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(29) Longitudinal Impact of Gender-Affirming Endocrine Intervention on the Mental Health and Well-Being of Transgender Youths: Preliminary Results


Authors:

Nicholas Eaton, PhD – Associate Professor, Department of Psychology, Stony Brook University

Tenille Taggart, MA – Graduate Student, Psychology, Stony Brook University

Kimberly Tafuri, Stony Brook Children's Hospital – Assistant Professor, Stony Brook Children's Hospital

Andrew Lane, Stony Brook University – Professor, Stony Brook Children's Hospital

Jennifer Osipoff, Stony Brook Children's Hospital – Associate Professor, Pediatric Endocrinology, Stony Brook Children's Hospital

Thomas Wilson, Stony Brook Children's Hospital – Chief, Pediatric Endocrinology, Stony Brook Children's Hospital

Christal Achille, Stony Brook Children's Hospital – Fellow, Pediatric Endocrinology, Stony Brook Children's Hospital

Abstract:

Objective :

Transgender youths experience high rates of stigma and discrimination. Combined with developing secondary sex characteristics, these factors contribute to poorer mental health, depression and increased suicide attempts/completions. Previous studies indicate that endocrine and/or surgical interventions are associated with improvements to mental health in adult trans individuals. Little is known about its impact on trans youths, particularly in the USA.

Methods :

We examined the longitudinal impact of endocrine intervention in transgender youths (aged 9-21) across three waves of data. At approximately 6-month intervals, participants completed mental health assessments and parents completed the Nisonger Child Behavior Rating Form (NCBRF-TIQ). To assess endocrine treatment effects, we utilized a subsample of participants who were naïve to endocrine treatment at baseline (Wave 1: N = 95; Wave 2: n = 66; Wave 3: n = 50). We used linear and logistic regression to compare outcomes between transgender youths who began and never began endocrine treatment at subsequent waves.

Results :

We found that female to male subjects (FTM) on any endocrine treatment reported significant reductions in Wave 3 depressive symptoms (ps < .05). On the NCBRF-TIQ, FTM on hormone suppression scored lower on the Overly Sensitive factor (p = .05), whereas FTM on any endocrine treatment scored lower on the Oppositional factor (p = .04).  Male to female subjects (MTF) on hormone suppression and any endocrine intervention reported significant reductions in depression at Waves 2 and 3 (ps < .05). On the NCBRF-TIQ, MTF on cross-sex steroids scored significantly lower on the Oppositional (p = .02) and Withdrawn/Dysphoric (p = .04) factors, and they also scored significantly lower on the D-Total factor (p = .02) - a composite of the Disruptive Behavior Disorder Subscales.

Discussion :

Previous studies from the Netherlands demonstrated benefit to transgender youth only after cross sex steroid therapy and gender confirmation surgery.  We found that endocrine intervention may improve depression and behavior in transgender youth in the USA.

Conclusion : Our results suggest that endocrine intervention is associated with reduced problem behaviors. This effect was observed in both FTM and MTF, but gender and type of intervention were associated with different outcomes. These preliminary findings suggest that endocrine intervention may be beneficial for trans youths, similar to their positive associations in trans adults.

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