1. In this prospective cohort study, treatment with gender-affirming hormone (GAH) was associated with improved positive affect and life satisfaction in transgender youth.
2. Treatment of GAH has also been associated with reduced symptoms of depression and anxiety.
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Study rundown: GAH is used to alleviate gender dysphoria in transgender and non-binary youth by increasing conformity in appearance. GAH are important interventions that improve psychosocial functioning in transgender and non-binary youth and lead to lasting improvements over time. In this prospective cohort study tracking transgender youth on GAH there was a significant improvement in appearance conformity, positive affect and life satisfaction. In addition, depression and anxiety scores decreased significantly over time. Increases in appearance conformity were associated with lower depression and anxiety scores and increases in positive affect and life satisfaction scores over time. Young men who began GAH early in puberty had higher scores on appearance conformity, positive affect, and satisfaction with life at baseline than those who began GAH later. Young men who began GAH later in puberty experienced greater improvements in appearance conformity than those who began GAH early in puberty. One of the limitations of the study is that despite the significant improvements noted for young men in GAH, there is still significant variance, and some of it is not improved. It is prudent to examine other important factors affecting transgender and non-binary youth outside of access to gender affirmation care.
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in depth [prospective cohort study]: This prospective, observational cohort study examined the psychosocial functioning of transgender and non-binary youth after the initiation of GAH. Latent development curve modeling was used to examine individual pathways for multiple psychosocial outcomes. Study visits occurred at baseline, 6, 12, 18, and 24 months after initiation of treatment. A total of 291 participants had longitudinal data on available primary outcome variables. Significant improvements were noted within participants for all psychosocial outcomes (Wilk’s lambda, 0.32; P<0.001). Appearance match increase (annual increase on a 5-point scale, 0.48; 95% confidence interval [CI], 0.42 to 0.54), positive affect (annual increase on a 100-point scale, 0.80; 95% CI, 0.08 to 1.54), and life satisfaction (annual increase on a 100-point scale, 2.32; 95% CI, 1.64 to 3.00) . A decrease was observed in depression (annual change on a 63-point scale, -1.27; 9% CI, -1.98 to -0.57) and anxiety scores (annual change on a 100-point scale, -1.46; 95% CI, -2.13 to - 0.79) during the two-year treatment period. Increases in appearance conformity were associated with decreases in depression (r = -0.68) and anxiety (r = -0.52) scores. Increases in appearance conformity were also associated with increased positive affect (r = 0.74) and life satisfaction (r = 0.84). Onset of GAH early in puberty had higher scores for appearance, congruence, positive affect, and life satisfaction at baseline. Young men who began GAH later in puberty had greater improvements in appearance conformity than those who began GAH early in puberty. In summary, the current study found that GAH improved young men's quality of life over a two-year period.
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