Table 2.
Summary of studies of effect of hormonal treatment on mental health in gender dysphoria
| Study | Aim of study | Population receiving CSHT | Age (years), mean ± SD | Sample (N) | Assessment instrument(s) | Type of assessment(s) | Results |
|---|---|---|---|---|---|---|---|
| Bonierbale et al42 | Effect of CSHT on personality traits | 37 MtF and 15 FtM | Median: 31, range: 18–58 (age at assessment; age information regarded both GID individuals with and without CSHT) | 106 | MMPI-2 | Self-reported | Lower psychopathology in CSHT adults |
| Bouman et al38 | Effect of CSHT on anxiety, depression, self-esteem, and interpersonal functioning | 38 MtF | MtF: 58.03±5.87 (age at the assessment) | 71 | HADS, RSE, and IIP-32 | Self-reported | Lower anxiety, higher level of self-esteem, less problems with socialization, and interpersonal functioning in CSHT MtF; no effect of CSHT on depression |
| Colizzi et al45 | Effect of CSHT on dissociative symptoms | 82 MtF and 36 FtM | MtF: 30.41±9.77; FtM: 29.81±6.39 (ages at onset of CSHT and at study recruitment were the same) | 118 | DES | Self-reported | Lower dissociative symptoms after CSHT with levels lower than that found in general population |
| Colizzi et al37 | Effect of CSHT on anxiety, depression, psychopathological symptoms, and functional impairment | 78 MtF and 29 FtM | MtF: 29.25±7.27; FtM: 29.08±8.48 (ages at onset of CSHT and at study recruitment were the same) | 107 | SAS, SDS, SCL-90-R, and SCID-I | Self-reported and clinical interview | Lower anxiety, depression, psychopathological symptoms, and functional impairment after CSHT |
| Fisher et al39 | Effect of CSHT on body uneasiness and psychopathological symptoms | 42 MtF and 26 FtM | MtF: 33.1±10.25; FtM: 28.7±6.5 (age information regarded both GID individuals with and without CSHT) | 125 | BUT and SCL-90-R | Self-reported | Lower body uneasiness only in CSHT MtF adults and positive effect of cumulative dose of estradiol on body uneasiness reduction; no effect of CSHT on psychopathological symptoms |
| Gómez-Gil et al44 | Effect of CSHT on mental health quality of life | 120 GID adults | 31.2±9.9 (age at assessment; age information regarded both GID individuals with and without CSHT) | 193 | WHOQOL-BREF | Self-reported | Higher social and psychological quality of life in CSHT adults |
| Heylens et al40 | Effect of CSHT on psychopathological symptoms | 46 MtF and 11 FtM | Not mentioned | 57 | SCL-90-R and psychosocial questionnaire | Self-reported | Lower psychopathological symptoms after CSHT with levels similar to general population; no effect of CSHT on psychosocial parameters |
| Colizzi et al14 | Effect of CSHT on perceived stress | 45 MtF and 25 FtM | MtF: 29.25±9.87; FtM: 26.78±8.09 (ages at onset of CSHT and at study recruitment were the same) | 70 | PSS | Self-reported | Lower perceived stress after CSHT with levels similar to normative samples |
| Gorin-Lazard et al36 | Effect of CSHT on self-esteem, depression, quality of life, and global functioning | 29 MtF and 20 FtM | 35.1±10.2 | 67 | SSEI, BDI, SQUALA, and GAF | Self-reported | Higher self-esteem and quality of life and lower depressive symptoms in CSHT adults; no effect of CSHT on global functioning |
| Gómez-Gil et al35 | Effect of CSHT and its duration on social distress, anxiety, and depression | 84 MtF and 36 FtM | 24.6±8.1 (at onset of CSHT); 33.6±9.1 (at study recruitment) | 187 | SADS and HADS | Self-reported | Lower social distress, anxiety, and depression in CSHT adults; no effect of CSHT duration on these parameters |
| Gorin-Lazard et al43 | Effect of CSHT on mental health-related quality of life | 25 MtF and 19 FtM | MtF: 39.4±9.8; FtM: 29.9±8.4 (age information regarded both GID individuals with and without CSHT) | 61 | SF-36 | Self-reported | Higher emotional, social, and mental quality of life in CSHT adults, with higher mental health-related quality of life than in non-GID controls |
| Gómez-Gil et al41 | Effect of CSHT on personality traits | 69 MtF and 10 FtM | MtF: 29.9±9; FtM: 27.6±7.5 (age at assessment; age information regarded both GID individuals with and without CSHT) | 163 | MMPI-2 | Self-reported | Lower psychopathology in CSHT MtF adults; no effect of CSHT in FtM |
| Miles et al29 | 1. Effect of CSHT on mood states | 1. 27 MtF | 1. 37.07±8.68 | 103 | POMS | Self-reported | 1. Higher confidence and composure in CSHT MtF adults |
| 2. Effect of CSHT withdrawal on mood states | 2. 27 MtF | 2. 39.63±9.68 | 2. No effect | ||||
| 3. Effect of CSHT duration on mood states | 3. 20 MtF | 3. 40.30±7.50 | 3. No effect | ||||
| 4. Effect of CSHT on mood states | 4. 74 MtF | 4. X | 4. Higher confidence and composure in CSHT MtF adults | ||||
| Newfield et al24 | Effect of CSHT and its duration on mental health-related quality of life | 248 FtM | FtM: 32.6±10.8 (age at assessment; age information regarded both GID individuals with and without CSHT) | 365 | SF-36 | Self-reported | Higher emotional, social, and mental quality of life in CSHT FtM adults, with CSHT duration associated with higher emotional quality of life |
| Slabbekoorn et al31 | Effect of CSHT on emotional functioning, affect intensity, anger readiness, nonverbal emotional expressiveness, and mood states | 54 MtF and 47 FtM | MtF: 32.9±10.8; FtM: 25.7±7.5 (ages at onset of CSHT and at study recruitment were the same) | 101 | ELOMS, AIM, ASQ, ACT, and PAF | Self-reported | Higher positive emotions, affect intensity, anger readiness, and emotional expressiveness in MtF after CSHT; higher aggressive emotions and anger readiness, and lower affect intensity in FtM after CSHT; and no effect of CSHT on mood in FtM adults |
| Blanchard et al34 | Effect of CSHT on psychological (depression and tension) and social (cohabitation and involvement) adjustment | 34 MtF | 27.9±8.8 (age at assessment; age information regarded both GID individuals with and without CSHT) | 55 | Annual questionnaire and MMPI | Self-reported | No effect of CSHT on psychological and social adjustment |
| Leavitt et al30 | Effect of CSHT and its duration on personality traits | 22 MtF | 26.6±3.6 | 41 | MMPI | Self-reported | Lower psychopathology in CSHT MtF adults with scores tending to approximate the norms for male populations; positive effect of CSHT duration on psychopathology reduction |
Note: N, entire sample involved in the study.
Abbreviations: AIM, affect intensity measure; ACT, affective communication test; ASQ, short anger situation questionnaire; BDI, Beck Depression Inventory; BUT, body uneasiness test; CSHT, cross-sex hormonal treatment; DES, Dissociative Experiences Scale; ELOMS, expectancy list of mood and sexual interest; FtM, female-to-male; GAF, Global Assessment of Functioning scale; GID, gender identity disorder; HADS, Hospital Anxiety and Depression Scale; IIP-32, Inventory of Interpersonal Problems-32; MMPI-2, Minnesota Multiphasic Personality Inventory-2; MtF, male-to-female; PAF, premenstrual assessment form; POMS, Profile of Mood States; PSS, Perceived Stress Scale; RSE, Rosenberg Self-Esteem Scale; SADS, Social Anxiety and Distress Scale; SAS, Zung Self-rating Anxiety Scale; SCL-90-R, Symptom Checklist-90-R; SCID-I, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders I; SDS, Zung Self-rating Depression Scale; SSEI, Social Self-Esteem Inventory; SF-36, Short Form (36) Health Survey; SQUALA, Subjective Quality of Life Analysis; WHOQOL-BREF, World Health Organization Quality of Life-shorter version; “X”, not mentioned.