A systematic review of psychosocial functioning changes after gender-affirming hormone therapy among transgender people

This systematic review assessed the state and quality of evidence for effects of gender-affirming hormone therapy on psychosocial functioning. Forty-six relevant journal articles (six qualitative, 21 cross-sectional, 19 prospective cohort) were identified. Gender-affirming hormone therapy was consis...

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Bibliographic Details
Published in:Nature human behaviour 2023-08, Vol.7 (8), p.1320-1331
Main Authors: Doyle, David Matthew, Lewis, Tom O. G., Barreto, Manuela
Format: Article
Language:English
Subjects:
4014/477/2811
631/477/2811
692/163/2743
Adjustment
Ambiguity
Anger
Behavioral Sciences
Biomedical and Life Sciences
Change agents
Cross-Sectional Studies
Endocrine therapy
Experimental Psychology
Gender
Gender-affirming care
Health disparities
Hormone replacement therapy
Hormones
Humans
Life Sciences
Mental depression
Microeconomics
Neurosciences
Personality and Social Psychology
Prospective Studies
Psychological distress
Psychosocial factors
Psychosocial Functioning
Quality of Life
Social functioning
Symptoms
Systematic review
Transgender Persons
Trends
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Summary:This systematic review assessed the state and quality of evidence for effects of gender-affirming hormone therapy on psychosocial functioning. Forty-six relevant journal articles (six qualitative, 21 cross-sectional, 19 prospective cohort) were identified. Gender-affirming hormone therapy was consistently found to reduce depressive symptoms and psychological distress. Evidence for quality of life was inconsistent, with some trends suggesting improvements. There was some evidence of affective changes differing for those on masculinizing versus feminizing hormone therapy. Results for self-mastery effects were ambiguous, with some studies suggesting greater anger expression, particularly among those on masculinizing hormone therapy, but no increase in anger intensity. There were some trends toward positive change in interpersonal functioning. Overall, risk of bias was highly variable between studies. Small samples and lack of adjustment for key confounders limited causal inferences. More high-quality evidence for psychosocial effects of gender-affirming hormone therapy is vital for ensuring health equity for transgender people. This systematic review examines the evidence on whether and how hormone therapy for transgender people influences psychosocial functioning. Overall, the strongest evidence was found for reductions in depressive symptoms and psychological distress after hormone therapy.
ISSN:2397-3374
2397-3374
DOI:10.1038/s41562-023-01605-w