Mental Health for Transgender Youths Boosts after Hormone Therapy

A new study by New England Journal of Medicine revealed in January 2023 that transgender youths had diminished depressive and anxious symptoms and heightened life content a two-year after hormone therapy.

The study collected 315 transgender youths of ages between 12 and 20 years old to participate in a two-year study. 190 participants were transmasculine, meaning they were assigned female at birth. During the study, all participants received gender-affirming hormone therapy.

How was the study conducted?

Made of physicians and professors from Chicago, Boston, and Los Angeles, the research was aided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The study utilized mental health scales that evaluated depression and anxiety, along with their positive sentiments and life contentment. They also measured appearance congruence, which refers to how transgender individuals are satisfied with their physical appearance that match their gender identity. They all used numeric elements to measure their gratification.

What did the study find?

The study found that hormone therapy was a successful technique for transgender and nonbinary youths. Researchers also noted that appearance congruence was a pivotal point for transgender and nonbinary youths’ mental health.

Disparities in mental and physical health between youths who experienced considerable puberty, related to the sex assigned at birth, and those who did not, also provide additional importance of appearance congruence.

Out of the participants, only 24 youths did not experience substantial gender-incongruent puberty, as they started puberty blockers during beginning stages of puberty, or began hormone therapy with the start of their puberty.

“Those who had not gone through substantial gender-incongruent puberty had higher scores for appearance congruence, positive affect, and life satisfaction and lower scores for depression and anxiety at baseline than youth who had undergone substantial endogenous puberty,” said the study.

Depressive and anxious symptoms also notably diminished with a growth in life content for those pronounced female at birth, but not for those who were pronounced male. This cause may be contributed to a couple of reasons, including physical changes related with estrogen, as it may take two to five years for breast growth to occur.

From this study, researchers theorized that it may take longer for transgender feminine youths to visibly see an impact on their mental health.

Aside from this, testosterone-related puberty symptoms, including deeper voice, may be “more pronounced and observable” compared with an estrogen-related puberty.

They also mentioned that the less life satisfaction could be related to less welcoming responses of transfeminine youths, contrasting with transmasculine youths.

The study continued that it is important for our society to pay attention and understand gender-affirming hormones for transgender and nonbinary youths.

Stanford University of Medicine also revealed in their study from 2022 that gender-affirming hormone therapy in youth causes a happier adulthood.

"This study is particularly relevant now because many state legislatures are introducing bills that would outlaw this kind of care for transgender youth," said Assistant Professor of Child & Adolescent Psychiatry at The University of California San Francisco Jack Turban, MD. "We are adding to the evidence base that shows why gender-affirming care is beneficial from a mental health perspective."

"For some transgender youth, their negative reactions to living in bodies that develop during puberty in ways that don’t match who they know themselves to be can be very damaging," continued Turban.

It is critical that transgender and nonbinary youths receive the care and attention needed to transition comfortably to the lives they desire.

"These results won’t be surprising to providers, but unfortunately a lot of legislators have never met any transgender youth. It’s important for legislators to see the numbers that back up the experiences of transgender youth, their families and the people who work in this field."