Gender-affirming care may lower depression risk, study finds, but many are losing access
Transgender adults who received gender-affirming hormone therapy had a significantly lower risk of moderate-to-severe depression over four years compared to those who did not receive such care, according to a new study published in the journal JAMA Network Open.
The study tracked 3,592 transgender, nonbinary, and gender-diverse adults and found that those prescribed hormones like estrogen or testosterone had a 15% lower risk of depression symptoms, reinforcing the mental health benefits of this treatment.
The findings "support the mental health-promoting role of hormones" and their status as "a medically necessary treatment,” said Sari Reisner, an associate professor of epidemiology at University of Michigan School of Public Health and one of the study’s authors. "Hormones play a vital role in the mental health of trans people who need them."
The study acknowledges that other factors, such as mental health treatment, social support and other influences on mood, could have affected the findings. It also did not track the duration patients received gender-affirming hormone therapy or whether they underwent other forms of gender-affirming care, such as surgery.
Transgender people in the U.S. are two to three times more likely to have a history of depression, according to the Centers for Disease Control and Prevention. The study warns that mental health disparities continue to worsen in transgender and gender diverse communities, as access to gender-affirming care becomes more difficult.
Dr. Alexes Hazen, a New York City plastic surgeon specializing in gender-affirming procedures, says she has seen a rise in depression among her patients in recent months. Many have expressed concerns over the wave of state laws restricting or banning gender-affirming care, which has made finding treatment more difficult and left many feeling hopeless.
“Unfortunately, some states are not as friendly to patients and care providers,” Hazen said. “Some states have publicly stated their allegiance to trans and nonbinary folks, and those places will become safe havens for care.”
As barriers to gender-affirming care grow, the new study underscores its importance for mental health in transgender patients. These services "address the pervasive mental health inequities that trans people experience," Reisner said, emphasizing that access to this care is both medically necessary and essential for reducing depression risk.
"Our findings underscore the importance of protecting and upholding the right to accessible healthcare for trans people," Reisner said,
Hazen recommended community-based health centers that cater to LGBTQ+ patients as a key resource for gender-affirming care. The study also reinforced the importance of these clinics, arguing that the gender-affirming treatment they provide improves access and supports mental health, particularly for those in underserved communities.
Alice Gao, MD, MPH, is a family medicine resident at Temple Northwest Community Family Medicine and a member of the ABC News Medical Unit.
