Gender-Affirming Medical Interventions and Mental Health in Transgender Adults

• Published in: Psychology of sexual orientation and gender diversity 2019-06, Vol.6 (2), p.182-193
• Main Authors: Tomita, Kevin K., Testa, Rylan J., Balsam, Kimberly F.
• Format: Article
• Language: English
• Subjects: Alcohol Abuse; Female; Gender Identity; Health Care Psychology; Human; Intervention; Major Depression; Male; Mental Health; Mental Health Services
• ISSN: 2329-0382; 2329-0390
• DOI: 10.1037/sgd0000316

Purpose: Researchers have provided evidence for behavioral health disparities between transgender and cisgender individuals. Few studies considered the impact of possessing sex characteristics at birth that are not congruent with gender identity. In studies that examined gender-affirming medical interventions (GAMIs) and behavioral health in transgender adults, important variables and a range of behavioral health symptoms have not been considered. This study explored relationships between three GAMIs and scores on 6 symptom measures, while controlling for key variables. We hypothesized that, compared with transgender people who desire but have not yet engaged in a GAMI, those who engaged in the GAMI will report lower symptom scores on behavioral health outcomes. Method: Using a cross-sectional design, data from 868 transgender people were analyzed through comparison of the behavioral health of those who completed a given GAMI and those who wanted to complete the intervention. Results: GAMIs were associated with lower scores on measures of depression, social anxiety, generalized anxiety, and PTSD and higher scores on alcohol abuse for trans masculine identity spectrum (TMIS) people who completed GAMIs compared with those who desired but did not complete GAMIs. Results related to trans feminine identity spectrum (TFIS) people largely demonstrated nonsignificant differences. Discussion: Results indicate that among those who desire GAMIs, the completion of GAMIs are associated with better behavioral health for TMIS people, with the exception of alcohol abuse. Nonsignificant differences in the results of TFIS people may be attributable to differences in sample size, social ramifications, GAMI satisfaction, and hormone effects. Public Significance Statement This study suggests that the use of gender-affirming hormone replacement therapy, chest surgery, and genital surgeries may positively affect the mental health of transgender people who seek GAMIs. In addition, it highlights trends in mental health outcome and gender as related to the relationships between GAMIs and mental health.