Growing Evidence and Remaining Questions in Adolescent Transgender Care

This editorial discusses the findings of a study by Chen et al. (2023) involving 315 transgender adolescents treated with gender-affirming hormones (GAH) over 24 months. Results showed improvements in appearance congruence, positive affect, life satisfaction, and reductions in depression and anxiety, supporting the efficacy of GAH. However, variability in outcomes persisted, with some participants still experiencing mental health challenges, including two suicides. The study highlights the mediating role of bodily changes in psychological outcomes but leaves gaps regarding mental health care integration and social determinants (e.g., family support, autism spectrum disorder). Concerns about detransitioning were noted, with 2.9% discontinuing GAH, though reasons remain unclear. The authors emphasize the need for further research on long term effects (e.g., bone/brain development, fertility) and cross cultural validation of the Dutch model. Despite uncertainties, the study reinforces GAH’s benefits for mental health in transgender youth, advocating for continued multidisciplinary care while addressing remaining questions.

This editorial discusses the findings of a study by Chen et al. (2023) involving 315 transgender adolescents treated with gender-affirming hormones (GAH) over 24 months. Results showed improvements in appearance congruence, positive affect, life satisfaction, and reductions in depression and anxiety, supporting the efficacy of GAH. However, variability in outcomes persisted, with some participants still experiencing mental health challenges, including two suicides. The study highlights the mediating role of bodily changes in psychological outcomes but leaves gaps regarding mental health care integration and social determinants (e.g., family support, autism spectrum disorder). Concerns about detransitioning were noted, with 2.9% discontinuing GAH, though reasons remain unclear. The authors emphasize the need for further research on long term effects (e.g., bone/brain development, fertility) and cross cultural validation of the Dutch model. Despite uncertainties, the study reinforces GAH’s benefits for mental health in transgender youth, advocating for continued multidisciplinary care while addressing remaining questions.