As we saw in How Can Therapists and Parents Support Transgender Teenagers? There are high rates of suicide, self-harm and depression in transgender youth. One of the ways to decrease these awful mental health outcomes is medical transitioning, where transgender youth transition from the gender they were assigned at birth to their affirmed gender by developing the characterised physical features of their affirmed gender. An effective way of medical transitioning is by Hormone Replacement Therapy because masculine hormones can make fat move away from the hips and thighs and deepen the voice. Whereas feminine hormones can make body fat move towards the hips and thighs and lead to the development of breasts. However, Hormone Replacement Therapy focuses on physical benefits for transgender youth, and yet this is a psychology podcast and I am a firm believer in the biopsychosocial model. Therefore, in this biological psychology podcast episode, we’re going to be investigating the psychological benefits of Hormone Replacement Therapy on transgender youth. This is going to be a lot of fun. If you enjoy learning about how hormones affect our behaviour, mental health and self-image, then you’ll love today’s episode.
Today’s podcast episode has been sponsored by Biological Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also, you can buy the eBook directly from me at https://www.payhip.com/connorwhiteley
How Hormone Replacement Therapy Improves Physical and Social Wellbeing?
The main piece of research we’ll be using for this podcast episode comes from Doyle et al. (2023) because they did a large meta-analysis that got data from 46 journal articles. These articles were based on interviews with people who had taken hormones and people that hadn’t, as well as analyses of people taking hormones over longer periods of time.
The research clearly shows that gender-affirming hormone therapy reduces depressive symptoms as well as psychological distress in transgender people. Also, what I find really interesting is that the research shows that hormone therapy helps transgender people improve in key areas of psychosocial functioning. Mainly in trust and self-control.
Furthermore, the researchers noted that hormone therapy mostly leads to a decrease in distress in transgender people and doesn’t necessarily lead to an increase in positive emotion states. In other words, hormone replacement therapy leads to a decrease in depression, isolation and sadness and doesn’t really promote feelings of positivity.
Which I think is an idea finding because I don’t think hormone replacement therapy needs to promote positive feelings as that will be a byproduct anyway of the process. For example, if you have depression, sadness and you’re isolated and hormone replacement therapy reduces those symptoms then you’re going to feel better anyway. And I’ve talked to my trans friend a lot and they always tell me how much better they feel after starting hormone therapy.
In addition, Doyle et al. (2023) doesn’t provide a clear explanation of why these benefits happen. We aren’t sure if this has something to do with chemical changes in the brain or from improved body image or a mixture of the two. Personally, from everyone I’ve heard from trans people, it mainly comes from their improved body image and they feel a lot more comfortable in their own skin. But of course, there are going to be other factors as well at play.
When it comes to improvements in quality of life, there is some evidence of this but these results are complicated by the emotional changes that occur during hormone therapy. For instance, in a lot of studies where participants are taking masculinising hormones, these hormones tend to decrease emotions whereas feminising hormones tend to increase emotions in participants. Since participants on feminising hormones report emotional imbalances, increased emotional expressions and mood swings.
Moreover, there is no clear way to tell how existing gender stereotypes affect people taking gender-affirming hormone therapy. Yet researchers do know that these factors do impact the participant’s report on their overall quality of life.
Finally, whilst Doyle et al. (2023) has some strong conclusions about the benefits of gender-affirming hormone therapy, there are gaps in the literature too. Since it is difficult to get control groups of a good size for randomised, controlled studies as well as study sizes tend to be small. Yet I personally think that is mainly because the transgender community is so, so tiny compared to the rest of the population. Also, the data could be skewed by the studies using a volunteer sample of transgender people, instead of other more representative or stratified samples.
Biological Psychology Conclusion
At the end of this biological psychology podcast episode, the takeaway message is very clear. Hormone therapy for transgender people decreases psychological distress, depression and it improves lives. As well as this is even more important when we consider depression plays a major role in self-harm and suicide behaviour that is scarily common in the transgender community. And thanks to Doyle et al. (2023), we now understand that hormone therapy helps transgender people a lot and it might very well save their lives.
Therefore, whilst there are gaps in the literature, and let me just say there are gaps in all academic literature, it is research that proves and supports the importance of this life-saving and life-affirming therapy for transgender people.
I know in the USA in particular there are a lot of laws going through at the moment in the year of writing this episode in 2023, that aim to restrict gender-affirming medical practice. I’ve seen some funny reasons given including how banning gender-affirming medical practices will help people and improve lives.
That is a lie and Doyle et al. (2023) proves that.
Banning transgender medical care will not help anyone, but it will lead to increased rates of depression, isolation and sadness. And then that will have a knock-on effect on increased rates of self-harm and suicide so let’s not allow life-saving medical care to be banned because this episode shows us, physical healthcare can have massive benefits for our physical and mental health.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Biological Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also, you can buy the eBook directly from me at https://www.payhip.com/connorwhiteley
Have a great day.
Clinical Psychology References
Doyle, D. M., Lewis, T. O., & Barreto, M. (2023). A systematic review of psychosocial functioning changes after gender-affirming hormone therapy among transgender people. Nature Human Behaviour, 1-12.
Eisenberg, M. E., Gower, A. L., McMorris, B. J., Rider, G. N., Shea, G., & Coleman, E. (2017). Risk and protective factors in the lives of transgender/gender nonconforming adolescents. Journal of Adolescent Health, 61(4), 521-526.
Eisenberg, M. E., Gower, A. L., McMorris, B. J., Rider, G. N., Shea, G., & Coleman, E. (2017). Risk and protective factors in the lives of transgender/gender nonconforming adolescents. Journal of adolescent health, 61(4), 521-526.
http://transpulseproject.ca/wp-content/uploads/2012/10/Impacts-of-Strong-Parental-Support-for-Trans-Youth-vFINAL.pdf
Iverson, Jo. (2020). Once A Girl, Always A Boy. Berkeley, CA: She Writes Press
Perez-Brumer, A., Day, J. K., Russell, S. T., & Hatzenbuehler, M. L. (2017). Prevalence and correlates of suicidal ideation among transgender youth in California: findings from a representative, population-based sample of high school students. Journal of the American Academy of Child & Adolescent Psychiatry, 56(9), 739-746.
SANSFAÇON, A. P., GELLY, M. A., FADDOUL, M., & LEE, E. O. J. (2020). Parental support and non-support of trans youth: towards a nuanced understanding of forms of support and trans youth's expectations. Enfances, Familles, Generations, (36).
Seibel, B. L., de Brito Silva, B., Fontanari, A. M., Catelan, R. F., Bercht, A. M., Stucky, J. L., ... & Costa, A. B. (2018). The impact of the parental support on risk factors in the process of gender affirmation of transgender and gender diverse people. Frontiers in psychology, 9, 399.
Veale, J. F., Watson, R. J., Peter, T., & Saewyc, E. M. (2017). Mental Health Disparities Among Canadian Transgender Youth. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 60(1), 44–49. https://doi.org/10.1016/j.jadohealth.2016.09.014
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