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A journal club style critical review of current publications in evidence-based transgender medical care.

Monday, January 2, 2012

Hormone-treated transsexuals report less social distress, anxiety and depression

     Cross sectional, descriptive study of transsexuals in Spain suggests that cross-sex hormone therapy reduces symptoms of anxiety and depression, as well as social anxiety. (1)

     Most studies of the efficacy of trans related medical practices on reducing anxiety and depression have focused on surgical procedures.  Limited quantitative data exist on the role cross-sex hormone therapy (csHT) may play in reducing anxiety and depression independent of surgical interventions (THJC Nov 5, 2011).  This team of investigators at a single gender specialty center in Barcelona, Spain conducted a cross sectional, descriptive study of measures of anxiety, depression and social anxiety in 120 FTM and MTF transsexuals currently receiving csHT and 67 on a waiting list who were not yet treated.  Social anxiety was measured using the Social Anxiety and Distress Scale (SADS) and anxiety and depression were measured using the Hospital Anxiety and Depression Scale, both of which have been validated in Spanish.

     Results demonstrated that csHT was assosciated with lower scores of anxiety and depression as well as social anxiety.  A subgroup analysis of transsexuals on csHT who had also had a surgical intervention vs. those who had not showed no difference in scores on any of the scales.  Interestingly, scores of anxiety and depression as well as social anxiety were within control ranges across all respondent groups.


     That csHT independent of surgical status is associated with reduced symptoms of anxiety and depression and social anxiety is no surprise to clinicians experienced in working with transsexuals.  More longitudinal study in this area is important since in many cultures and settings csHT is the only intervention that is available or desired.  It is interesting that transsexuals both pre- and receiving csHT had anxiety, depression and social anxiety scores within the control ranges;  While this might be the case in this population in Barcelona, a liberal city in a nation with a strong environment of LGBT rights and government-funded trans care, the results found here may not be applicable in other dissimilar settings.  Furthermore, the population studied was almost exclusively heterosexual (i.e. trans women attracted to men and trans men attracted to women) and may represent a group more conforming to gender binaries than a larger umbrella trans population.


1) Gómez-Gil E, Zubiaurre-Elorza L, Esteva I, Guillamon A, Godás T, Cruz Almaraz M, et al. Hormone-treated transsexuals report less social distress, anxiety and depression. Psychoneuroendocrinology [Internet]. 2011 Sep 19 [cited 2012 Jan 2];Available from:

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