Access to gender-affirming care can improve the mental health of trans adolescents

Share on Pinterest
For transgender and non-binary youth, having access to gender-affirming hormone therapy (GAHT) when they want it can have a huge impact on their risk of depression and significantly reduce their risk of suicide.
Maskot / Getty Images
  • New research from the Trevor Project has found that transgender and non-binary youth under the age of 18 who received gender-affirming hormone therapy (GAHT) had an almost 40% lower risk of depression in the past year.
  • They also had an almost 40 percent lower probability of attempted suicide.
  • The study also found that nearly 80 percent of young people who received GAHT said they had at least one parent who also supported their gender identity.
  • Research highlights how access to gender-affirming care can have a dramatic impact on the mental and physical health of transgender and non-binary youth.

A new peer-reviewed study by researchers at the Trevor Project highlights how access to gender-affirming hormone therapy (GAHT) can impact transgender and non-binary youth.

Published today in the Journal of Adolescent Health, the study found a link between access to GAHT and lower rates of depression, suicidal ideation and suicide attempts among transgender and non-binary youth in the United States.

Published at a time when nefarious state laws across the country seek to bar access to this treatment for young people, this research underscores how necessary equity and access to gender-affirming care is, both for mental health and general health and well-being. transgender and non-binary youth.

To calculate the data for this study, researchers at the Trevor Project turned to their 2021 national survey on the mental health of LGBTQ youth, which was conducted online between October 12, 2020 and December 31, 2020. She interviewed a total of 34,759 LGBTQ youth between 13 and 24 years old.

Of that number, 11,914 identified as transgender or non-binary, and 9,019 of that number provided data on GAHT. (The Trevor Project reports that “transgender and non-binary” is an umbrella term that incorporates a wide variety of identities for non-cisgender people.)

Researchers found that half of all transgender and non-binary respondents said they did not use GAHT but would like to use such therapies, while 36% said they were not interested in GAHT . In addition, 14 percent were already receiving GAHT.

One of the most striking findings is that transgender and non-binary youth who received GAHT were less likely to experience recent depression and consider suicide compared to youth who wanted to access GAHT but did not have it. not received.

The Trevor Project reveals that young people under the age of 18 who received GAHT were almost 40 percent less likely to experience depression or attempted suicide in the past year.

The support of parents or guardians is closely linked to this question of access. The study shows that nearly 80 percent of young people who received GAHT said they had at least one parent who also supported their gender identity.

As has been demonstrated at all levels, in all aspects of American health care, racial disparities run deep in who ultimately has access to this type of medical therapy.

Youth of color showed lower access rates to GAHT when they wanted to compared to their white peers.

Amy Green, PhD, vice president of research for the Trevor project, told Healthline that previous studies of access to GAHT were clinical, examining small samples of young people and tracing their experiences over time.

These smaller-scale studies showed that receiving GAHT and gender-affirming care showed increased body satisfaction as well as lower rates of depression, but they often did not include comparison groups. to provide a more comprehensive and holistic view of mental health. the health impact that access, or lack of access, to GAHT can have on a young person.

It also includes people who wanted this type of care but did not or could not receive it.

She said this new study offers a nuanced and comprehensive overview and offers a roadmap on how we can discuss and approach improving access to GAHT for young people in the future.

Green said that “one of the strongest findings” from the study is the benefits experienced by young people who reported having support for their gender identity from their parents compared to young people who experienced a lack of support.

Green said we “need to find ways to provide better education, better support and information to parents” because this is not just a “huge protective factor” for the mental health of transgender and non-binary youth, but it is also a necessity for them to have access to the care they need, in particular for minors.

She said that while healthcare professionals and society in general target this issue of supporting parents and guardians and accepting their child’s gender identity, if we approach it as a key factor in Mental health issues that may arise from gender dysphoria, we will be doing a great service to our trans and non-binary youth in this country.

“If they can have that [parental] support, then in terms of mental health, they can be better protected from rejection, which is one of our big risk factors, and then they can have better access to medications to help them reduce their dysphoria, ”said Green.

Dr Jack Turban, a researcher in child and adolescent psychiatry at Stanford University School of Medicine, where he researches the mental health of transgender youth, echoed Green in explaining just how important this element Parental and guardian support is important for young people who might be suffering from gender dysphoria. and who might want to access GAHT.

“Medical interventions are only one aspect of gender-affirming care for transgender youth. We also know that family acceptance of a young person’s gender identity is a major protective factor against mental health issues, ”said Turban, who was not affiliated with this research. “Much of the clinical work in this area involves helping families understand, support and validate their children’s experiences.

Turban told Healthline that in general, parental consent is required for a minor to access various gender-affirming medical interventions.

An adolescent who does not have this support from a parent or guardian is usually unable to access the care he or she needs.

What can a young person do who would like to access the GAHT but does not have this support?

“In general, adolescents cannot access gender-affirming medical care without parental support. Unfortunately, there is a lot of gender-affirming medical care misinformation, so many families never look up the initial conversations with a gender clinic to access specific information, ”Turban said.

He explained that it is important for families to know that “going to a gender clinic does not mean that a teenager will immediately start medical procedures”.

“Families often come to the clinic just to hear medically accurate information. This is vital given that there is so much misinformation online and in the media, ”Turban said.

Green said previous data revealed that many gender clinics and gender clinics tend to serve a higher proportion of white and non-binary transgender youth compared to youth of color.

These young people of color “tend to have more difficulty accessing care, which includes mental health and other health care,” Green said.

“There shouldn’t be a barrier to treatment that deals with one aspect of a person’s race and ethnicity, we shouldn’t see differences in terms of who can get care. The fact that we are doing this points to larger systemic issues in health care, ”she said.

“If you look at any of the data on COVID-19, for example, it really highlighted, both in mental health care and in health care in general, just how much communities of color have less access to health care and affordable health care. Unfortunately, this is a problem that we see playing out here. “

Turban said that “youth with intersectional identities” – think of transgender youth of color, for example – “have higher rates of mental health problems.”

This is because of what he calls the “multiple dimensions of stigma” that affect them.

Turban pointed to previous research that finds these trans youth of color are less likely to have access to gender-affirming medical care in general.

“Unfortunately, there are too few trained medical providers who are gender-affirming, especially for adolescents. This resulted in long clinic waiting lists – sometimes over a year. We desperately need medical schools and residences to improve education in this area, ”he said. “With 1.9% of adolescents with the United States identifying itself as transgender, it is inconceivable that so few doctors are trained to care for these young people.

When asked what the main takeaway from this study was, Green said people should understand that transgender and non-binary LGBTQ youth must have access to gender-affirming hormones if they want to.

She said this was crucial given that transgender and non-binary youth have “one of the highest risks for depression and suicide.”

“We should focus on finding ways to support these young people rather than ways to further contribute to stigma and rejection,” Green said. “Sadly, there are laws and policies being enacted or planned across the country that strive to remove some of the affirmative care for transgender and non-binary youth.”

She said data like this is important because it shows that for the majority of these young people, access to care like GAHT is associated with better mental health outcomes. Legislation designed to suppress access can have a negative impact on these young people.

The “negative rhetoric” swirling around this legislation can play a major role in these negative outcomes.

Turban echoed these thoughts.

“This study comes at a critical time as several states have introduced unscientific legislation that would limit access to gender-affirming medical care for transgender youth, despite opposition from all major medical organizations,” he said. he declares. “I hope this study will draw more attention to the dangerousness of this bill.”

About Christopher Johnson

Check Also

Resources on pronouns at UCCS – Le Scribe

For UCCS students, staff and faculty who have not yet learned the use of pronouns, …