Objective: This study is a longitudinal evaluation of the effectiveness of gender-affirming hormones for improving psychological well-being and decreasing suicidality among transgender youth referred to a transgender health specialty clinic at a large Midwest children’s hospital. Method: Forty-seven youth (13.73–19.04 years; M = 16.59, SD = 1.19) who received gender-affirming hormones were assessed at least 2 times: before the start of treatment and at least 3 months after treatment. Results: After gender-affirming hormones, a significant increase in levels of general well-being and a significant decrease in levels of suicidality were observed. Conclusion: These findings suggest that gender-affirming hormones are a valuable medical intervention with promising psychosocial outcomes for transgender youth.
Implications for Impact Statement
This study suggests that gender-affirming hormones are a helpful medical intervention for transgender youth. Gender-affirming hormones were found to be associated with decreases in suicidality and improvements in general well-being.
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References
1.
AinsworthT. A.SpiegelJ. H. (2010). Quality of life of individuals with and without facial feminization surgery or gender reassignment surgery. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 19, 1019–1024. 10.1007/s11136-010-9668-7
2.
American Psychological Association. (2015). Guidelines for psychological practice with transgender and gender nonconforming people. American Psychologist, 70, 832–864. 10.1037/a0039906
3.
BowenR.BalbuenaL.PetersE. M.Leuschen-MewisC.BaetzM. (2015). The relationship between mood instability and suicidal thoughts. Archives of Suicide Research, 19, 161–171. 10.1080/13811118.2015.1004474
4.
ChenD.Edwards-LeeperL.StancinT.TishelmanA. (2018). Advancing the practice of pediatric psychology with transgender youth: State of the science, ongoing controversies, and future directions. Clinical Practice in Pediatric Psychology, 6, 73–83. 10.1037/cpp0000229
5.
ChenD.HidalgoM. A.LeibowitzS.LeiningerJ.SimonsL.FinlaysonC.GarofaloR. (2016). Multidisciplinary care for gender-diverse youth: A narrative review and unique model of gender-affirming care. Transgender Health, 1, 117–123. 10.1089/trgh.2016.0009
6.
ChenM.FuquaJ.EugsterE. A. (2016). Characteristics of referrals for gender dysphoria over a 13-year period. Journal of Adolescent Health, 58, 369–371. 10.1016/j.jadohealth.2015.11.010
7.
ChewD.AndersonJ.WilliamsK.MayT.PangK. (2018).Hormonal treatment in young people with gender dysphoria: A systematic review. Pediatrics, 141,e20173742. 10.1542/peds.2017-3742
8.
ColemanE.BocktingW.BotzerM.Cohen-KettenisP.DeCuypereG.FeldmanJ.. . .MonstreyS. (2012). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism, 13, 165–232. 10.1080/15532739.2011.700873
9.
CostaR.DunsfordM.SkagerbergE.HoltV.CarmichaelP.ColizziM. (2015). Psychological support, puberty suppression, and psychosocial functioning in adolescents with gender dysphoria. Journal of Sexual Medicine, 12, 2206–2214. 10.1111/jsm.13034
10.
DavisS. A.MeierS. C. (2014). Effects of testosterone treatment and chest reconstruction surgery on mental health and sexuality in female-to-male transgender people. International Journal of Sexual Health, 26, 113–128. 10.1080/19317611.2013.833152
11.
de VriesA. L. C.McGuireJ. K.SteensmaT. D.WagenaarE. C. F.DoreleijersT. A. H.Cohen-KettenisP. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134, 696–704. 10.1542/peds.2013-2958
12.
Edwards-LeeperL.SpackN. P. (2012). Psychological evaluation and medical treatment of transgender youth in an interdisciplinary “Gender Management Service” (GeMS) in a major pediatric center. Journal of Homosexuality, 59, 321–336. 10.1080/00918369.2012.653302
13.
FisherA. D.CastelliniG.BandiniE.CasaleH.FanniE.BenniL.. . .RelliniA. H. (2014). Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria. Journal of Sexual Medicine, 11, 709–719. 10.1111/jsm.12413
14.
HembreeW. C.Cohen-KettenisP. T.GoorenL.HannemaS. E.MeyerW. J.MuradM. H.. . .T’SjoenG. G. (2017). Endocrine treatment of gender-dysphoric/gender-incongruent persons: An endocrine society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 102, 3869–3903. 10.1210/jc.2017-01658
15.
HorowitzL. M.BridgeJ. A.TeachS. J.BallardE.KlimaJ.RosensteinD. L.. . .PaoM. (2012). Ask Suicide-Screening Questions (ASQ): A brief instrument for the pediatric emergency department. Archives of Pediatrics & Adolescent Medicine, 166, 1170–1176. 10.1001/archpediatrics.2012.1276
16.
HoubenM.Van Den NoortgateW.KuppensP. (2015). The relation between short-term emotion dynamics and psychological well-being: A meta-analysis. Psychological Bulletin, 141, 901–930. 10.1037/a0038822
17.
JamesS. E.HermanJ. L.RankinS.KeislingM.MottetL.AnafiM. (2016). The report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.
18.
Keo-MeierC. L.HermanL. I.ReisnerS. L.PardoS. T.SharpC.BabcockJ. C. (2015). Testosterone treatment and MMPI-2 improvement in transgender men: A prospective controlled study. Journal of Consulting and Clinical Psychology, 83, 143–156. 10.1037/a0037599
19.
LopezS. J.Magyar-MoeJ. L.PetersenS. E.RyderJ. A.KrieshokT. S.O’ByrneK. K.. . .FryN. A. (2006). Counseling psychology’s focus on positive aspects of human functioning. Counseling Psychologist, 34, 205–227. 10.1177/0011000005283393
20.
McKnightP. E.McKnightK. M.SidaniS.FiguerdoA. J. (2007). Missing data: A gentle introduction. New York, NY: Guilford Press.
21.
Olson-KennedyJ.Cohen-KettenisP. T.KreukelsB. P.Meyer-BahlburgH. F.GarofaloR.MeyerW.RosenthalS. M. (2016). Research priorities for gender nonconforming/transgender youth: Gender identity development and biopsychosocial outcomes. Current Opinion in Endocrinology, Diabetes, and Obesity, 23, 172–179. 10.1097/MED.0000000000000236
22.
Olson-KennedyJ.WarusJ.OkontaV.BelzerM.ClarkL. F. (2018). Chest reconstruction and chest dysphoria in transmasculine minors and young adults: Comparisons of nonsurgical and postsurgical cohorts. Journal of the American Medical Association Pediatrics, 172, 431–436. 10.1001/jamapediatrics.2017.5440
23.
SchneiderB. A.Avivi-ReichM.MozuraitisM. (2015). A cautionary note on the use of the analysis of covariance (ANCOVA) in classification designs with and without within-subject factors. Frontiers in Psychology,6, 474. 10.3389/fpsyg.2015.00474
24.
SimonsL.SchragerS. M.ClarkL. F.BelzerM.OlsonJ. (2013). Parental support and mental health among transgender adolescents. Journal of Adolescent Health, 53, 791–793. 10.1016/j.jadohealth.2013.07.019
25.
SlabbekoornD.Van GoozenS. H. M.GoorenL. J.Cohen-KettenisP. T. (2001). Effects of cross-sex hormone treatment on emotionality in transsexuals. International Journal of Transgenderism, 5, 2–18.
26.
SmithA. J.Hallum-MontesR.NevinK.ZenkerR.SutherlandB.ReagorS.. . .BrennanJ. M. (2018). Determinants of transgender individuals’ well-being, mental health, and suicidality in a rural state. Rural Mental Health, 42, 116–132. 10.1037/rmh0000089
27.
TestaR. J.HabarthJ.PetaJ.BalsamK.BocktingW. (2015). Development of the gender minority stress and resilience measure. Psychology of Sexual Orientation and Gender Diversity, 2, 65–77. 10.1037/sgd0000081
28.
TestaR. J.MichaelsM. S.BlissW.RogersM. L.BalsamK. F.JoinerT. (2017). Suicidal ideation in transgender people: Gender minority stress and interpersonal theory factors. Journal of Abnormal Psychology, 126, 125–136. 10.1037/abn0000234
VarniJ. W.SeidM.KurtinP. S. (1999). Pediatric health-related quality of life measurement technology: A guide for health care decision makers. Journal of Clinical Outcomes Management, 6, 33–44.
