Highs, Lows, and Hormones: A Qualitative Metasynthesis of Transgender Individuals’ Experiences Undergoing Gender-Affirming Hormone Therapy

Fowler, James A.; Warzywoda, Sarah; Franks, Nia; Mendis, Marini; Lazarou, Mattea; Bisshop, Fiona; Wood, Penny; Dean, Judith

doi:10.1080/00918369.2023.2186759

Cited by 6 publications

(2 citation statements)

References 86 publications

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“…Depression is related to disturbed sleep and circadian rhythm alterations, meaning that changes in the interaction between depression and chronotype after starting GAHT could be affecting our results (Dai and Hao 2019 ; Soria and Urretavizcaya 2009 ). Furthermore, some transgender persons report increased engagement in social activities after starting GAHT (Fowler et al 2023 ). It is therefore possible that participants stayed up later or changed sleep times due to changes in social events, although there are no known differences in social activities between transmasculine and transfeminine persons.…”

Section: Discussionmentioning

confidence: 99%

Chronotype changes after sex hormone use: A prospective cohort study in transgender users of gender-affirming hormones

Morssinkhof,

Zwager,

van der Tuuk

et al. 2024

Chronobiology International

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Chronotype, an individual’s preferred sleep-wake timing, is influenced by sex and age. Men sometimes report a later chronotype than women and older age is associated with earlier chronotype. The sex-related changes in chronotype coincide with puberty and menopause. However, the effects of sex hormones on human chronotype remain unclear. To examine the impact of 3 months of gender-affirming hormone therapy (GAHT) on chronotype in transgender persons, this study used data from 93 participants from the prospective RESTED cohort, including 49 transmasculine (TM) participants starting testosterone and 44 transfeminine (TF) participants starting estrogens and antiandrogens. Midpoint of sleep and sleep duration were measured using the ultra-short Munich ChronoType Questionnaire (µMCTQ). After 3 months of GAHT, TM participants’ midpoint of sleep increased by 24 minutes (95% CI: 3 to 45), whereas TF participants’ midpoint of sleep decreased by 21 minutes (95% CI: −38 to −4). Total sleep duration did not change significantly in either group. This study provides the first prospective assessment of sex hormone use and chronotype in transgender persons, showing that GAHT can change chronotype in line with cisgender sex differences. These findings provide a basis for future studies on biological mechanisms and clinical consequences of chronotype changes.

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Section: Discussionmentioning

confidence: 99%

Chronotype changes after sex hormone use: A prospective cohort study in transgender users of gender-affirming hormones

Morssinkhof,

Zwager,

van der Tuuk

et al. 2024

Chronobiology International

View full text Add to dashboard Cite

show abstract

“…This tool reports methodological quality in three categories: ++ referring to strong methodological quality, + referring to moderate methodological quality, and – referring to methodologically weak quality. This tool does not stipulate how many criteria are required to be met to reach specific quality parameters, but following previous applications of the tool (Fowler et al, 2023), high‐quality studies met 10/14 criteria, moderate quality met 4/10 criteria, and weak studies met three or fewer criteria.…”

Section: Methodsmentioning

confidence: 99%

Digital mental health interventions: A narrative review of what is important from the perspective of LGBTQIA+ people

Fowler,

Buckley,

Muir

et al. 2023

J Clin Psychol

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ObjectivesDigital mental health interventions are a promising therapeutic modality to provide psychological support to LGBTQIA+ (lesbian, gay, bisexual, trans, Queer, intersex, asexual, plus other gender, sexual, and romantic minority identities) people. The aim of this narrative review is to explore how the LGBTQIA+ community has been engaged in the design of digital mental health interventions, how content has been tailored to the LGBTQIA+ community, and features identified as important by LGBTQIA+ participants.MethodsA total of 33 studies were included in this review from a larger yield of 1933 identified from systematic searches of five databases (PsycINFO, PubMed, Scopus, CINAHAL, and Medline). Data were analyzed narratively and using content analysis.ResultsOnly half of the studies reported engaging the LGBTQIA+ community in intervention designs. Interventions have been tailored in a variety of ways to support LGBTQIA+ individuals—such as through affirming imagery, recruitment through LGBTQIA+ networks, and designing content to focus specifically on LGBTQIA+ issues. A range of features were identified as important for participants, namely how content was tailored to LGBTQIA+ experiences, providing connection to community, and links to other relevant LGBTQIA+ resources. While not a primary aim, results also showed that a wide range of digital modalities can significantly improve a range of mental health problems.ConclusionDigital interventions are an acceptable and effective form of therapeutic intervention, but future research needs to focus on meaningful engagement of community members to inform design and implementation.

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One person, many changes: a socioecological qualitative analysis of the experiences of transfeminine individuals undergoing feminising gender-affirming hormone therapy

Fowler,

Warzywoda,

Reyment

et al. 2024

Culture, Health & Sexuality

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Highs, Lows, and Hormones: A Qualitative Metasynthesis of Transgender Individuals’ Experiences Undergoing Gender-Affirming Hormone Therapy

Cited by 6 publications

References 86 publications

Chronotype changes after sex hormone use: A prospective cohort study in transgender users of gender-affirming hormones

Chronotype changes after sex hormone use: A prospective cohort study in transgender users of gender-affirming hormones

Digital mental health interventions: A narrative review of what is important from the perspective of LGBTQIA+ people

One person, many changes: a socioecological qualitative analysis of the experiences of transfeminine individuals undergoing feminising gender-affirming hormone therapy

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