Mental Health Changes in US Transgender Adults Beginning Hormone Therapy Via Telehealth: Longitudinal Cohort Study.

IF 6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES Journal of Medical Internet Research Pub Date : 2025-02-14 DOI:10.2196/64017

Jae Downing Corman, Jaclyn M W Hughto, Theresa I Shireman, Kellan Baker, Kate Steinle, Michelle Forcier

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Abstract

Background: Gender-affirming hormone therapy (GAHT) has shown potential for improving mental health outcomes among transgender and gender-diverse adults. How clinical outcomes change among adults receiving GAHT via telehealth across the United States is not well known.

Objective: This study evaluated the relationship between initiating GAHT via a telehealth clinic and changes in depression, anxiety, and suicide ideation over a 3-month period.

Methods: This cohort study evaluated the relationship between initiating GAHT via a telehealth clinic and changes in mental health over a 3-month period. Data were collected at baseline and 3 months later among adults who had their first GAHT visit between August and November 2023. The study included adults aged 18 years and older initiating GAHT for the first time, with a final sample of 342 adults across 43 states (192 initiated estrogen and 150 initiated testosterone therapy). The primary outcomes were depression symptoms using the Patient Health Questionnaire-9 (PHQ-9), anxiety symptoms using the General Anxiety Disorder-7 (GAD-7), and suicide ideation in the past 2 weeks.

Results: Before GAHT initiation, 40% (136/342) of participants reported depression (PHQ-9 ≥10), 36% (120/342) reported anxiety (GAD-7 ≥8), and 25% (91/342) reported suicidal ideation. By follow-up, significant reductions were observed in PHQ-9 (-2.4, 95% CI -3.0 to -1.8) and GAD-7 scores (-1.5, 95% CI -2.0 to -1.0). Among those with elevated symptoms, 40% (48/120) to 42% (56/133) achieved a clinically meaningful response (≥50% reduction in baseline scores), and 27% (36/133) to 28% (33/120) achieved remission (PHQ-9 or GAD-7 score <5). Of those with suicide ideation at baseline, 60% (50/83) had none at follow-up.

Conclusions: This study highlights the important relationship between telehealth-delivered GAHT and mental health, emphasizing the importance of accessible and timely care.

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美国跨性别成人通过远程医疗开始激素治疗的心理健康变化：纵向队列研究

背景：性别确认激素疗法（GAHT）已显示出改善跨性别和性别多样化成年人心理健康结果的潜力。美国各地通过远程医疗接受GAHT治疗的成年人的临床结果如何变化尚不清楚。目的：本研究评估通过远程医疗诊所启动GAHT与3个月期间抑郁、焦虑和自杀意念变化之间的关系。方法：本队列研究评估了通过远程医疗诊所启动GAHT与3个月期间心理健康变化之间的关系。在基线和3个月后收集了在2023年8月至11月期间首次接受GAHT治疗的成年人的数据。该研究包括首次接受GAHT治疗的18岁及以上的成年人，最终样本来自43个州的342名成年人（192名接受雌激素治疗，150名接受睾酮治疗）。主要结局是患者健康问卷-9 （PHQ-9）中的抑郁症状，一般焦虑障碍-7 （GAD-7）中的焦虑症状，以及过去2周内的自杀意念。结果：在GAHT开始前，40%（136/342）的参与者报告抑郁（PHQ-9≥10），36%（120/342）的参与者报告焦虑（GAD-7≥8），25%（91/342）的参与者报告自杀意念。通过随访，观察到PHQ-9评分（-2.4,95% CI -3.0至-1.8）和GAD-7评分（-1.5,95% CI -2.0至-1.0）显著降低。在症状升高的患者中，40%（48/120）至42%（56/133）达到临床有意义的缓解（基线评分降低≥50%），27%（36/133）至28%（33/120）达到缓解（PHQ-9或GAD-7评分）。结论：本研究强调了远程医疗提供的GAHT与心理健康之间的重要关系，强调了可获得和及时护理的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Internet Research 医学-卫生保健

CiteScore

14.40

自引率

5.40%

发文量

654

审稿时长

1 months

期刊介绍： The Journal of Medical Internet Research (JMIR) is a highly respected publication in the field of health informatics and health services. With a founding date in 1999, JMIR has been a pioneer in the field for over two decades. As a leader in the industry, the journal focuses on digital health, data science, health informatics, and emerging technologies for health, medicine, and biomedical research. It is recognized as a top publication in these disciplines, ranking in the first quartile (Q1) by Impact Factor. Notably, JMIR holds the prestigious position of being ranked #1 on Google Scholar within the "Medical Informatics" discipline.