New Study Finds Gender-Affirming Hormone Therapy Linked to Lower Rates of Depression, Suicide Risk Among Transgender Youth

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This is the first large-scale study to examine hormone therapy among transgender and nonbinary youth.

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"It’s critical that all transgender and nonbinary youth across the country have access to medical care that is affirming, patient-centered, and evidence-based."

Researchers at The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people, today published a new peer-reviewed study in the Journal of Adolescent Health that found gender-affirming hormone therapy (GAHT) is significantly related to lower rates of depression, suicidal thoughts, and suicide attempts among transgender and nonbinary youth. These findings underscore the need to expand access to best-practice, gender-affirming medical care, as is currently prescribed by doctors across the country and recommended by the major medical and mental health associations.

The article, titled “Association of Gender-Affirming Hormone Therapy with Depression, Thoughts of Suicide, and Attempted Suicide among Transgender and Nonbinary Youth,” is the first large-scale study to examine hormone therapy among transgender and nonbinary youth, based on a sample of more than 9,000 who provided data on GAHT.

Key findings include:

  • Half of all transgender and nonbinary young people said they were not using GAHT but would like to, 36% were not interested in receiving GAHT, and 14% were already receiving GAHT. On average, the young people sampled were just over 17 and a half years old.
  • Young people receiving GAHT reported a lower likelihood of experiencing recent depression and considering suicide compared to those who wanted GAHT but did not receive it. Specifically for young people under age 18, receiving GAHT was associated with nearly 40% lower odds of recent depression and of a past-year suicide attempt.
  • Parent support for their child’s gender identity had a strong relationship with receipt of GAHT, with nearly 80% of those who received GAHT reporting they had at least one parent who supported their gender identity.
  • Youth of color had lower rates of accessing GAHT when they wanted it compared to white youth.

“The Trevor Project is proud to publish the first large-scale study to examine hormone therapy among transgender and nonbinary youth. It’s clear that gender-affirming care has the potential to reduce rates of depression and suicide attempts while banning this vital care and exposing young people to harmful political rhetoric can cause real harm,” said Amit Paley, CEO & Executive Director of The Trevor Project. “It’s critical that all transgender and nonbinary youth across the country have access to medical care that is affirming, patient-centered, and evidence-based.”

“This study emphasizes the potential benefits of gender-affirming hormone therapy as a mechanism to reduce feelings of gender dysphoria and minority stress among transgender and nonbinary youth — thereby working to improve mental health outcomes and prevent suicide,” said Dr. Amy Green, VP of Research at The Trevor Project. “These data should serve as a call to action to resist blanket bans on gender-affirming medical care and to invest in more research on this topic so that youth and their families can make evidence-informed decisions regarding care.”

A record number of anti-transgender bills have been debated across the country in 2021, including the passage of a ban on gender-affirming medical care in Arkansas and at least 20 other states considering similar legislation. This study found that transgender and nonbinary youth who lived in the South — the region where the majority of bans on GAHT have been introduced (subsequent to the collection of this data) — reported the highest rates of not being able to access GAHT when they wanted it. These efforts to restrict gender-affirming care may negatively impact mental health through two separate but linked pathways, the first by directly prohibiting medical care that many of youth rely on to reduce feelings of gender dysphoria and the second by increasing minority stress through exposure to negative public attention and harmful rhetoric in debates around transgender rights.

The study builds upon research that demonstrates how transgender and nonbinary youth face elevated risk for depression, thoughts of suicide, and attempting suicide compared with youth who are cisgender and straight, including cisgender members of the LGBTQ community. A 2020 study, “Understanding the Mental Health of Transgender and Nonbinary Youth,” published by The Trevor Project’s researchers in the Journal of Adolescent Health, found that transgender and nonbinary youth were 2 to 2.5 times as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to their cisgender LGBQ peers. Further, Trevor’s 2021 National Survey on LGBTQ Youth Mental Health found that more than half (52%) of transgender and nonbinary youth seriously considered suicide in the past year, and 1 in 5 reported attempting suicide — compared to 32% of cisgender LGBQ youth who seriously considered suicide and 1 in 10 who attempted suicide in the past year.

If you or someone you know needs help or support, The Trevor Project’s trained crisis counselors are available 24/7 at 1-866-488-7386, via chat at TheTrevorProject.org/Get-Help, or by texting START to 678678.

Methodology
The content and methodology for The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health were approved by an independent Institutional Review Board.

This quantitative cross-sectional survey was conducted using an online platform between October 12, 2020 and December 31, 2020 among 34,759 LGBTQ youth respondents between the ages of 13–24 residing in the United States, including 11,914 transgender or nonbinary youth (9,019 of which reported data on GAHT). This report uses “transgender and nonbinary” as an umbrella term to encompass a wide variety of gender identities held by non-cisgender youth. For additional information on methodology such as sample description and comparability, filters and exclusions, question development, and more please visit https://www.TheTrevorProject.org/survey-2021.

About The Trevor Project
The Trevor Project is the world's largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people. The Trevor Project offers a suite of 24/7 crisis intervention and suicide prevention programs, including TrevorLifeline, TrevorText, and TrevorChat as well as the world’s largest safe space social networking site for LGBTQ youth, TrevorSpace. Trevor also operates an education program with resources for youth-serving adults and organizations, an advocacy department fighting for pro-LGBTQ legislation and against anti-LGBTQ rhetoric/policy positions, and a research team to discover the most effective means to help young LGBTQ people in crisis and end suicide.

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Rob Todaro

Dr. Amy Green
The Trevor Project
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