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hormone therapy boosts mental health of transgender and nonbinary youth, study says

trans and nonbinary children and youth who receive gender-affirming care display fewer symptoms of anxiety and depression, research shows.

by dave yasvinski
published jan 24, 2023
read time 3 minute read
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read time 3 minute read
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kids who receive gender-affirming care have stronger mental health
transgender or nonbinary youth often experience gender dysphoria, a sense of intense discomfort caused by the discrepancy between their physical appearance and their gender identity. getty
a new study has found that transgender and nonbinary youth who received gender-affirming care experienced fewer symptoms of depression and anxiety more than two years after treatment began. the observational study, published in the new england journal of medicine, found that administering gender-affirming hormones resulted in significant improvements to appearance congruence — or the degree to which one’s external appearance aligns with gender. the study, which followed 315 transgender and nonbinary youth between the ages of 12 and 20 for over two years, is believed to be the largest of its kind in the u.s. parental consent was required before minors could participate.
“our results provide robust scientific evidence that improved appearance congruence secondary to hormone treatment is strongly linked to better mental health outcomes in transgender and nonbinary youth,” said diane chen, lead author of the study and a pediatric psychologist with the gender and sex development program at ann & robert h. lurie children’s hospital of chicago.
“this is critical, given that transgender youth experience more depression and anxiety and are at a higher risk for suicidality than cisgender youth.”

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transgender or nonbinary youth often experience gender dysphoria, a sense of intense discomfort caused by the discrepancy between their physical appearance and their gender identity. gender-affirming hormones, such as testosterone or estradiol, are used to decrease this discrepancy by promoting the appearance of gender-congruent secondary sex characteristics, such as hair growth or breast development.
following the start of treatment, researchers met with study participants every six months to determine their levels of appearance congruence, anxiety, depression, positive affect and life satisfaction. overall, they found that appearance congruence, positive affect and life satisfaction all improved after treatment, while depression and anxiety decreased. appearance congruence was found to be associated with each psychosocial outcome, including those assessed at baseline and during follow-ups.
“the critical results we report demonstrate the positive psychological impact of gender-affirming hormones for treatment of youth with gender dysphoria,” said johanna olson-kennedy, senior author of the study and medical director of the center for transyouth health and development at children’s hospital los angeles.
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“amidst a landscape of misinformation, we hope these findings support the use of timely and appropriate medical interventions for this vulnerable group of adolescents.”
all of the health centres that participated in the study employed a team of medical and mental health providers that worked together to determine if gender dysmorphia was present and if gender-affirming treatment was appropriate.
“the positive findings of this observational study match the lived clinical experience of mental health experts who, in their many years of providing gender-affirming care, have repeatedly learned from the youth themselves about their mental health,” said diane ehrensaft, co-author of the study and director of mental health at the uc san francisco child and adolescent gender center.
“as the longitudinal study proceeds, we look forward to learning more from this cohort of patients — all of whom were screened carefully before beginning gender-affirming hormone treatment — about their journey going forward.”
according to researchers, the importance of hormone treatment for people who have never felt comfortable in their own skin cannot be overstated.
“our results provide a strong scientific basis that gender-affirming care is crucial for the psychological well-being of our patients,” said robert garofalo, co-author and principal investigator of the study. “we must ensure that access to this care remains available to youth with gender dysphoria.”
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dave yasvinski is a writer with healthing.ca
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