Hormone Therapy, Mental Health, and Quality of Life Among Transgender People: A Systematic Review

Abstract We sought to systematically review the effect of gender-affirming hormone therapy on psychological outcomes among transgender people. We searched PubMed, Embase, and PsycINFO through June 10, 2020 for studies evaluating quality of life (QOL), depression, anxiety, and death by suicide in the...

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Published inJournal of the Endocrine Society Vol. 5; no. 4; p. bvab011
Main Authors Baker, Kellan E, Wilson, Lisa M, Sharma, Ritu, Dukhanin, Vadim, McArthur, Kristen, Robinson, Karen A
Format Journal Article
LanguageEnglish
Published US Oxford University Press 01.04.2021
Subjects
Anxiety
Case studies
Conjugated estrogens
Gender identity
Mental health
Meta-Analysis
Psychological research
Transgender people
Transgender
hormone therapy
sex hormones
systematic review
mental health
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Summary:Abstract We sought to systematically review the effect of gender-affirming hormone therapy on psychological outcomes among transgender people. We searched PubMed, Embase, and PsycINFO through June 10, 2020 for studies evaluating quality of life (QOL), depression, anxiety, and death by suicide in the context of gender-affirming hormone therapy among transgender people of any age. We excluded case studies and studies reporting on less than 3 months of follow-up. We included 20 studies reported in 22 publications. Fifteen were trials or prospective cohorts, one was a retrospective cohort, and 4 were cross-sectional. Seven assessed QOL, 12 assessed depression, 8 assessed anxiety, and 1 assessed death by suicide. Three studies included trans-feminine people only; 7 included trans-masculine people only, and 10 included both. Three studies focused on adolescents. Hormone therapy was associated with increased QOL, decreased depression, and decreased anxiety. Associations were similar across gender identity and age. Certainty in this conclusion is limited by high risk of bias in study designs, small sample sizes, and confounding with other interventions. We could not draw any conclusions about death by suicide. Future studies should investigate the psychological benefits of hormone therapy among larger and more diverse groups of transgender people using study designs that more effectively isolate the effects of hormone treatment.
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ISSN:2472-1972
2472-1972
DOI:10.1210/jendso/bvab011