TY - JOUR
T1 - Changes in depression symptom profile with gender-affirming hormone use in transgender persons
AU - Morssinkhof, Margot W L
AU - Wiepjes, Chantal M
AU - van den Heuvel, Odile A
AU - Kreukels, Baudewijntje P C
AU - van der Tuuk, Karin
AU - T'Sjoen, Guy
AU - den Heijer, Martin
AU - Broekman, Birit F P
N1 - Funding Information: This work was supported by the NWO , Netherlands [ZonMW Veni grant, grant number 91619085 , 2018] supplied to BB. The NWO had no involvement in the study design, data collection, analysis or interpretation of the data, writing of the report or decision to submit the article. All other authors have no financial conflicts of interest. Publisher Copyright: © 2024 The Authors
PY - 2024/3/1
Y1 - 2024/3/1
N2 - BACKGROUND: Women show higher prevalence of depression and different symptomatology than men, possibly influenced by sex hormones. Many transgender persons, who face a high risk of depression, use Gender-Affirming Hormone Therapy (GAHT), but the impact of GAHT on depressive symptom profiles is unknown.METHODS: This study examined depressive symptoms in transgender persons before GAHT and after 3- and 12 months of GAHT. We used the Inventory of Depressive Symptomatology-Self Report to assess depressive symptoms, exploratory factor analysis (EFA) to assess symptom clusters, and linear mixed models to assess changes in symptom clusters.RESULTS: This study included 110 transmasculine (TM) and 89 transfeminine (TF) participants. EFA revealed four symptom clusters: mood, anxiety, lethargy, and somatic symptoms. Changes in total depressive symptoms significantly differed between TM and TF groups. After 3 months of GAHT, TM participants reported improvement in lethargy (-16 %; 95%CI: -29 %; -2 %), and after 12 months TF participants reported worsening in low mood (24 %; 95%CI: 3 %; 51 %), but absolute score changes were modest. Neither group showed changes in anxiety or somatic symptoms.LIMITATIONS: This study had limited sample sizes at 12 months follow-up and did not include relevant biological or psychosocial covariates.DISCUSSION: Changes in depressive symptoms after GAHT use differ in TM and TF persons: TM persons report slight improvements in lethargy, whereas TF persons report a slight increase in low mood. Starting GAHT represents a significant life event with profound social and physical effects, and further research should assess social and biological effects of GAHT on mood-related symptoms.
AB - BACKGROUND: Women show higher prevalence of depression and different symptomatology than men, possibly influenced by sex hormones. Many transgender persons, who face a high risk of depression, use Gender-Affirming Hormone Therapy (GAHT), but the impact of GAHT on depressive symptom profiles is unknown.METHODS: This study examined depressive symptoms in transgender persons before GAHT and after 3- and 12 months of GAHT. We used the Inventory of Depressive Symptomatology-Self Report to assess depressive symptoms, exploratory factor analysis (EFA) to assess symptom clusters, and linear mixed models to assess changes in symptom clusters.RESULTS: This study included 110 transmasculine (TM) and 89 transfeminine (TF) participants. EFA revealed four symptom clusters: mood, anxiety, lethargy, and somatic symptoms. Changes in total depressive symptoms significantly differed between TM and TF groups. After 3 months of GAHT, TM participants reported improvement in lethargy (-16 %; 95%CI: -29 %; -2 %), and after 12 months TF participants reported worsening in low mood (24 %; 95%CI: 3 %; 51 %), but absolute score changes were modest. Neither group showed changes in anxiety or somatic symptoms.LIMITATIONS: This study had limited sample sizes at 12 months follow-up and did not include relevant biological or psychosocial covariates.DISCUSSION: Changes in depressive symptoms after GAHT use differ in TM and TF persons: TM persons report slight improvements in lethargy, whereas TF persons report a slight increase in low mood. Starting GAHT represents a significant life event with profound social and physical effects, and further research should assess social and biological effects of GAHT on mood-related symptoms.
KW - Depression
KW - Estrogen
KW - Gender affirming hormone therapy
KW - Testosterone
KW - Transgender
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85181909377&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/38154588
U2 - https://doi.org/10.1016/j.jad.2023.12.056
DO - https://doi.org/10.1016/j.jad.2023.12.056
M3 - Article
C2 - 38154588
SN - 0165-0327
VL - 348
SP - 323
EP - 332
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -