White Hughto Jaclyn M, Reisner Sari L
The Fenway Institute, Fenway Health, Boston, Massachusetts; Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
The Fenway Institute, Fenway Health, Boston, Massachusetts; Division of General Pediatrics, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Transgend Health. 2016 Jan;1(1):21-31. doi: 10.1089/trgh.2015.0008. Epub 2016 Jan 13.
To review evidence from prospective cohort studies of the relationship between hormone therapy and changes in psychological functioning and quality of life in transgender individuals accessing hormone therapy over time.
MEDLINE, PsycINFO, and PubMed were searched for relevant studies from inception to November 2014. Reference lists of included studies were hand searched.
Three uncontrolled prospective cohort studies, enrolling 247 transgender adults (180 male-to-female [MTF], 67 female-to-male [FTM]) initiating hormone therapy for the treatment of gender identity disorder (prior diagnostic term for gender dysphoria), were identified. The studies measured exposure to hormone therapy and subsequent changes in mental health (e.g., depression, anxiety) and quality of life outcomes at follow-up. Two studies showed a significant improvement in psychological functioning at 3-6 months and 12 months compared with baseline after initiating hormone therapy. The third study showed improvements in quality of life outcomes 12 months after initiating hormone therapy for FTM and MTF participants; however, only MTF participants showed a significant increase in general quality of life after initiating hormone therapy.
Hormone therapy interventions to improve the mental health and quality of life in transgender people with gender dysphoria have not been evaluated in controlled trials. Low quality evidence suggests that hormone therapy may lead to improvements in psychological functioning. Prospective controlled trials are needed to investigate the effects of hormone therapy on the mental health of transgender people.
回顾前瞻性队列研究的证据，以探究激素治疗与接受激素治疗的跨性别者心理功能及生活质量随时间变化之间的关系。
检索了MEDLINE、PsycINFO和PubMed自数据库建立至2014年11月的相关研究。对纳入研究的参考文献列表进行了手工检索。
确定了三项非对照前瞻性队列研究，共纳入247名开始接受激素治疗以治疗性别认同障碍（性别焦虑症之前的诊断术语）的跨性别成年人（180名男性变女性[MTF]，67名女性变男性[FTM]）。这些研究测量了激素治疗的暴露情况以及随访时心理健康（如抑郁、焦虑）和生活质量结果的后续变化。两项研究表明，与开始激素治疗前的基线相比，在3至6个月和12个月时心理功能有显著改善。第三项研究表明，FTM和MTF参与者在开始激素治疗12个月后生活质量结果有所改善；然而，只有MTF参与者在开始激素治疗后总体生活质量有显著提高。
改善性别焦虑症跨性别者心理健康和生活质量的激素治疗干预措施尚未在对照试验中进行评估。低质量证据表明，激素治疗可能会改善心理功能。需要进行前瞻性对照试验来研究激素治疗对跨性别者心理健康的影响。
