Hormone therapy reduces depression in trans & nonbinary adults, new study says

A recent study involving 3,592 trans, nonbinary, and gender-diverse (TGD) patients found that gender-affirming hormone therapy (GAHT) helped reduce moderate-to-severe depressive symptoms in 15% of the participants over two years, according to ‘LGBTQ Nation’.

The significance of these findings lies in the fact that TGD individuals generally experience higher depression rates compared to cisgender individuals, and the current presidential administration in the U.S.A. has attempted to label gender-affirming healthcare studies as “junk science.” The study analysed TGD patients aged between 18 and over 51 who received primary care at either Fenway Health Institute in Boston or the Callen-Lorde Community Health Center in New York City from 2016 to 2019.

A survey revealed that 15.3% experienced moderate-to-severe depressive symptoms. Those with depression who underwent GAHT had a 15% reduction in the risk of experiencing depressive symptoms in the preceding two weeks compared to those who did not opt for GAHT.

According to the study, the mechanisms by which GAHT alleviates depressive symptoms in TGD individuals are likely biopsychosocial, including physiological hormone changes, reduced gender dysphoria, and enhanced gender congruence, which positively impact social functioning.

The study emphasised that hormone therapy was seamlessly incorporated into each patient’s primary care, provided in urban gender-affirming medical settings, and offered via affordable, low-barrier means. As a result, it suggests that easing access and integrating hormone therapy into TGD individuals’ primary health care may most effectively reduce depressive symptoms.

The study’s authors noted that TGD adults are two to four times as likely to experience depression as cisgender adults, with GAHT contributing to improved mental health outcomes. However, prior studies have often been limited by short durations, small or culturally homogeneous samples, or neglected the impact of sociodemographic factors on patient outcomes.

In contrast, the current study featured a large and diverse sample consisting of 63.1% white, 16.1% Hispanic/Latinx, 11.7% Black, and 6.8% multiracial individuals. While 58.8% of participants were under 30, the remainder were older. Additionally, 35.4% were trans women, 32.6% were trans men, 18.9% were nonbinary, 52.1% lived below the federal poverty line, 5.1% had HIV, 55.2% had private health insurance, 34.2% had public insurance, and 4.1% were uninsured.

Researchers observed that trans women and nonbinary participants assigned female at birth exhibited a significantly higher risk of depressive symptoms compared to trans men. Nonetheless, the study did not account for other gender-affirming treatments, antidepressant use, or external influences on depression levels.

Researchers stressed the importance of universal depression screening in this population and implementing systems for diagnosis, treatment, and follow-up for those with depressive symptoms.

This study challenges the current presidential administration’s anti-trans healthcare stance. In late January, the president issued an executive order halting federal funding for medical institutions studying, providing, or teaching gender-affirming care.

The order dismissed studies supporting the need for gender-affirming care as “junk science” and required the Department of Health and Human Services (HHS) to produce a report within 90 days outlining alternative treatments for children with gender dysphoria.

This upcoming report is expected to resemble the Cass Review from the U.K., which rejected numerous studies validating gender-affirming care, providing a precedent for U.K. conservatives to limit such care for minors.

The nine researchers involved in this study — some of whom identify as trans or nonbinary — are affiliated with 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.