Association of Gender-Affirming Hormone Therapy With Depression, Thoughts of Suicide, and Attempted Suicide Among Transgender and Nonbinary Youth

Abstract

There are no large-scale studies examining mental health among transgender and nonbinary youth who receive gender-affirming hormone therapy (GAHT). The purpose of this study is to examine associations among access to GAHT with depression, thoughts of suicide, and attempted suicide among a large sample of transgender and nonbinary youth. Methods: Data were collected as part of a 2020 survey of 34,759 lesbian, gay, bisexual, transgender, queer, and questioning youth aged 13e24, including 11,914 transgender or nonbinary youth. Adjusted logistic regression assessed whether receipt of GAHT was associated with lower levels of depression, thoughts of suicide, and attempted suicide among those who wanted to receive GAHT. Results: Half of transgender and nonbinary youth said they were not using GAHT but would like to, 36% were not interested in receiving GAHT, and 14% were receiving GAHT. Parent support for their child's gender identity had a strong relationship with receipt of GAHT, with nearly 80% of those who received GAHT reporting they had at least one parent who supported their gender identity. Use of GAHT was associated with lower odds of recent depression (adjusted odds ratio [aOR] ¼ .73, p < .001) and seriously considering suicide (aOR ¼ .74, p < .001) compared to those who wanted GAHT but did not receive it. For youth under age 18, GAHT was associated with lower odds of recent depression (aOR ¼ .61, p < .01) and of a past-year suicide attempt (aOR ¼ .62, p < .05). Conclusions: Findings support a relationship between access to GAHT and lower rates of depression and suicidality among transgender and nonbinary youth.

Sex Assigned at Birth Ratio Among Transgender and Gender Diverse Adolescents in the United States

“…Indeed, the notion of ROGD has been used by legislators to prohibit TGD youth from accessing gender-affirming medical Multiple studies have revealed that prohibiting TGD adolescents from accessing gender-affirming medical care would be expected to have detrimental impacts on TGD youth wellbeing. [16][17][18]22 The current study adds to the extant research arguing against the ROGD hypothesis by providing evidence inconsistent with the theories that (1) social contagion drives TGD identities, with unique susceptibility among AFAB youth, and…”

The Inclusion of Sex and Gender Beyond the Binary in Toxicology

“…Additionally, some trans and nonbinary people may take gender-affirming hormone treatments intentionally designed to alter their biological systems and improve mental health outcomes (Green et al, 2021). Transparent communication of health risks associated with hormone treatments is crucial to ensuring the health of all individuals.…”

A response to puberty blockers for gender dysphoric youth: A lack of sound science

“…The existing literature shows that access to affirming healthcare, hormone therapy, puberty suppression, and supportive communities are associated with improved mental health outcomes. 13,14 The authors cite sources to refute claims about the implications for improved mental health when access to gender-affirming healthcare is provided to TGD individuals. For example, Jorgensen et al highlight how puberty suppression alone has not been shown to improve symptoms of gender dysphoria, and they interpret this as no improvement in mental health outcomes.…”

“…Puberty suppression, followed by subsequent GAHT, in an affirming environment can improve gender dysphoria. 14 Additionally, one of the claims cited includes the necessity for data regarding mental health outcomes for adolescents with gender dysphoria matched with non-TGD peers with at least one co-existing mental health condition. This statement implies that gender dysphoria alone is a mental health condition, disregarding the source of mental health distress imposed by gender incongruence and societal pressures.…”

“…15 Existing data from the US Transgender Survey and studies conducted by the Trevor Project have found significant improvements in mental health for TGD adolescents and adults when provided with access to GAHT. 13,14 In a study conducted by Green et al 14 evaluating mental health outcomes in TGD youth, individuals who had access to GAHT were found to have a 27% and 26% lower rate of depression and serious thoughts about suicide, respectively. Another factor associated with lower rates of depression and suicidality was supportive parents.…”