Baker Kellan E, Wilson Lisa M, Sharma Ritu, Dukhanin Vadim, McArthur Kristen, Robinson Karen A
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Johns Hopkins Evidence-Based Practice Center, Baltimore, MD, USA.
J Endocr Soc. 2021 Feb 2;5(4):bvab011. doi: 10.1210/jendso/bvab011. eCollection 2021 Apr 1.
We sought to systematically review the effect of gender-affirming hormone therapy on psychological outcomes among transgender people. We searched PubMed, Embase, and PsycINFO through June 10, 2020 for studies evaluating quality of life (QOL), depression, anxiety, and death by suicide in the context of gender-affirming hormone therapy among transgender people of any age. We excluded case studies and studies reporting on less than 3 months of follow-up. We included 20 studies reported in 22 publications. Fifteen were trials or prospective cohorts, one was a retrospective cohort, and 4 were cross-sectional. Seven assessed QOL, 12 assessed depression, 8 assessed anxiety, and 1 assessed death by suicide. Three studies included trans-feminine people only; 7 included trans-masculine people only, and 10 included both. Three studies focused on adolescents. Hormone therapy was associated with increased QOL, decreased depression, and decreased anxiety. Associations were similar across gender identity and age. Certainty in this conclusion is limited by high risk of bias in study designs, small sample sizes, and confounding with other interventions. We could not draw any conclusions about death by suicide. Future studies should investigate the psychological benefits of hormone therapy among larger and more diverse groups of transgender people using study designs that more effectively isolate the effects of hormone treatment.
我们试图系统评价性别肯定激素疗法对跨性别者心理结局的影响。我们检索了截至2020年6月10日的PubMed、Embase和PsycINFO，以查找评估任何年龄跨性别者在性别肯定激素疗法背景下的生活质量（QOL）、抑郁、焦虑和自杀死亡情况的研究。我们排除了病例研究以及随访时间少于3个月的研究。我们纳入了22篇出版物中报道的20项研究。其中15项为试验或前瞻性队列研究，1项为回顾性队列研究，4项为横断面研究。7项评估了生活质量，12项评估了抑郁，8项评估了焦虑，1项评估了自杀死亡情况。3项研究仅纳入了跨性别女性；7项仅纳入了跨性别男性，10项两者都纳入了。3项研究聚焦于青少年。激素疗法与生活质量提高、抑郁减轻和焦虑减轻相关。不同性别认同和年龄的相关性相似。这一结论的确定性受到研究设计中高偏倚风险、小样本量以及与其他干预措施混杂的限制。我们无法得出关于自杀死亡的任何结论。未来的研究应采用能更有效分离激素治疗效果的研究设计，调查更大且更多样化的跨性别者群体中激素疗法的心理益处。
