The largest study of its kind ever conducted in the United States highlights the impact of gender-affirming hormone therapy on the psychosocial functioning and mental health of transgender and nonbinary youth.
A multicenter study of more than 300 transgender and nonbinary youth funded by the National Institutes of Health (NIH) found that receiving sex-affirming hormone therapy improved appearance, , and improved life satisfaction, further pointing to an association between increased appearance matching and improved life satisfaction, and improved depression and anxiety symptoms.
“Our results provide strong scientific evidence that gender-affirming care is important for the psychological well-being of patients,” said Lurie, principal investigator and co-author of the Children’s Gender and Sex Development Program. “We must make this treatment available to young people with gender dysphoria,” the director, Northwestern University Feinberg School of Medicine, said in a statement.
The current study, named the Trans Youth Care–United States (TYCUS) study, sought to assess the physical and psychosocial outcomes associated with receiving gender-affirming hormone therapy in transgender and binary youth in the United States. It was designed as a prospective observational study. Participants included in this study were between the ages of 12 and 20 years old and from July 2016 to June 2019 at Ann and Robert H. Lurie Children’s Hospital in Chicago, UCSF Benioff Children’s Hospital, Boston Children’s Hospital, and Los Angeles Children’s Hospital. Recruited from a gender clinic. .
According to the study protocol, study visits were performed at baseline and again at 6, 12, 18, and 24 months after starting treatment. During these visits, participants completed the Transgender Concordant Scale, the Beck Depression Inventory-II, the Revised Child’s Manifest Anxiety Scale, and the positive impact and life satisfaction measures from the NIH Toolbox Emotional Battery. bottom. The researchers noted that as part of TYCUS he created two different cohorts. One cohort is evaluating the effect of sex-affirming hormone therapy and the other cohort is evaluating the effect of gonadotropin-releasing hormone agonist therapy. Current research only reports on the effects of sex-affirming hormone therapy.
For analytic purposes, latent growth curve modeling was used to estimate 2-year trajectories of appearance match, depression, anxiety, positive impact, and life satisfaction. The investigators noted that additional analyzes are planned to explore how initial levels and rates of change in appearance match correlate with each psychosocial outcome of interest.
A total of 315 participants who underwent up to 5 follow-up visits were identified for inclusion in the study. A total of 6114 observations were recorded from this cohort during the study period. This cohort had a mean age of 16±1.9 years, 60.3% were transmasculine, 64.8% were designated female at birth, and 58.7% were non-Latino or non-Latino Caucasian. The researchers noted that two participants committed suicide during the study and six withdrew before completion, although data collected prior to death or discontinuation of the study were included in the analysis.
Appearance match scores increased during the follow-up period (0.48 point increase per year on a 5-point scale). [95% CI, 0.42 to 0.54]; standardized β=1.47) and positive impact T-score (annual increase on 100 point scale, 0.80 points) [95% CI, 0.08 to 1.54]; β=.19) and life satisfaction (up 2.32 points per year on a 100-point scale) [95% CI, 1.64 to 3.00]; β=.52).In addition, investigators found a reduction in depression scores (annual change on a 63-point scale, -1.27 points; 95% CI, -1.98 to -0.57; standardized β = -.29) and anxiety T scores ( 100 point scale, -1.46 points [95% CI, -2.13 to -0.79]; β=-.35).
Further analysis showed that increased appearance matching was associated with a concomitant increase in positive affect and life satisfaction, and a concomitant decrease in depression and anxiety symptoms. During the study period, the most common adverse event was suicidal ideation, reported by 11 (3.5%).
“Our results provide robust scientific evidence that improved appearance consistency with hormone therapy is strongly associated with improved mental health in transgender and nonbinary youth,” said the study’s lead author. Diane Cheng, Ph.D., Ph.D. An associate professor at the Robert H. Lurie Children’s Hospital in Chicago and Northwestern University Feinberg School of Medicine said in the aforementioned statement. “This is important given that transgender youth experience depression and anxiety and are at higher risk of suicide than cisgender youth.”
This study, “Psychosocial functioning of transgender adolescents after 2 years of hormone administration,” New England Journal of Medicine.