New study: Gender affirming hormone therapy is associated with lower depression risk
as published in jama open network
A new longitudinal study on the effects of gender affirming hormone therapy was released this week in the journal JAMA Open Network. The top line finding: Receiving HRT is is associated with a decreased risk of severe depression.
This new study longitudinally followed 3,592 trans people receiving care at Callen-Lorde in New York City and Fenway Health in Boston from 2016-2019. All participants identified as trans, were aged 18 or older, and consented to the analysis of their electronic health records (EHRs). Overall, the cohort was roughly divided into thirds by gender identity (trans woman, trans man, and non-binary) and was largely representative of the United States’ racial makeup.
Using the data available in a patient’s EHR, researchers could determine the individual’s demographic characteristics, depression risk (from patient health questionnaires), and prescriptions. These data were then used to generate a predictive model on the effects of HRT prescriptions and of other demographic factors.
The researchers’ statistical model returned an adjusted risk ratio (ARR) which indicates whether the variable is associated with elevated depression risk (ARR > 1) or decreased depression risk (ARR < 1). If ARR = 1, then there is no relationship between the variable and depression risk.
For example, specific transgender identities (eg. trans woman, trans man, and non-binary) were all modeled to have an ARR near 1, meaning trans identities are largely not related one’s depression risk.1
HRT prescription was modeled to have an ARR of 0.85 (with a 95% confidence interval of 0.75-0.98), indicating decreased depression risk in trans people who have sought and received HRT prescriptions. This data indicates the mental health benefits of HRT in adult trans people.
It is also worth noting some additional correlative factors in determining trans people’s depression risk. Trans people living below or near the federal poverty line have strongly elevated risks of depression (with ARRs > 1.19). While perhaps not surprising, these data are a reminder of the ways in which negative mental health outcomes are not distributed evenly across the trans community. Instead, trans identity intersects with someone’s multitude of other identities to produce their specific lived experience.
Given the ongoing censorship of research on trans populations and the concerted right-wing push to strip health care options from trans people, data such as this are key to defending medically necessary gender-affirming care.
Importantly, these results are also in agreement with the lived experiences of trans people who have sought and received HRT. Access to these medications have vastly improved the mental health of numerous trans-identifying people, myself included. Our experiences are valid just as they have always been.
from the archive
While this is generally true, it is worth nothing that both trans women had non-binary people assigned female at birth had ARRs greater than one, indicating slightly higher depression risk compared to trans men and nonbinary people assigned male at birth.
Don’t need some scientists or doctors to tell me that. I live it.
I'm a statistic; Callen-Lorde is my provider, and I get GAC from them. I've been feeling a lot better about myself since starting HRT. Some people have even called me beautiful and it's even made me feel really happy!
Transitioning was the best decision I ever made. I just hate being oppressed for it, though.