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Gender-affirming hormone therapy associated with lower suicide risk for trans youth, large-scale study finds

A flag denoting trans rights is seen drawn in chalk in this stock image (Pexels/Katie Rainbow) A flag denoting trans rights is seen drawn in chalk in this stock image (Pexels/Katie Rainbow)
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A new large-scale study has found that gender affirming hormone therapy can have life-saving benefits for transgender and non-binary youth, with those receiving it reporting lower suicidality and depression.

In the survey, which looked at more than 9,000 transgender and non-binary youth between the ages of 13 and 24, respondents reported a lower likelihood of suffering from recent depression and suicidal thoughts if they had received gender-affirming hormone therapy (GAHT) compared to those who wanted hormone therapy but had not received it.

For those under the age of 18, access to GAHT was associated with an almost 40 per cent lower chance of suffering from recent depression.

Those under 18 who had received GAHT were also nearly 40 per cent less likely to have had a suicide attempt in the past year compared to those who wanted hormones but had not received them.

Researchers said it is the first large-scale study to look at hormone therapy among transgender and non-binary 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,†Amit Paley, CEO and executive director of The Trevor Project, “It’s critical that all transgender and non-binary youth across the country have access to medical care that is affirming, patient-centered, and evidence-based.â€

The study was run by The Trevor Project, a non-profit focused on ending suicide among LGBTQ2S+ youth, and was

The study also highlighted the lack of access for many: half of the respondents said they had not yet received gender-affirming hormone therapy (GAHT), but wanted to.

Only 14 per cent said they were receiving GAHT, while 36 per cent stated they were not interested in receiving it.

Data was pulled from a larger survey run by the Trevor Project in 2020, which was filled out by more than 34,000 LGBTQ2S+ youth in the U.S. aged 13-24, including 11,914 transgender or non-binary youth.

Of those 11,914 participants, 9,019 answered questions about GAHT. Around 63 per cent of respondents aged 13-24 were non-binary, with trans men making up 29 per cent and trans women making up just eight per cent of the respondents.

Trans and non-binary youth were asked if they were currently taking gender-affirming hormones as part of their transition, and then were asked to report on depression and suicidal thoughts and behaviours.

Receiving GAHT was associated with a drop in depression – 61 per cent of those receiving GAHT reported experiencing recent depression, while 75 per cent of those still waiting for hormone therapy said they had experienced recent depression.

Those who received GAHT compared to those who wanted it were also less likely to have considered suicide in the past year. Fifteen per cent of those receiving GAHT had attempted suicide in the past year, compared to 23 per cent of those who wanted GAHT and had yet to receive it.

That 23 per cent means that more than 900 youth aged 13-24 who were still waiting to receive hormone therapy reported having attempted suicide in the past year.

When looking only at respondents under the age of 18, a little more than a quarter of those who still hadn’t received GAHT said they had attempted suicide in the past year.

The study noted that while trans and non-binary youth are “at elevated risk for depression,†this does not stem inherently from being transgender, but from the difficulties of existing in the world as a transgender person battling both dysphoria and the perceptions of others.

“Mental health disparities among transgender and non-binary youth stem from minority stress based on the harmful ways transgender and non-binary youth are treated by others,†the study stated.

“Feelings of gender dysphoria associated with incongruence between one's physical traits and gender identity are also associated with mental health challenges for transgender and non-binary youth.â€

Parental support was hugely important in accessing GAHT, the study found, with almost 80 per cent of those who received GAHT reporting that their parents supported their gender identity.

When it came to just those aged 13-17, 94 per cent who received GAHT had parental support.

A little more than a quarter of respondents who wanted GAHT but hadn’t received it said they were not out yet to their parents.

Those who had received GAHT were more likely to have received gender identity based abuse from others, at 62 per cent compared to 49 per cent of those who wanted GAHT but hadn’t received it.

One thing the Trevor Project noted in its release was that survey respondents living in the southern U.S. were less likely to have received GAHT despite wanting it, and that many southern states have, subsequent to the data collection for this survey, recently introduced legislation to

“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 non-binary youth — thereby working to improve mental health outcomes and prevent suicide,†Dr. Amy Green, VP of research at The Trevor Project, said in the release.

“[This] 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.†

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