Transgender adults in the U.S. who received gender-affirming care had a significantly lower risk of moderate-to-severe depression compared to those who did not receive treatment, researchers said Monday.
Nearly 3,600 patients who were prescribed hormones such as estrogen or testosterone over the course four years had a 15 percent lower risk of related metal health symptoms, including hopelessness and suicidal thoughts. The participants received treatment at facilities in Boston and New York.
The findings “support the mental health-promoting role of hormones” and their status as “a medically necessary treatment,” Dr. Sari Reisner, an associate professor of epidemiology at University of Michigan School of Public Health, told ABC News. “Hormones play a vital role in the mental health of trans people who need them.”
Reisner is a co-author of the study published in the journal JAMA Network Open.
Hormone therapy is a treatment that helps people to transition genders and achieve physical characteristics that are more masculine or feminine. It can improve a person’s mental health and quality of life, aligning an individual’s outer appearance with their gender identity.
But, access to the healthcare is dwindling, with restrictive policies and laws in place that block hormone therapy or transition surgery. Nearly 40 percent of transgender youth live in states that have passed bans on gender-affirming care, according to the non-profit Human Rights Campaign.
Previous research found that having access to hormones and puberty blockers for individuals between the ages of 13 and 20 was associated with 60 percent lower odds of moderate to severe depression and 73 percent lower odds of self-harm or suicidal thoughts compared to youth who did not receive the same medications over the course of a year. A study last year found that anti-transgender laws fueled up to a 72 percent increase in suicide attempts among transgender and nonbinary youth.
“It’s not just about accessing care; it’s about accessing it in a timely fashion,” author Diana Tordoff explained in 2023. “Delays in prescribing puberty hormones or blockers may in fact worsen mental health symptoms for trans young people.”
Depression is a major issue throughout the U.S., affecting millions of Americans each year. About one out of every six adults will have depression at some point in their life, according to the Centers for Disease Control and Prevention.
American transgender and nonbinary adults — who make up approximately 1.6 percent of adults — feel these impacts disproportionately, with a two-to-four-fold increased risk of depression relative to those whose gender identity aligns with the sex they were assigned at birth.
Research from the UCLA School of Law found that more than 40 percent of transgender adults in the U.S. have attempted suicide. And disparities continues to worsen as gender-affirming care becomes more difficult to access.
Notably, starting gender-affirming hormone treatment as an adolescent has been linked to better mental health than waiting until adulthood.
“Our findings underscore the importance of protecting and upholding the right to accessible healthcare for trans people,” Reisner said.
If you are based in the U.S., and you or someone you know needs mental health assistance right now, call or text 988, or visit 988lifeline.org to access online chat from the 988 Suicide and Crisis Lifeline. This is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week. If you are in another country, you can go to befrienders.org to find a helpline near you.
