Faculty of Medicine and Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK.
School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Andrology. 2021 Nov;9(6):1808-1816. doi: 10.1111/andr.12884. Epub 2020 Sep 3.
Cross-sectional studies show that transgender people are more likely than cisgender people to experience depression and anxiety before gender-affirming hormone treatment (GAHT). However, the effect of GAHT on mental health in transgender people, and the role of other factors that may have a predictive effect, is poorly explored.
Using a longitudinal methodology, this study investigated the effect of 18-month GAHT on depression and anxiety symptomatology and the predictors on mental health outcomes in a large population of transgender people.
Participants (n = 178) completed a socio-demographic questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Autism Spectrum Quotient-Short Version (AQ-Short) at pre-assessment (T0) and at 18 months after initiation of GAHT (T1).
From T0 to T1, symptomatology was significantly decreased for depression (P < .001) and non-significantly reduced for anxiety (P = .37). Scores on the MSPSS predicted reduction in depression, while scores on the AQ-Short predicted reduction in anxiety.
GAHT reduces symptoms of depression which are predicted by having higher levels of social support. Although anxiety symptoms also reduce, the changes are not significant and high levels of anxiety still remain post-GAHT.
These results highlight the important mental health benefits of GAHT. Support services (professional, third sector or peer support) aiming at increasing social support for transgender individuals should be made available.
横断面研究表明,在接受性别肯定激素治疗(GAHT)之前,跨性别者比顺性别者更有可能经历抑郁和焦虑。然而,GAHT 对跨性别者心理健康的影响,以及可能具有预测作用的其他因素的作用,尚未得到充分探讨。
本研究采用纵向方法,调查了 18 个月 GAHT 对大量跨性别者抑郁和焦虑症状的影响,以及对心理健康结果的预测因素。
参与者(n=178)在基线评估(T0)和 GAHT 开始后 18 个月(T1)时完成了一份社会人口学问卷、医院焦虑和抑郁量表(HADS)、多维感知社会支持量表(MSPSS)和自闭症谱系商数简表(AQ-Short)。
从 T0 到 T1,抑郁症状显著下降(P<.001),焦虑症状非显著下降(P=.37)。MSPSS 得分预测抑郁症状的减轻,而 AQ-Short 得分预测焦虑症状的减轻。
GAHT 降低了抑郁症状,而社会支持水平较高则预测了抑郁症状的减轻。尽管焦虑症状也有所减轻,但变化不显著,GAHT 后仍存在较高水平的焦虑。
这些结果强调了 GAHT 对心理健康的重要益处。应提供旨在增加跨性别者社会支持的支持服务(专业、第三部门或同伴支持)。