7830 Gender-Affirming Hormone Therapy Improves Levels of Depression in Transgender Individuals Within the First Year of Treatment

Abstract

Disclosure: C.M. Godar: None. S.C. De La Torre: None. M.K. Shakir: None. T.D. Hoang: None.

Introduction: High rates of depression and suicidality are known threats to the health of transgender individuals in the United States. Epidemiologic studies report depression rates as high as 69% of the transgender population. Nearly 40% of the trans population has a history of suicide attempt, which is 8 times that of the general US population. Initiation of gender-affirming hormone therapy (GAHT) is a life-saving intervention that improves gender dysphoria and the overall health status of patients who choose this therapy. In this study we apply a validated metric, the Beck Depression Inventory (BDI), to demonstrate the mental health benefits of GAHT in transgender people. Methods: A prospective study of 31 transgender patients was approved by IRB at an academic medical center. 18 transgender females and 13 transgender males completed the BDI prior to initiation of GAHT and again after one year of GAHT use. The BDI is a 21-item self-reported questionnaire that is scored to identify levels of depression. Depression levels are stratified as normal (1-10 levels), mild mood disturbance (11-16 levels), borderline clinical depression (17-20 levels), moderate depression (21-30 levels), severe depression (31-40 levels), or extreme depression (>40 levels). Median scores for baseline and 12-month data were analyzed for total population and male and female subgroups. Results: In the total study population, an average BDI score of 11 at baseline (range 0-32) improved to average score of 8 after 1 year of GAHT (range 0-28). Average BDI for transgender females was at 10.5 at baseline and 7.4 at 1 year. Average BDI for transgender males was 10.7 at baseline and 7.7 at 1 year. Transgender females reported increased crying (question 10), and transgender males reported increased irritability (question 11) at 1 year. Both genders report increased satisfaction with life, interest in others, physical appearance, and sleep quality. Both genders report slight decrease of suicidal ideation (average BDI 0.9 decreased to 0.1 for question 9) though with no decrease in median BDI score. Discussion: Uninterrupted access to GAHT is critical to the well-being of transgender individuals. GAHT use improves depression by about 3 levels as demonstrated above and is one component of a holistic treatment approach to include behavioral health therapy, gender-affirming surgeries, and speech therapy to improve gender dysphoria and overall quality of life. Regular behavioral health follow-up is important to support at-risk patients through gender transition. BDI is a simple, open-access tool to screen for depression and expedite behavioral health treatment for this vulnerable population.

Presentation: 6/2/2024