Children's Health Systems of Texas, Dallas, Texas; and
University of Texas Southwestern Medical Center, Dallas, Texas.
Pediatrics. 2020 Apr;145(4). doi: 10.1542/peds.2019-3006.
Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported.
Participants ( = 148; ages 9-18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas ( = 25 puberty suppression only; = 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI.
Affirmed males reported greater depression and anxiety at baseline, but these differences were small ( < .01). Youth reported large improvements in body dissatisfaction ( < .001), small to moderate improvements in self-report of depressive symptoms ( < .001), and small improvements in total anxiety symptoms ( < .01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively.
Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.
我们的首要目标是通过性别、年龄和 Tanner（即青春期）阶段检查基线时对身体不满、抑郁和焦虑症状的差异。我们的第二个目标是测试在接受性别肯定激素治疗的第一年中，年轻人症状的变化。我们的第三个目标是通过人口统计学和治疗特征检查随时间变化的潜在差异。青年自杀意念、自杀企图和非自杀性自我伤害（NSSI）的经历也有报道。
参与者（= 148；年龄 9-18 岁；平均年龄 14.9 岁）在德克萨斯州达拉斯的一个多学科项目中接受性别肯定激素治疗（= 25 例仅青春期抑制；= 123 例女性化或男性化激素治疗）。参与者在初次就诊时和随访时完成了评估身体不满（身体意象量表）、抑郁（快速抑郁症状清单）和焦虑（儿童焦虑相关情绪障碍筛查）的调查。临床医生完成了快速抑郁症状清单，并收集了有关青年自杀意念、自杀企图和 NSSI 经历的信息。
确认的男性在基线时报告了更多的抑郁和焦虑，但这些差异很小（<0.01）。年轻人报告身体不满有较大改善（<0.001），自我报告的抑郁症状略有改善（<0.001），总焦虑症状略有改善（<0.01）。人口统计学或治疗相关特征与随时间的变化无关。自杀意念的终生和随访发生率分别为 81%和 39%，自杀企图为 16%和 4%，NSSI 为 52%和 18%。
结果提供了更多证据，证明性别肯定激素治疗在减少身体不满方面起着关键作用。心理健康也有适度的初步改善。
