Hormone-treated transsexuals report less social distress, anxiety and depression

Psychoneuroendocrinology. 2012 May;37(5):662-70. doi: 10.1016/j.psyneuen.2011.08.010. Epub 2011 Sep 19.


Introduction: The aim of the present study was to evaluate the presence of symptoms of current social distress, anxiety and depression in transsexuals.

Methods: We investigated a group of 187 transsexual patients attending a gender identity unit; 120 had undergone hormonal sex-reassignment (SR) treatment and 67 had not. We used the Social Anxiety and Distress Scale (SADS) for assessing social anxiety and the Hospital Anxiety and Depression Scale (HADS) for evaluating current depression and anxiety.

Results: The mean SADS and HADS scores were in the normal range except for the HAD-Anxiety subscale (HAD-A) on the non-treated transsexual group. SADS, HAD-A, and HAD-Depression (HAD-D) mean scores were significantly higher among patients who had not begun cross-sex hormonal treatment compared with patients in hormonal treatment (F=4.362, p=.038; F=14.589, p=.001; F=9.523, p=.002 respectively). Similarly, current symptoms of anxiety and depression were present in a significantly higher percentage of untreated patients than in treated patients (61% vs. 33% and 31% vs. 8% respectively).

Conclusions: The results suggest that most transsexual patients attending a gender identity unit reported subclinical levels of social distress, anxiety, and depression. Moreover, patients under cross-sex hormonal treatment displayed a lower prevalence of these symptoms than patients who had not initiated hormonal therapy. Although the findings do not conclusively demonstrate a direct positive effect of hormone treatment in transsexuals, initiating this treatment may be associated with better mental health of these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / drug therapy*
  • Anxiety / psychology
  • Depression / drug therapy*
  • Depression / psychology
  • Estrogens / therapeutic use*
  • Female
  • Gender Identity
  • Humans
  • Male
  • Sex Reassignment Surgery
  • Stress, Psychological / drug therapy*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • Testosterone / therapeutic use*
  • Transsexualism / drug therapy*
  • Transsexualism / psychology
  • Young Adult


  • Estrogens
  • Testosterone