Table 3C.
Summary of findings on mental health outcomes of GnRHa treatment in TGD adolescents. Only studies with moderate-high level quality of evidence are reported.
| Reference | Design/Population | Intervention (duration) | Global function/Cognition behavioral and emotional problems | Suicide ideation | Depression/Anxiety | QoL/wellbeing | Body Dissatisfaction |
|---|---|---|---|---|---|---|---|
| Achille 2020 (24) | P/50 (17 AMAB, 33 AFAB) |
GnRHa (18 m) and/or GAHT |
N/A | ↓ | ↓ | ↑ QoL | N/A |
| Arnoldussen 2022 (25) | R/72 (27 AMAB, 45 AFAB) |
GnRHa (2,4 y) and/or GAHT |
The IQ scores and educational achievement were not significantly different between AMAB and AFAB | N/A | N/A | N/A | N/A |
| Costa 2015 (26) | P/201 (77 AMAB; 124 AFAB) |
GnRHa (18m) + psychological support |
GD adolescents receiving also GnRHa had > psychosocial functioning (+12m) | N/A | N/A | ↑ well-being | N/A |
| De Vries 2011 (27) | P/70 (33 AMAB, 37 AFAB) |
GnRHa (2 y) | ↓behavioral and emotional problems, depressive symptoms ↑ psychological functioning |
N/A | ↓/= | N/A | = Body image and gender dysphoria (> natal female) |
| De Vries 2014 (28) | P/55 (22 AMAB, 33 AFAB) |
GnRHa (N/A) | ↑ psychological functioning | N/A | ↓ | ↑ QoL | ↓ |
| Fisher 2024 (4) | P/36 (14 AMAB, 22 AFAB) | GnRHa (3-12 m) | ↑ psychological functioning | ↓ | ↓ | N/A | ↓ |
| Tordoff 2022 (29) | P/104 (27 AMAB, 63 AFAB, 10 NB, 4 unknown) |
GnRHa (N/A) + GAHT |
N/A | ↓ (PS and GAH) | ↓ (PS and GAH) | N/A | N/A |
| Van der Miesen 2020 (30) | P/178 (68 AMAB, 110 AFAB) |
GnRHa (N/A) vs no treatment |
N/A | ↓ | ↓ | N/A | N/A |
AFAB, assigned female at birth; AMAB, assigned male at birth; NB, non-binary; P, prospective; QoL, quality of life; R, retrospective; TGD, transgender and gender-diverse.Arrow down: reduced; Arrow up: increased.