Citation

Kuper LE, Stewart S, Preston S, Lau M, López X. Pediatrics 2020; 145(4): e20193006.

Copyright

(Copyright © 2020, American Academy of Pediatrics)

DOI

10.1542/peds.2019-3006

PMID

32220906

Abstract

OBJECTIVES: Our first aim was to examine baseline differences in body dissatisfaction, depression, and anxiety symptoms by gender, age, and Tanner (ie, pubertal) stage. Our second aim was to test for changes in youth symptoms over the first year of receiving gender-affirming hormone therapy. Our third aim was to examine potential differences in change over time by demographic and treatment characteristics. Youth experiences of suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) are also reported.
METHODS: Participants (n = 148; ages 9-18 years; mean age 14.9 years) were receiving gender-affirming hormone therapy at a multidisciplinary program in Dallas, Texas (n = 25 puberty suppression only; n = 123 feminizing or masculinizing hormone therapy). Participants completed surveys assessing body dissatisfaction (Body Image Scale), depression (Quick Inventory of Depressive Symptoms), and anxiety (Screen for Child Anxiety Related Emotional Disorders) at initial presentation to the clinic and at follow-up. Clinicians completed the Quick Inventory of Depressive Symptoms and collected information on youth experiences of suicidal ideation, suicide attempt, and NSSI.
RESULTS: Affirmed males reported greater depression and anxiety at baseline, but these differences were small (P <.01). Youth reported large improvements in body dissatisfaction (P <.001), small to moderate improvements in self-report of depressive symptoms (P <.001), and small improvements in total anxiety symptoms (P <.01). No demographic or treatment-related characteristics were associated with change over time. Lifetime and follow-up rates were 81% and 39% for suicidal ideation, 16% and 4% for suicide attempt, and 52% and 18% for NSSI, respectively.
CONCLUSIONS: Results provide further evidence of the critical role of gender-affirming hormone therapy in reducing body dissatisfaction. Modest initial improvements in mental health were also evident.

Language: en

Keywords

Humans; Child; Female; Male; Adolescent; Anxiety; Depression; Age Factors; Sex Factors; Self-Injurious Behavior; Suicidal Ideation; Suicide, Attempted; Mental Health; Self Report; Puberty; Sexual Behavior; Panic Disorder; Gender Dysphoria; Transgender Persons; Symptom Assessment; Sex Reassignment Surgery; Body Dissatisfaction