A new peer-reviewed study published in the Journal of Adolescent Health finds that transgender youth who receive gender-affirming hormone therapy have lower rates of depression, suicidal thoughts, and suicide attempts than their other trans and nonbinary peers who have not received hormones.
The article, “Association of Gender-Affirming Hormone Therapy with Depression, Thoughts of Suicide, and Attempted Suicide among Transgender and Nonbinary Youth,” is being hailed as the first large-scale study examining transgender youth receiving hormone therapy, based on a sample of more than 9,000 trans or nonbinary youth.
Researchers at the LGBTQ youth suicide prevention organization The Trevor Project, who conducted the study, found that only 14% of trans-identifying youth were receiving gender-affirming hormone therapy. Another 50% said they wanted to access hormones, but had not been able to, while 36% said they did not wish to receive hormone therapy.
Those youth receiving hormone therapy reported a lower likelihood of experiencing recent depression or considering suicide, compared to their peers who wanted hormone therapy but have not been able to receive it.
Specifically, for youth under age 18, receiving gender-affirming hormone therapy was associated with 40% lower odds of recent depression and of a suicide attempt in the past year.
Parental support of transgender youth’s gender identities had a strong relationship with whether a youth received hormone therapy, with 80% of those receiving it saying they had at least one parent supporting their gender identity.
Additionally, youth of color had lower rates of accessing gender-affirming hormone therapy when they wanted it compared with white youth.
The study builds upon past research finding that transgender and nonbinary youth face elevated risk for depression, thoughts of suicide, and suicide attempts compared with youth who are cisgender or straight, including cisgender members of the LGBTQ community.
A 2020 study by The Trevor Project found that trans and nonbinary youth were two to 2.5 times as likely to experience depressive symptoms and suicidal ideation, and attempt suicide, compared to other LGBQ youth.
The organization’s 2021 National Survey on LGBTQ Youth Mental Health found that more than half of trans or nonbinary youth had seriously considered suicide in the past year, with 1 in 5 reporting a suicide attempt, compared to cisgender LGBQ youth, only 32% of whom had considered suicide and 1 in 10 who attempted it in the past year.
Jonah DeChants, PhD., a research scientist for The Trevor Project and one of the leading researchers involved in the study, told Metro Weekly in an interview that researchers followed best practices when asking youth about their feelings of depression, suicidal ideation, and suicide attempts, adopting language used in other surveys so that the findings could be easily compared to other large-scale studies involving transgender youth and mental health.
DeChants also notes that the study’s 14% figure includes only those youth who are receiving hormone therapy. Other youth may opt not to pursue hormone therapy but may be taking puberty blockers to assist in their gender transition.
Above all, says DeChants, the researchers behind the study are hoping to provide some context for the effect that gender-affirming hormone therapy can have on trans youth’s mental well-being, especially at a time when various state legislatures have either passed or are considering bans prohibiting minors — even those with parental permission — from accessing gender-affirming medical interventions of any type.
He notes that those legislative efforts can exacerbate feelings of depression or suicidal ideation among youth who may feel singled out or have their self-esteem undermined by negative public attention and the hostile anti-transgender rhetoric that often accompanies those debates.
“We’re hoping that folks will take away that these are really important, potentially life-saving medical interventions that young people should have access to, and that limiting access through the kinds of bans that we have seen in various state legislatures across the country does not help people, but limit the number of options that young people have,” DeChants says.
“We believe that young people should be able to make these medical choices with their families and with their medical providers. So we would hope that folks would see this study as strong evidence that these bans are not evidence-based and that we need to be improving access to these kinds of treatments rather than limiting it.”
DeChants also says that the large sample size allowed researchers to examine different identities or characteristics among trans and nonbinary youth, thereby allowing them to notice specific trends or patterns, such as the fact that trans youth of color and trans youth in the South are more likely to be unable to access gender-affirming hormone treatments despite wanting to.
Asked about critics who might claim that The Trevor Project study is flawed or is being used to push an ideological agenda, DeChants defended the researchers’ credentials and credibility, noting that many of the research staffers have advanced degrees, have been trained in the scientific process, and have worked previously in academic settings.
“We are very intentional about making sure that our data for this survey is not connected to to our crisis services. We do not use Trevor’s brand to recruit for this survey. It does not get promoted on Trevor’s social media accounts. We do everything in our power to make sure that we are following the scientific method in order to document the trends that we are seeing,” he said.
“In addition, this study went through a very rigorous review process with the Journal of Adolescent Health. I would encourage folks to learn more about the peer-review process and the ways in which scientific journals that the studies that they receive. This study was sent out to least two, I believe three, other scientists in the field who study this topic and who provided thorough feedback.
“We went through multiple rounds of feedback and revision before it was finally published. So we have done everything in our power to use the scientific method to make sure that we are presenting accurate information.”
Dr. Amy Green, the vice president of research at The Trevor Project, said in a statement: “This study emphasizes the potential benefits of gender-affirming hormone therapy as a mechanism to reduce feelings of gender dysphoria and minority stress among transgender and nonbinary youth — thereby working to improve mental health outcomes and prevent suicide.
“These data should serve as a call to action to resist blanket bans on gender-affirming medical care and to invest in more research on this topic so that youth and their families can make evidence-informed decisions regarding care.”
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