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Better mental health found among transgender people who started hormones as teens

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Story at a glance

  • New research suggests beginning gender-affirming hormone treatment in adolescence is associated with better mental outcomes for trans adults.
  • Odds of severe psychological distress were reduced by 222 percent, 153 percent, and 81 percent for those who began hormones in early adolescence, late adolescence and adulthood, respectively, according to the study.
  • More than 20 states last year introduced bills to restrict access to gender-affirming care for trans youth, and at least 22 anti-trans bills have been introduced in 2022.

Beginning gender-affirming hormone treatment in adolescence has been linked to better mental health outcomes for transgender adults, according to new research.

Drawing on data collected in 2015 from more than 27,000 transgender adults in the U.S., researchers found that those who had begun hormone treatment in adolescence were less likely to experience major mental health disorders or abuse drugs or alcohol than those who started treatment in adulthood.

Better mental health outcomes were also recorded among trans adults who had received gender-affirming hormone treatment at any age compared to those who desired treatment but were never able to receive it.

Odds of severe psychological distress were reduced by 222 percent, 153 percent, and 81 percent for those who began hormones in early adolescence, late adolescence and adulthood, respectively, according to the study. Odds of previous-year suicidal ideation were 135 percent lower in people who began hormones in early adolescence, 62 percent lower in those who began in late adolescence, and 21 percent lower in those who began as adults.


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“This study is particularly relevant now because many state legislatures are introducing bills that would outlaw this kind of care for transgender youth,” Jack Turban, a postdoctoral scholar in pediatric and adolescent psychiatry at Stanford Medicine and the study’s lead author, said in a news release. “We are adding to the evidence base that shows why gender-affirming care is beneficial from a mental health perspective.”

More than 20 states last year introduced bills to restrict access to gender-affirming care for trans youth, according to the American Civil Liberties Union. Only one state — Arkansas — passed a law prohibiting doctors from providing transgender minors with gender-affirming care, including puberty blockers and hormones.

Less than a month into the 2022 legislative session, at least 22 anti-trans bills have been introduced.

In a recent poll released by the Trevor Project, an LGBTQ+ youth suicide prevention and crisis intervention group, more than 60 percent of LGBTQ+ youth said their mental health has deteriorated due to recent efforts to limit the rights of transgender and nonbinary people.

Another recent Trevor Project study found that receiving gender-affirming hormone therapy significantly reduces the risk of suicide and depression in transgender youth.

Still, in the PLOS One study, some transgender adults said they did not want hormone treatment.

“There’s no one correct way to be transgender,” Turban said.

Trans youth seeking out care are routinely offered counseling as part of their treatment to help them determine what types of care best fit their needs. For those who opt to receive gender-affirming hormones, being denied access to that treatment can cause significant distress, Turban said.

“For some transgender youth, their negative reactions to living in bodies that develop during puberty in ways that don’t match who they know themselves to be can be very damaging,” he said, noting that individuals who feel uncomfortable developing breasts may bind their chests so tightly they develop skin infections or even rib fractures.

“These results won’t be surprising to providers, but unfortunately a lot of legislators have never met any transgender youth,” Turban said. “It’s important for legislators to see the numbers that back up the experiences of transgender youth, their families and the people who work in this field.”


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