Gender-affirming care may improve the mental health of transgender adolescents

Transgender and non-binary adolescents who received gender-verifying care were significantly less likely to have moderate or severe depression and suicidal tendencies than those who did not. rice field. JAMA network open..

“Our research is based on solid scientific evidence that access to gender identity disorder care is critical to the mental health and well-being of transuse.” Diana M. Tordoff, MPH, A PhD student in epidemiology at the University of Washington told Healio. “Our findings show that puberty suppressants (PBs) and sex-verifying hormones (GAHs) can alleviate depression and suicidal tendencies in a relatively short period of one year, and that delays in prescribing PBs and hormones are real. Shows that it can exacerbate the mental health symptoms of transuse. “

In a prospective observation cohort study, Tordoff et al. Investigated changes in mental health of transgender and non-binary adolescents and young adults seeking gender-affirming care. The researchers used a 9-item scale for patient health questions and a 7-item scale for generalized anxiety disorder to assess participants’ depression, anxiety, and suicidal tendencies.

From August 2017 to June 2018, we tracked 104 young people aged 13 to 20 at an urban interdisciplinary gender clinic. The average age was 15.8 years, with 64.4% of young people being Caucasian. The study cohort included 63 transmasculine individuals (60.6%), 27 transfeminine individuals (26%), 10 non-binary or genderfluid individuals (9.6%), and gender identity. It included 4 individuals (3.8%) who did not.

Tordoff et al. Reported that 80.8% of the study cohort completed the study after 3 and 6 months of follow-up, and 62.5% completed the study after 1 year of follow-up.

Prevalence of mental health problems

Overall, 56.7% of adolescents reported moderate to severe depression, 50% had moderate to severe anxiety, and 43.3% reported thoughts of self-harm or suicidal tendencies at baseline. ..

A year later, 66.3% of adolescents received PB, GAH, or both interventions. According to the researchers, the rest of the participants did not receive either intervention.

After adjusting for confounding factors, Tordoff et al. Have 60% lower odds for depression (adjusted OR = 0.4; 95% CI, 0.17-0.95) and 73% lower odds for suicidal tendencies (aOR = 0.27; 95%). CI, 0.11-0.65) was reported. Among adolescents who have been treated to confirm their gender compared to adolescents who did not receive it. However, there was no significant association between PB or GAH and anxiety (aOR = 1.01; 95% CI, 0.41-2.51).

“Our findings have important policy implications, and the recent wave of law limiting access to gender-affirming care has been [transgender and nonbinary] “Youth,” wrote Tordoff and his colleagues.

Recently, the Texas state government. Greg Abbott We have instructed transgender minors to report cases of gender-verifying medical care.Child abuse under existing Texas law.. “

In response, ACP issued a statement strongly opposed to “government interference in patient-physician relationships that prevents physicians from providing evidence-based medical services to patients.”

Meanwhile, there are other legislative and governmental efforts directly aimed at criminalizing gender-affirming care for transgender youth, Tordov said.

“These efforts increase the stigma and discrimination experienced by these young people in trans-use and their family well-being, and by denying access to important, life-saving, evidence-based health, seriously in the short term and. There is no doubt that it will have a long-term adverse effect. Be careful, “she added.

In addition to addressing anti-transgender legislation, healthcare systems and insurers need to reduce barriers and increase access to gender-affirming care, researchers wrote.

Multi-faceted approach to care

In a related editorial, Brett DorotinaBS, Department of Psychiatry, Massachusetts General Hospital and Fenway Institute Jack L. Turban, MD, MHS, Stanford University Psychiatry and Behavioral Science Fellow discussed the need for a multifaceted approach to addressing mental health disparities between transgender and gender-diversified youth.

Gender-identifying care has been found to reduce suicidal tendencies and the likelihood of depression in this population, but “medical intervention alone is not sufficient to address it. [transgender and gender-diverse] Gap in youth mental health, “they wrote.

Other steps should include the implementation of evidence-based experiential learning programs in medical education to properly train physicians on how to treat these young people.

Dorotina and Turban write that the proposed transgender ban could adversely affect the mental health of transgender and gender-diversified youth and would ban the ability to use gender-appropriate public facilities. ing.

“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. “Even if the transgender opposition bills are not passed, recent debates over them remain. [transgender and nonbinary] Young people who are expected to worsen their mental health. “

reference:

Dorotina B, Turban JL JAMA network Open.. 2022; doi: 10.1001 /jamanetworkopen.2022.0926.

Governor Abbott directs DFPS to investigate transsexual procedures as child abuse. https://gov.texas.gov/news/post/governor-abbott-directs-dfps-to-investigate-gender-transitioning-procedures-as-child-abuse.. Accessed on February 25, 2022.

HB 1557 / SB 1834: Harms LGBTQ + youth and censors discussions related to sexual orientation and gender identity at school. https://www.aclufl.org/en/legislation/hb-1557-sb-1834-harming-lgbtq-youth-and-censoring-discussions-related-sexual-orientation.. Accessed on February 24, 2022.

Internists oppose policies that disrupt the patient-doctor relationship and penalize evidence-based care. http://r.mail.acpnews.org/mk/mr/2tpx2J7087ysYBGedDSg-ZWb9oHBoWj_IAV3DIwx_UCDcZtFzj5yMyMlTCF6YoZ3QEwNwdHLpb3KSAycaiw3vTTHmnSOHVlQYR.. Published February 24, 2022. Accessed on February 24, 2022.

The Governor of Texas is calling on citizens to report abuse to parents of transgender children. https://www.nbcnews.com/nbc-out/out-politics-and-policy/texas-governor-calls-citizens-report-parents-transgender-kids-abuse-rcna17455.. Published February 23, 2022. Accessed on February 24, 2022.

Tordoff DM, et al. JAMA network Open.. 2022; doi: 10.1001 /jamanetworkopen.2022.0978.