Amid Attacks on Care for Trans Youth, New Study Confirms Why It's Life or Death

Researchers say it points to the growing scientific conclusion that “gender affirming care is life saving care.”
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A new study has once again demonstrated the positive mental health effects of giving trans youth access to puberty blockers and hormones, adding to the ever-growing pile of evidence in favor of such life-saving medical interventions.

The study, published in the American Medical Association’s monthly open-access journal, examined changes in mental health outcomes among a cohort of trans youth in the first year after treatment was initiated. Participants who had received puberty blockers, hormone therapy, or both were 60% less likely to report being moderately to severely depressed and 73% less likely to report suicidality, compared to participants who did not.

Conversely, depressive symptoms and suicidality were “two-fold to three-fold higher than baseline levels” for youth who were not able to begin gender-affirming care at three and six months, respectively. Interestingly, researchers did not observe an association between anxiety levels and the reception of gender-affirming care, suggesting that anxiety symptoms may take longer to resolve than depression and suicidiality.

The researchers surveyed 104 patients, aged 13 to 20, receiving care at the Seattle Children’s Gender Clinic, using standard screenings for depression and anxiety. The participants completed a baseline survey within 24 hours of initiating treatment, with follow up surveys conducted at three, six, and 12 months after care began to track changes in their mental health over time.

As one might expect, a large proportion of participants reported a moderate to severe baseline of depression (56.7%) and anxiety (50%). Additionally, 43.3% of participants reported self-harm or suicidal thoughts in the past two weeks at the time of the baseline survey. Because trans youth are, at baseline, such a high-risk group, “understanding the immediate aftermath of initiation of this care has great implications for the holistic treatment that they have to have in order to be adequately supported at the initiation of transition, which is just itself an incredibly stressful time,” according to Arin Collin, a medical student at the University of Washington who assisted with the study.

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Rates of depression and suicidality were lower for youth who accessed affirming care.

While other studies have examined the long-term mental health impacts that gender-affirming healthcare can have for trans youth, this study is one of a growing number to confirm that access to puberty blockers and hormones could be a highly effective way to improve mental health outcomes in a relatively short period of time.

Conversely, the study also demonstrates how “delays in access to care really negatively impact people's well being and mental health,” according to Diana M. Tordoff, a PhD candidate at the University of Washington and study author — findings that hold special significance, given the nationwide assault on trans healthcare.

Last week, Texas governor Greg Abbott’s directive to prosecute gender affirming care for minors as “child abuse” provoked nationwide outrage, as did Florida’s so-called “Don’t Say Gay” bills, which bar discussion of LGBTQ+ identities from classrooms and would force teachers to out their students. It’s worth noting that at least 14 other states have also introduced legislation this year that seeks to criminalize care for trans youth, with several states scheduling hearings for such bills this week.

Collin and Tordoff say that their research points to the growing scientific conclusion that “gender affirming care is life saving care.”

“A preponderance of data shows that access to care will allow folks who would otherwise die to live not just a life, but to participate fully in society and live a full life in a way that most of us can take for granted,” says Collin.

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