Longitudinal impact of gender-affirming endocrine intervention on the mental health and well-being of transgender youths: preliminary results

Int J Pediatr Endocrinol. 2020;2020:8. doi: 10.1186/s13633-020-00078-2. Epub 2020 Apr 30.


Background/aims: Transgender youths experience high rates of depression and suicidal ideation compared to cisgender peers. Previous studies indicate that endocrine and/or surgical interventions are associated with improvements to mental health in adult transgender individuals. We examined the associations of endocrine intervention (puberty suppression and/or cross sex hormone therapy) with depression and quality of life scores over time in transgender youths.

Methods: At approximately 6-month intervals, participants completed depression and quality of life questionnaires while participating in endocrine intervention. Multiple linear regression and residualized change scores were used to compare outcomes.

Results: Between 2013 and 2018, 50 participants (mean age 16.2 + 2.2 yr) who were naïve to endocrine intervention completed 3 waves of questionnaires. Mean depression scores and suicidal ideation decreased over time while mean quality of life scores improved over time. When controlling for psychiatric medications and engagement in counseling, regression analysis suggested improvement with endocrine intervention. This reached significance in male-to-female participants.

Conclusion: Endocrine intervention may improve mental health in transgender youths in the US. This effect was observed in both male-to-female and female-to-male youths, but appears stronger in the former.

Keywords: Cross sex hormone; Depression; Estrogen; GnRH analogue; Puberty; Puberty suppression; Quality of life; Suicidal ideation; Suicide; Testosterone; Transgender; Transgender management; Transgender youth.