens facing the hormonal changes that come with puberty.

A young person experiencing body hair, voice changes, breast development, etc. may turn to hormone suppression to prevent permanent, unwanted changes to their body. Gender-affirming hormones, on the other hand, take a more positive approach, changing body characteristics to calculate a person’s gender identity.

“In short, sex-affirming hormones help adolescents resolve their gender dysphoria by promoting the development of secondary sex characteristics that are consistent with their gender identity.”
– Dr. Megan Gandy

When gender dysphoria is resolved, a very different, more pleasant psychological state often emerges: gender euphoriaor “joy of sex,” said Dr. Gandhi.

Dr. Gandhi describes gender euphoria as the idea that there is joy in performing a gender that is consistent with one’s gender identity.

Dr. Gandhi called the new study a “rigorous longitudinal study,” saying “it is a reliable source of scientific information that adds to the growing body of literature that informs this area of ​​practice.”

“Clinicians and scientists may find this a useful study in the midst of a growing political climate that prohibits such medical treatment,” she added.

“There’s so much misinformation out there, and a lot of people just don’t realize that it’s not just a phase that these kids are going through,” Dr. Khan said.

Dr. Khan also noted that “gender-affirming hormone therapy is not necessarily a dangerous and extreme measure that people receive and end up regretting or having long-lasting negative effects in their lives.”

“Time and time again, research has shown positive mental outcomes among transgender and non-binary youth who receive gender-affirming hormones,” said Dr. Allen.

“This is often overlooked, depending on where one gets their news,” he added.

Wherever there are bans on gender-affirming hormone treatments, Dr. Gandhi predicted, research like this study will be impossible, leaving their burden on transgender nonbinary youth unknown. She also fears that the bans threaten to impede the progress of scientific research, affecting everyone.

Rather, she hopes that “clinicians, scientists, and the general public can use this article to make informed decisions about their support for gender-affirming hormone treatment for sex-diverse adolescents.”

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