The study, which was written up in the New England Journal of Medicine, is another contribution to the body of knowledge about how hormone therapy for trans kids affects their mental health.
Having received gender-affirming hormone therapy for two years, transgender teens reported higher levels of life satisfaction and less signs of worry and sadness, according to a recent study.
The study, which was released on Wednesday in the New England Journal of Medicine, examined 315 transgender children and adolescents between the ages of 12 and 20, with an average age of 16, over a two-year period when they were receiving gender-affirming hormone therapy.
A collection of doctors and professors affiliated with educational institutions and children's hospitals in Chicago, Boston, and Los Angeles make up the researchers. The Eunice Kennedy Shriver National Institute of Child Health and Human Development provided funding for the study.
The researchers employed questionnaires to assess levels of depressive and anxious symptoms, joy and sense of well-being, and appearance congruence, or how much a trans person believes their physical characteristics match their gender identification. Participants assigned a number to each of these characteristics.
Researchers discovered that individuals generally reported higher levels of happiness, life satisfaction, and appearance congruence. These increases were linked to improvements in symptoms of anxiety and despair.
The results, according to researchers, support the use of hormone therapy as a successful treatment for young transgender and nonbinary people.
The findings, according to the researchers, also point to the significance of appearance congruence for the wellbeing of young trans and nonbinary people. The disparities in mental and physical health between young people who had experienced significant "gender-incongruent" adolescence, or the puberty linked to their assigned sex at birth, and those who had not, also provided evidence for the significance of appearance congruence for wellbeing.
Only a tiny subgroup (24 people) in the study did not experience gender-incongruent puberty to a significant degree, either because they received puberty blockers early in puberty or because they started gender-affirming hormones later in puberty.
In comparison to youth who had undergone significant endogenous puberty, or the puberty associated with their assigned sex, "those who had not undergone substantial gender-incongruent puberty had higher scores for appearance congruence, positive affect, and life satisfaction and lower scores for depression and anxiety at baseline," the researchers wrote.
Additionally, they found that among trans and nonbinary youth who were born with the gender designation of female but not male, depressive and anxiety symptoms dramatically decreased, and life satisfaction greatly increased. They stated that a number of causes could account for this disparity, including: First, it can take two to five years for some physical changes brought on by estrogen, such breast growth, to have their "maximum effect."
The researchers hypothesized that in order to see a change in the mental health of trans feminine youth, a longer follow-up period may be required.
Second, they claimed that physical modifications brought on by a testosterone-driven puberty, like a deeper voice, may be "more prominent and observable" than those brought on by an estrogen-driven puberty.
Third, the researchers speculated that the variations in anxiety and life satisfaction may be due to transfeminine people's lower level of social acceptance than transmasculine persons.
Transfeminine adolescents may experience more minority stress than transmasculine youth, which is the stress experienced by stigmatized minority groups like LGBTQ individuals, according to research published in the Journal of Adolescent Health in 2021.
The authors of the new study stated that it "would appear crucial, given the documented mental health disparities observed in this population, particularly in the context of increasing politicization of gender-affirming medical care," to understand how gender-affirming hormones affect the mental health and well-being of transgender and nonbinary youth.
State legislatures have debated scores of legislation over the past two years that aim to limit access to gender-affirming medical treatments like hormone therapy, puberty blockers, and surgery for transgender kids.
Restrictions on this type of care have been signed into law by governors in four states: Arkansas, Alabama, Tennessee, and Arizona; however, the laws in Arkansas and Alabama have been suspended awaiting legal action.
At least 16 states have introduced this type of legislation so far this year.
The care is experimental, and kids are too immature to make decisions about their health care that could have long-lasting effects, according to the legislation's proponents.
Medical organizations, like the American Medical Association and the American Academy of Pediatrics, reject any attempts to limit the care that is provided to minors that is gender affirming.
These organizations cite the rising corpus of evidence showing that care has important benefits for the mental and physical health of transgender youth, who have disproportionately high suicide rates.
More than half of transgender and nonbinary kids (53%) had seriously considered suicide in the previous year, according to a national poll conducted by the Trevor Project, a nonprofit organization dedicated to preventing juvenile suicide and providing crisis intervention services. 19% of respondents said they had tried suicide in the previous year.
A half-dozen further studies, in addition to the one published in the New England Journal of Medicine, have demonstrated the benefits of hormone therapy and access to puberty blockers for transgender children's mental health, including a decrease in suicidal ideation.
Early access to gender-affirming medical care has been linked to greater mental health, according to three studies, two of which were published in 2020 and one of which was released in 2021.
And a 2021 study that used data from the Trevor Project and was published in the Journal of Adolescent Health discovered that gender-affirming hormone therapy is significantly associated with a lower incidence of suicide and depression in transgender young people between the ages of 13 and 24.
The New England Journal of Medicine Study's authors acknowledged that there were some restrictions on their investigation. The gender clinics in children's hospitals in Chicago, Boston, and Los Angeles, for instance, were where they sought out participants.
They concluded that the results might not be applicable to young people who lack access to complete gender-affirming care or who self-medicate with gender-affirming hormones.
They also observed that there was considerable variation in the degree of improvement in participants' mental health, with some continuing to report high levels of anxiety and despair and lower levels of happiness and life satisfaction.
Six people withdrew from the study, and two participants committed suicide, according to the researchers. They also highlighted that the analysis incorporated the data acquired prior to their passing or leaving the study.
Other elements, such parental support, that are known to influence transgender youth's psychosocial functioning were not examined in the study. The lack of a comparison group in the study, according to the researchers, hinders their capacity to prove causality. To determine whether the gains are maintained over a longer period of time, they intend to research those additional components and keep track of the cohort.
If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the network, previously known as the National Suicide Prevention Lifeline, at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources
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