A newly published study of 3,592 transgender, nonbinary, and gender-diverse (TGD) patients found that 15% of patients with moderate-to-severe depressive symptoms had their symptoms lessened during a two-year span of receiving gender-affirming hormone therapy (GAHT).
The study’s findings are notable both because TGD people tend to experience higher rates of depression than cisgender people and because the recent presidential administration has tried to discredit studies affirming gender-affirming healthcare as “junk science.”
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The report also slammed the UK’s controversial Cass Review.
The study looked at TGD patients (ranging from ages 18 to over 51) who received primary care from either the Fenway Health Institute in Boston, Massachusetts, or the Callen-Lorde Community Health Center for LGBTQ+ people in New York City during a 48-month period from 2016 to 2019.
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A questionnaire found that 15.3% had moderate-to-severe depressive symptoms. The depressed patients who received GAHT had a 15% lower risk of experiencing depressive symptoms over the past two weeks than those who didn’t receive GAHT.
“The mechanisms through which GAHT improves depressive symptoms are likely biopsychosocial for TGD people, including physiologic changes in the hormone [group], reductions in gender dysphoria, and increases in gender congruence impacting social functioning,” the study stated.
The study also stressed that hormone therapy was integrated into each patient’s primary care, offered in an urban gender-affirming medical setting, and made accessible through affordable and low-barrier options. As such, the study suggests that hormone therapy may best alleviate depressive symptoms when it’s more easily accessible and integrated into a TGD person’s gender-affirming primary healthcare.
TGD adults are two to four times more likely than cisgender adults to experience depression, the study’s authors wrote, and GAHT is known to improve mental health outcomes. But most studies until now have either only covered short time spans, haven’t had a small or culturally similar sample size, or haven’t taken into account how sociodemographic characteristics affect patient outcomes.
Comparatively, this study’s large sample size was 63.1% white, 16.1% Hispanic/Latinx, 11.7% Black, and 6.8% multiracial. While 58.8% were under the age of 30, the rest were over that age. Additionally, 35.4% were trans women, 32.6% were trans men, 18.9% were nonbinary, 52.1% lived below the federal poverty level, 5.1% had HIV, 55.2% had private health insurance, 34.2% had public health insurance, and 4.1% were uninsured.
Researchers found that trans women and nonbinary patients who were assigned female at birth had a significantly increased risk of depressive symptoms compared with trans men. However, researchers noted that the study didn’t take into account whether its participants had any other sorts of gender-affirming medical care, were taking anti-depressant drugs, or if any other external factors affected the participants’ depression levels.
Nevertheless, researchers added that their study also “underscores the importance of universal screening for depression in this population, accompanied by appropriate systems to ensure diagnosis, treatment, and follow-up for those with depressive symptoms.”
The study challenges the anti-trans medical bias of the current presidential administration. In late January, the president signed an executive order commanding the federal government to cut off any funding for medical institutions researching, providing, or teaching about gender-affirming care.
The order dismissed all studies upholding the necessity of gender-affirming care as “junk science” and gave the Department of Health and Human Services (HHS) a 90-day deadline to publish a document that looks at alternative approaches to treating children with gender dysphoria.
The forthcoming document will likely amount to a U.S. version of the Cass Review, a U.K. document that disavowed hundreds of studies showing the usefulness of gender-affirming care. The Cass Review has provided a basis for conservatives in the U.K. government to restrict gender-affirming care for minors across the country.
The nine researchers involved in the aforementioned study — some of whom are trans or nonbinary — all had associations with either Harvard Medical School’s Fenway Institute, the Callen-Lorde Community Health Center, or the University of California in San Francisco’s Gender Affirming Health Program.
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