Timely access to hormone therapy may be a key tool in improving the mental health of transgender people, according to new research.
In the research, which was presented at the Endocrine Society’s annual meeting on Sunday, a team of scientists from the University of Melbourne found that shortening the waiting period for gender-affirming testosterone therapy also reduced the psychological distress called gender dysphoria among transgender adults. The study is under peer review and has not yet been published.
The researchers also found a clinically meaningful decrease in depression, with more than a 50 percent reduction in suicide among study participants who didn’t have to wait to start hormone therapy.
This is the first randomized clinical trial in the world to support the significant benefits of testosterone in reducing gender dysphoria, depression and suicide in trans individuals who wish to start testosterone, said lead study author Brendan Nolan, Ph. D. college candidate, in a press release.
According to the American Psychiatric Association, gender dysphoria refers to the psychological distress transgender people may experience due to the discrepancy between their gender identity and the sex assigned to them at birth.
Transgender people experience high rates of depression and suicidal ideation due to issues such as stigma, abuse and difficulty accessing medical care. according to the 2015 United States Transgender Survey. The survey, which included more than 27,000 transgender adults in the United States, found that more than 40 percent have attempted suicide in their lifetime.
Nolan’s team examined the impact of affordable testosterone therapy on the mental health of 64 transgender adults seeking treatment to become more masculine. Gender-affirming hormone therapy such as this is considered medically necessary by the World Professional Organization for Standards of Care of Transgender Health.
The guidelines, which are considered the gold standard for transgender health care, recommend hormone therapy for transgender people desiring this treatment because of demonstrated improvements in psychosocial functioning and quality of life.
Nolan says there is ample research to track the benefits gender-affirming hormone therapy may have for gender dysphoria and depression. None of the studies, however, compared a group of trans people who start hormones with a group of trans people who want to take hormones, she told CNN.
During a three-month open-label randomized control study, study participants were divided into two groups: an intervention group in which participants could start testosterone therapy immediately, and a cohort with a standard waiting period of three months. months. The participants’ mental health was assessed via a questionnaire, called the PHQ-9, which assessed their risk of depression and suicide, according to a study abstract.
With a shorter waiting period for the intervention group, instead of a longer wait for the control group, none of the participants had to put off treatment longer than the standard three-month waiting period, Nolan said.
Nolan’s team found that those who started treatment immediately showed a decrease in gender dysphoria and a clinically meaningful reduction in depression compared to those on the waitlist.
The researchers also found less suicidal ideation in the fast-track group: Suicidal thoughts resolved in 11 or 52 percent of people receiving immediate testosterone therapy who indicated suicidal ideation during initial screening .
The same was true for just one participant receiving standard care.
Previously, Nolan noted, endocrinologists lacked evidence to demonstrate the benefits of early access to testosterone. But finding him helps change that, she says.
I hope it attracts more doctors interested in the area, he said, and more doctors willing to prescribe testosterone, since we now have the evidence to show the mental health benefits of starting testosterone early.
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