Gender-verifying medications have a dramatic impact on the risk of suicide in transgender adolescents

Studies suggest that gender-affirming medical interventions may help protect transgender and non-binary (TNB) adolescents from suicide.

In a prospective cohort study of 104 adolescents, those who started adolescent inhibitors and sex-confirming hormones had a 73% chance of suicide compared to adolescents who did not receive gender-verifying treatment. Low (adjusted OR 0.27, 95% CI 0.11-0.65), reported by Diana M. Tordoff, MPH, and colleagues at the University of Washington, Seattle.

Similarly, the use of puberty inhibitors and hormones was associated with a 60% lower odds of depression over 12 months (aOR 0.40, 95% CI 0.17-0.95). JAMA network open..

However, the use of puberty inhibitors and sex-confirming hormones was not associated with reduced anxiety levels (aOR 1.01, 95% CI 0.41-2.51).

As evidence of how common mental health problems in this population were, 56.7% of the study cohort of adolescents aged 13 to 20 had moderate to severe depression at baseline. Moreover, half suffered from moderate to severe anxiety, and 43.3% reported self-harm or suicidal ideation.

Nonetheless, by the end of the one-year observational study, only 66.3% of these individuals were treated with pubertal inhibitors, sex-confirming hormones, or both, but one-third of adolescents Interventions that did not receive any of these gender-confirmed medical treatments.

“Our findings have important policy implications, and the recent wave of law restricting access to gender-affirming care could have a significant negative impact on the well-being of young people in TNB. It suggests that, “said Tordoff’s group. “Beyond the need to address anti-gender legislation, there is an additional need for healthcare systems and insurers to reduce barriers and increase access to gender-affirming care.”

This study Governor of Texas Greg Abbott (R) He ordered the state to investigate cases of transsexual procedures in children last week, such as the administration of puberty blockers and the use of hormones, claiming that such procedures constitute child abuse under Texas law. ..

“Other legislation that could adversely affect TGD’s mental health [transgender and gender-diverse] Young people include a bill banning the use of public facilities that match gender identity and a bill banning participation in sports teams that match gender identity. ” Accompanying commentary According to Brett Dolotina, BS of Massachusetts General Hospital in Boston, and Jack L. Turban, MD, MHS of Stanford University School of Medicine in Palo Alto.

“It is especially important to emphasize that the law for young people of sexual and sexual minorities seems to have an impact that goes beyond the direct impact of the law,” they added.

However, despite a significant reduction in depression and suicidal tendencies, they still face suicide rates much higher than the national average, so gender-verifying medical interventions alone are enough for these vulnerable people. Not enough to help, Drotina and Turban wrote.

“”[O]Mental health determinants, including gender minority stress, also need to be addressed, “he said, suggesting a multifaceted approach that includes medical, social, educational, and policy-level interventions. did.

For their analysis, Tordoff’s group examined individuals at the Seattle Children’s Gender Clinic from August 2017 to June 2018. Of the 104 young people, 63 were transfeminine individuals (60.6%), 27 were transfeminine individuals (26.0%), 10 were non-binary or gender fluid individuals (9.6%), and “don’t know.” 4 young people (3.8%) who answered, or did not answer questions about gender identity.

Mental health results were assessed using a 9-item scale for patient health questions and a 7-item scale for generalized anxiety disorder. In the last two weeks, self-reported suicidal ideation and self-harm have been recorded.

In each study, participants reported whether they had received sex-verifying hormones such as estrogen or testosterone, or puberty inhibitors such as gonadotropin-releasing hormone analogs. The review of medical records also considered whether androgen blockers such as spironolactone and menstrual suppressors or contraceptives such as medroxyprogesterone acetate and levonorgestrel-releasing intrauterine devices were prescribed during the study.

Tordoff’s group represents young people with the highest levels of supportive caregivers who may be biased in patient selection in this study and have the resources to access a gender-verifying care clinic. I said that I am doing it. Nevertheless, the incidence of depression, anxiety, and suicidal tendencies was very high.

“Young people who do not have access to gender-affirming care due to lack of family support and resources need to place particular emphasis on future research and advocacy,” they concluded.