Gender-Affirming Hormone Use in Transgender Individuals: Impact on Behavioral Health and Cognition

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Abstract

With increasing numbers of transgender and gender non-binary individuals presenting for care, knowing how to elucidate the mental health and cognitive outcomes of gender-affirming hormone therapy (GAHT) is necessary. This article reviews the present literature covering GAHT effects on mood, behavioral health, and cognition in these individuals and offers research priorities to address knowledge gaps.

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Young adult psychological outcome after puberty suppression and gender reassignment.

Peggy Cohen-Kettenis, Annelou L C de Vries, Jenifer K McGuire … (2014)

In recent years, puberty suppression by means of gonadotropin-releasing hormone analogs has become accepted in clinical management of adolescents who have gender dysphoria (GD). The current study is the first longer-term longitudinal evaluation of the effectiveness of this approach.

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Transgender Population Size in the United States: a Meta-Regression of Population-Based Probability Samples

Jae Sevelius, Esther Meerwijk (2017)

Background. Transgender individuals have a gender identity that differs from the sex they were assigned at birth. The population size of transgender individuals in the United States is not well-known, in part because official records, including the US Census, do not include data on gender identity. Population surveys today more often collect transgender-inclusive gender-identity data, and secular trends in culture and the media have created a somewhat more favorable environment for transgender people. Objectives. To estimate the current population size of transgender individuals in the United States and evaluate any trend over time. Search methods. In June and July 2016, we searched PubMed, Cumulative Index to Nursing and Allied Health Literature, and Web of Science for national surveys, as well as “gray” literature, through an Internet search. We limited the search to 2006 through 2016. Selection criteria. We selected population-based surveys that used probability sampling and included self-reported transgender-identity data. Data collection and analysis. We used random-effects meta-analysis to pool eligible surveys and used meta-regression to address our hypothesis that the transgender population size estimate would increase over time. We used subsample and leave-one-out analysis to assess for bias. Main results. Our meta-regression model, based on 12 surveys covering 2007 to 2015, explained 62.5% of model heterogeneity, with a significant effect for each unit increase in survey year ( F = 17.122; df = 1,10; b = 0.026%; P = .002). Extrapolating these results to 2016 suggested a current US population size of 390 adults per 100 000, or almost 1 million adults nationally. This estimate may be more indicative for younger adults, who represented more than 50% of the respondents in our analysis. Authors’ conclusions. Future national surveys are likely to observe higher numbers of transgender people. The large variety in questions used to ask about transgender identity may account for residual heterogeneity in our models. Public health implications. Under- or nonrepresentation of transgender individuals in population surveys is a barrier to understanding social determinants and health disparities faced by this population. We recommend using standardized questions to identify respondents with transgender and nonbinary gender identities, which will allow a more accurate population size estimate.

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The new science of cognitive sex differences.

Elkan F. Halpern, Samuel Miller (2013)

Surprising new findings indicate that many conclusions about sex differences and similarities in cognitive abilities need to be reexamined. Cognitive sex differences are changing, decreasing for some tasks whereas remaining stable or increasing for other tasks. Some sex differences are detected in infancy, but the data are complex and depend on task characteristics. Diverse disciplines have revolutionized our understanding of why these differences exist. For instance, fraternal-twin studies align with earlier literature to help establish the role of prenatal androgens and large international datasets help explain how cultural factors such as economic prosperity and gender equity affect females and males differently. Understanding how biological and environmental factors interact could help maximize cognitive potential and address pressing societal issues. Copyright © 2013 Elsevier Ltd. All rights reserved.