Testosterone therapy reduces gender dysphoria, depression and suicidality in trans adults

Receiving rapid access to testosterone therapy reduced feelings of gender dysphoria and led to a clinically significant reduction in depression as well as a 50% reduction in suicidality among transgender and gender-diverse adults, according to research being presented Sunday at ENDO 2023, the Endocrine Society's annual meeting in Chicago, Ill.

This is the world-first randomized clinical trial supporting the significant benefits of testosterone in reducing gender dysphoria, depression and suicidality in trans individuals desiring commencement of testosterone."

Brendan Nolan, M.B.B.S., F.R.A.C.P., Ph.D. Candidate, University of Melbourne (Austin Health) in Melbourne, Australia

Gender dysphoria occurs when a person feels distressed that their gender identity does not align with the sex assigned at birth. When an individual's gender identity is not respected and the individual cannot access medical care, it can result in higher psychological problem scores and can raise the person's risk of committing suicide or other acts of self-harm.

Nolan and colleagues sought to understand the impact of testosterone therapy compared with no treatment on gender dysphoria, depression, and suicidality in trans adults seeking masculinization.

The three-month open-label randomized controlled trial included 64 transgender adults who were able to start testosterone therapy immediately (intervention group) compared with those who were on a standard waiting list of three months prior to beginning testosterone. The purpose of this segmentation was to ensure no person would have to prolong waiting to begin treatment beyond standard care practices.

People who were able to begin treatment immediately showed decreased gender dysphoria and a clinically significant decrease in depression and suicidal ideation compared with study participants on the waitlist.

Suicidal ideation resolved in 11 (52%) people with immediate testosterone therapy, compared with 1 (5%) given standard care, according to results from the Patient Health Questionnaire-9.

"Our findings illustrate the significant mental health benefits of early access to testosterone treatment and should provide an impetus for clinicians to ensure timely access to gender-affirming hormone therapy," Nolan said.