Gender-affirming surgeries reduce mental health treatment in transgender population

Transgender individuals who receive gender-affirming surgeries are less likely to require mental health treatment, according to the first total population study of transgender individuals with a gender incongruence diagnosis published in The American Journal of Psychiatry.

Bränström and colleagues used the Swedish Total Population Register to find individuals who received a diagnosis of gender incongruence between 2005 and 2015. The outcome measures were psychiatric outpatient health care visits, antidepressant and anxiolytic prescriptions and hospitalization after a suicide attempt in 2015.

Nearly 48% of those with a diagnosis of gender incongruence had received gender-affirming surgical treatments during follow-up periods. Of those who underwent gender-affirming surgery, 97% received prescriptions for hormone treatment.

The researchers found that individuals with a gender incongruence diagnosis were about six times more likely than the general population to have a mood and anxiety disorder health care visit, three to four times more likely to receive prescriptions for antidepressants and anxiolytics and six times more likely to be hospitalized after a suicide attempt.

According to Bränström and colleagues, the study examined years since hormone treatment in these individuals and years since last gender-affirming surgery to compare likelihood of outcome measures. The likelihood of being treated for a mood or anxiety disorder reduced by 8% for each year since last gender-affirming surgery and hospitalization after a suicide attempt lowered. Among individuals who received gender-affirming surgery more than 3 years prior, no suicide attempts were recorded.

The authors hypothesized that ensuring access to transgender-affirming mental health care might also reduce transgender individuals’ psychiatric risk.

“These findings begin to answer the call for population-based documentation of transgender health and extend earlier evidence of associations between gender-afrming treatment and improved mental health mostly derived from studies utilizing cross-sectional designs or short follow-up periods, self-reported exposures and outcomes and small nonprobability samples,” the researchers wrote. –by Erin T. Welsh

Disclosure: Bränström reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.