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 in | Journal of the Endocrine Society Vol. 5; no. 4; p. bvab011 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
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Oxford University Press
01.04.2021
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| Subjects | |
| Online Access | Get full text |
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| Abstract | 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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| AbstractList | 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. 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. 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. Key Words: Transgender, hormone therapy, sex hormones, mental health, systematic review |
| Audience | Academic |
| Author | McArthur, Kristen Robinson, Karen A Baker, Kellan E Sharma, Ritu Dukhanin, Vadim Wilson, Lisa M |
| AuthorAffiliation | 3 Johns Hopkins Evidence-Based Practice Center , Baltimore, MD, USA 1 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, USA 2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, MD, USA |
| AuthorAffiliation_xml | – name: 3 Johns Hopkins Evidence-Based Practice Center , Baltimore, MD, USA – name: 1 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD, USA – name: 2 Department of Medicine, Johns Hopkins University School of Medicine , Baltimore, MD, USA |
| Author_xml | – sequence: 1 givenname: Kellan E orcidid: 0000-0002-9716-7936 surname: Baker fullname: Baker, Kellan E email: kbaker39@jhu.edu – sequence: 2 givenname: Lisa M surname: Wilson fullname: Wilson, Lisa M – sequence: 3 givenname: Ritu surname: Sharma fullname: Sharma, Ritu – sequence: 4 givenname: Vadim surname: Dukhanin fullname: Dukhanin, Vadim – sequence: 5 givenname: Kristen surname: McArthur fullname: McArthur, Kristen – sequence: 6 givenname: Karen A surname: Robinson fullname: Robinson, Karen A |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33644622$$D View this record in MEDLINE/PubMed |
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| Copyright | The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. COPYRIGHT 2021 Oxford University Press |
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| Keywords | Transgender hormone therapy sex hormones systematic review mental health |
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We sought to systematically review the effect of gender-affirming hormone therapy on psychological outcomes among transgender people. We searched... We sought to systematically review the effect of gender-affirming hormone therapy on psychological outcomes among transgender people. We searched PubMed,... |
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| SubjectTerms | Anxiety Case studies Conjugated estrogens Gender identity Mental health Meta-Analysis Psychological research Transgender people |
| Title | Hormone Therapy, Mental Health, and Quality of Life Among Transgender People: A Systematic Review |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/33644622 https://search.proquest.com/docview/2494873442 https://pubmed.ncbi.nlm.nih.gov/PMC7894249 |
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