Transgender adults experiencing reduced depression levels due to gender-affirming hormone treatment, study confirms
Freshening Up on Gender-Affirming Hormone Therapy: Mental Health Boost for Transgender Patients
Gender-affirming hormone therapy (GAHT) could bring about not just physical changes, but also a positive impact on patients' mental health, as per recent findings.
"Transgender, nonbinary, and gender diverse patients prescribed hormones showed an astonishing 15% lower risk of moderate-to-severe depressive symptoms over 4 years of follow-up compared to those not receiving hormone treatment," said Dr. Sari Reisner, study lead author and associate professor at the University of Michigan School of Public Health.
The study-- published last week in the journal JAMA Network Open-- analyzed data from 3,592 patients at two community health centers in Boston and New York City. Researchers looked at both the participants' hormone therapy prescriptions and their Patient Health Questionnaire scores, which gauge their depression levels.
Those receiving GAHT over four years had significantly lower risks of developing moderate-to-severe depression symptoms, according to the study.
"When gender diverse patients access safe and effective hormone medication and care, they're more likely to experience healthier mental health outcomes over time," commented Dr. Michelle Forcier, medical director for FOLX Health, a mental health and wellness telehealth platform catering to the LGBTQIA+ community, and a clinician at TransHealth, a non-profit clinic in Massachusetts.
"Providing gender hormones not only offers physical benefits but, yet again, we demonstrate that they improve mental health outcomes as well," Forcier added, emphasizing that she was not involved in the research.
This study comes amidst President Trump's executive orders intended to limit gender-affirming medical care for transgender youth, disallow trans women from competing in most women's sports, and discharge transgender military members and recruits.
Depression Rates Higher in Transgender Population
Depression rates in individuals belonging to the transgender, nonbinary, or gender diverse communities are alarming and call for prompt attention, according to Reisner. "Trans people face mental health disparities with heightened rates of depression and suicidality compared to their cisgender (non-transgender) counterparts," he noted.
"Trans individuals are dying. The urgency couldn't be greater - now more than ever - to support us, care for us, and ensure we have the life-saving care that we require to thrive," Reisner highlighted.
Around 8.3% of American adults have experienced at least one major depressive episode, according to the National Institute of Mental Health. However, a 2023 study found that approximately 33% of transgender people exhibit signs of depression.
The elevated unfavorable health outcomes -- including anxiety, depression, and suicidality -- in transgender individuals can be attributed to a multitude of factors, as indicated by Dr. Michelle Forcier. "Minority stress and discrimination contribute significantly to higher risks for economic disadvantage, housing and homeless issues, substance use/abuse, and HIV," she explained.
In addition, systemic issues-- such as stigma, attacks on civil rights, and restrictions on health care access-- intensify mental health challenges, reiterated Dr. Melina Wald, a clinical psychologist at her private practice Bespoke Health in Connecticut and New York State. Wald co-founded Columbia University Medical Center's Gender and Sexuality Program.
Accessible to Everyone
A key strength of the study lies in the diverse age groups, races, ethnicities, and socioeconomic statuses represented, Forcier pointed out. "This sample mirrors the diversity of the US population more accurately than previous research focusing on specialty clinics," she said.
Furthermore, the study suggests that effective gender-affirming hormone care could be feasible in diverse community settings, Forcier added. "That these patients benefited from care in various primary care clinics suggests that effective gender-affirming hormone care is no longer confined to urban, academic, specialty clinics," she noted.
Overall, the scientific literature confirms that GAHT is safe and effective. "We've seen over 25 years of consistent, insistent evidence that gender-affirming approaches to care for transgender people deliver a variety of health benefits, with no studies suggesting that withholding medically indicated, safe, effective care provides any advantage at all," Forcier explained.
However, attention to mental health care for transgender individuals shouldn't cease at GAHT, Wald emphasized. "While gender-affirming hormone therapy is vital in improving mental health, the importance of access to evidence-based psychiatric interventions for the treatment of depression should not be overlooked," she said, advocating a comprehensive approach to mental health care for the transgender community.
- The study published in JAMA Network Open in 2023 found that transgender, nonbinary, and gender diverse patients receiving gender-affirming hormone therapy (GAHT) for four years had significantly lower risks of developing moderate-to-severe depression symptoms, compared to those not receiving hormone treatment.
- In the transgender, nonbinary, or gender diverse communities, depression rates are alarmingly higher, with approximately 33% exhibiting signs of depression, as compared to 8.3% of American adults, according to a 2023 study.
- Dr. Michelle Forcier, medical director for FOLX Health, noted that systemic issues such as stigma, attacks on civil rights, and restrictions on health care access intensify mental health challenges faced by the transgender population, contributing significantly to higher risks for economic disadvantage, housing and homeless issues, substance use/abuse, and HIV.
