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A systematic review of psychosocial functioning changes after gender-affirming hormone therapy among transgender people

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  • David Matthew Doyle

    (Amsterdam University Medical Centers, Location VUmc)

  • Tom O. G. Lewis

    (University of Exeter)

  • Manuela Barreto

    (University of Exeter)

Abstract

This systematic review assessed the state and quality of evidence for effects of gender-affirming hormone therapy on psychosocial functioning. Forty-six relevant journal articles (six qualitative, 21 cross-sectional, 19 prospective cohort) were identified. Gender-affirming hormone therapy was consistently found to reduce depressive symptoms and psychological distress. Evidence for quality of life was inconsistent, with some trends suggesting improvements. There was some evidence of affective changes differing for those on masculinizing versus feminizing hormone therapy. Results for self-mastery effects were ambiguous, with some studies suggesting greater anger expression, particularly among those on masculinizing hormone therapy, but no increase in anger intensity. There were some trends toward positive change in interpersonal functioning. Overall, risk of bias was highly variable between studies. Small samples and lack of adjustment for key confounders limited causal inferences. More high-quality evidence for psychosocial effects of gender-affirming hormone therapy is vital for ensuring health equity for transgender people.

Suggested Citation

  • David Matthew Doyle & Tom O. G. Lewis & Manuela Barreto, 2023. "A systematic review of psychosocial functioning changes after gender-affirming hormone therapy among transgender people," Nature Human Behaviour, Nature, vol. 7(8), pages 1320-1331, August.
    • Handle: RePEc:nat:nathum:v:7:y:2023:i:8:d:10.1038_s41562-023-01605-w
    DOI: 10.1038/s41562-023-01605-w
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    References listed on IDEAS

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    1. Berkman, Lisa F. & Glass, Thomas & Brissette, Ian & Seeman, Teresa E., 2000. "From social integration to health: Durkheim in the new millennium," Social Science & Medicine, Elsevier, vol. 51(6), pages 843-857, September.
    2. Julianne Holt-Lunstad & Timothy B Smith & J Bradley Layton, 2010. "Social Relationships and Mortality Risk: A Meta-analytic Review," PLOS Medicine, Public Library of Science, vol. 7(7), pages 1-1, July.
    3. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    4. Lewis, Tom & Doyle, David Matthew & Barreto, Manuela & Jackson, Debby, 2021. "Social relationship experiences of transgender people and their relational partners: A meta-synthesis," Social Science & Medicine, Elsevier, vol. 282(C).
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    1. McNamara, Meredithe & McLamore, Quinnehtukqut & Meade, Nicolas & Olgun, Melisa & Robinson, Henry & Alstott, Anne, 2024. "A thematic analysis of disinformation in gender-affirming healthcare bans in the United States," Social Science & Medicine, Elsevier, vol. 351(C).

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