transgender 青年激素治疗 2 年后的社会心理功能。
Psychosocial Functioning in Transgender Youth after 2 Years of Hormones.
机构信息
From the Gender and Sex Development Program, Potocsnak Family Division of Adolescent and Young Adult Medicine (D.C., R.G.), and the Pritzker Department of Psychiatry and Behavioral Health (D.C.), Ann and Robert H. Lurie Children's Hospital of Chicago, the Departments of Pediatrics (D.C., R.G.) and Psychiatry and Behavioral Sciences (D.C., J.B.), Northwestern University Feinberg School of Medicine, and the Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University (J.B.) - all in Chicago; the Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital (Y.-M.C.), and the Department of Pediatrics, Harvard Medical School (Y.-M.C.), Boston, and the Department of Psychology and Neuroscience, Boston College, Newton (A.C.T.) - all in Massachusetts; the Department of Pediatrics, Division of Pediatric Endocrinology (D.E., S.M.R.), and the Child and Adolescent Gender Center, Benioff Children's Hospital (D.E., S.M.R.), University of California, San Francisco, San Francisco, and the Gender Health Program, UCLA Health (M.A.H.), and the Division of General Internal Medicine and Health Services Research, Medicine-Pediatrics Section, Department of Medicine, David Geffen School of Medicine (M.A.H.), University of California, Los Angeles, the Center for Transyouth Health and Development, Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles (J.O.-K.), and the Department of Pediatrics, Keck School of Medicine, University of Southern California (J.O.-K.), Los Angeles - all in California.
出版信息
N Engl J Med. 2023 Jan 19;388(3):240-250. doi: 10.1056/NEJMoa2206297.
BACKGROUND
Limited prospective outcome data exist regarding transgender and nonbinary youth receiving gender-affirming hormones (GAH; testosterone or estradiol).
METHODS
We characterized the longitudinal course of psychosocial functioning during the 2 years after GAH initiation in a prospective cohort of transgender and nonbinary youth in the United States. Participants were enrolled in a four-site prospective, observational study of physical and psychosocial outcomes. Participants completed the Transgender Congruence Scale, the Beck Depression Inventory-II, the Revised Children's Manifest Anxiety Scale (Second Edition), and the Positive Affect and Life Satisfaction measures from the NIH (National Institutes of Health) Toolbox Emotion Battery at baseline and at 6, 12, 18, and 24 months after GAH initiation. We used latent growth curve modeling to examine individual trajectories of appearance congruence, depression, anxiety, positive affect, and life satisfaction over a period of 2 years. We also examined how initial levels of and rates of change in appearance congruence correlated with those of each psychosocial outcome.
RESULTS
A total of 315 transgender and nonbinary participants 12 to 20 years of age (mean [±SD], 16±1.9) were enrolled in the study. A total of 190 participants (60.3%) were transmasculine (i.e., persons designated female at birth who identify along the masculine spectrum), 185 (58.7%) were non-Latinx or non-Latine White, and 25 (7.9%) had received previous pubertal suppression treatment. During the study period, appearance congruence, positive affect, and life satisfaction increased, and depression and anxiety symptoms decreased. Increases in appearance congruence were associated with concurrent increases in positive affect and life satisfaction and decreases in depression and anxiety symptoms. The most common adverse event was suicidal ideation (in 11 participants [3.5%]); death by suicide occurred in 2 participants.
CONCLUSIONS
In this 2-year study involving transgender and nonbinary youth, GAH improved appearance congruence and psychosocial functioning. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.).
背景
关于接受性别肯定激素（GAH；睾酮或雌二醇）的跨性别和非二元青年的前瞻性结局数据有限。
方法
我们在美国的一个前瞻性观察队列中，对 GAH 启动后 2 年内的社会心理功能进行了纵向描述。参与者被招募参加一项关于身体和社会心理结局的四项前瞻性观察研究。参与者在基线和 GAH 启动后 6、12、18 和 24 个月时完成了 Transgender Congruence Scale、Beck Depression Inventory-II、Revised Children's Manifest Anxiety Scale（Second Edition）和 NIH（National Institutes of Health）Toolbox Emotion Battery 的积极情绪和生活满意度测量。我们使用潜在增长曲线模型来检查 2 年内外貌一致性、抑郁、焦虑、积极情绪和生活满意度的个体轨迹。我们还检查了初始外貌一致性水平及其变化率与每个社会心理结局的变化率之间的相关性。
结果
共有 315 名 12 至 20 岁（平均[±SD]，16±1.9 岁）的跨性别和非二元参与者参加了这项研究。共有 190 名参与者（60.3%）是跨男性（即出生时被指定为女性但在男性谱中认同自己的性别），185 名（58.7%）是非拉丁裔或非拉丁裔白人，25 名（7.9%）曾接受过青春期抑制治疗。在研究期间，外貌一致性、积极情绪和生活满意度增加，抑郁和焦虑症状减少。外貌一致性的增加与积极情绪和生活满意度的同时增加以及抑郁和焦虑症状的减少相关。最常见的不良事件是自杀意念（11 名参与者[3.5%]）；有 2 名参与者死于自杀。
结论
在这项涉及跨性别和非二元青年的 2 年研究中，GAH 改善了外貌一致性和社会心理功能。（由 Eunice Kennedy Shriver 国家儿童健康与人类发育研究所资助）。
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