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01.12.2018 | Sex and Gender Issues in Behavioral Health (CN Epperson and L Hantsoo, Section Editors) | Ausgabe 12/2018

Gender-Affirming Hormone Use in Transgender Individuals: Impact on Behavioral Health and Cognition

Zeitschrift:: Current Psychiatry Reports > Ausgabe 12/2018

Autoren:: Hillary B. Nguyen, Alexis M. Chavez, Emily Lipner, Liisa Hantsoo, Sara L. Kornfield, Robert D. Davies, C. Neill Epperson

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Wichtige Hinweise

This article is part of the Topical Collection on Sex and Gender Issues in Behavioral Health

Abstract

Purpose of Review

With increasing numbers of transgender and gender non-binary individuals presenting for care, knowing how to elucidate the mental health and cognitive outcomes of gender-affirming hormone therapy (GAHT) is necessary. This article reviews the present literature covering GAHT effects on mood, behavioral health, and cognition in these individuals and offers research priorities to address knowledge gaps.

Recent Findings

Although there are some conflicting data, GAHT overwhelmingly seems to have positive psychological effects in both adolescents and adults. Research tends to support that GAHT reduces symptoms of anxiety and depression, lowers perceived and social distress, and improves quality of life and self-esteem in both male-to-female and female-to-male transgender individuals.

Summary

Clinically, prescribing GAHT can help with gender dysphoria-related mental distress. Thus, timely hormonal intervention represents a crucial tool for improving behavioral wellness in transgender individuals, though effects on cognitive processes fundamental for daily living are unknown. Future research should prioritize better understanding of how GAHT may affect executive functioning.

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•• Nguyen HB, Loughead J, Lipner E, Hantsoo L, Kornfield SL, Epperson CN. What has sex got to do with it? The role of hormones in the transgender brain. Neuropsychopharmacology [Internet]. 2018; Available from: https://doi.org/10.1038/s41386-018-0140-7. This article is one of the latest, most comprehensive reviews on the brain, behavioral, and cognitive effects of gender-affirming hormone therapy in transgender individuals. CrossRefPubMed

Bale TL, Epperson CN. Sex as a biological variable: who, what, when, why, and how. Neuropsychopharmacology. 2017;42(2):386–96. CrossRefPubMed

Spitzer RL, Md KK, Williams JBW. Diagnostic and statistical manual of mental disorders, Third Edition. Am Psychiatr Assoc. 1980.

Psychiatry online | DSM Library [Internet]. [cited 2018 Aug 17]. Available from: https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420249.dsm-iv-tr.

DSM-5 [Internet]. [cited 2018 Aug 18]. Available from: https://www.psychiatry.org/psychiatrists/practice/dsm.

Flores AR, Herman JL, Gates GJ, Brown TNT. How many adults identify as transgender in the United States?. The Williams Institute; 2016.

Meerwijk EL, Sevelius JM. Transgender population size in the United States: a meta-regression of population-based probability samples. Am J Public Health. 2017;107(2):e1–8. CrossRefPubMedPubMedCentral

Mueller SC, De Cuypere G, T’Sjoen G. Transgender research in the 21st century: a selective critical review from a neurocognitive perspective. Am J Psychiatry. 2017;174(12):1155–62. CrossRefPubMed

Arnold AP, Breedlove SM. Organizational and activational effects of sex steroids on brain and behavior: a reanalysis. Horm Behav. 1985;19(4):469–98. CrossRefPubMed

10.

McCarthy MM, Arnold AP, Ball GF, Blaustein JD, De Vries GJ. Sex differences in the brain: the not so inconvenient truth. J Neurosci. 2012;32(7):2241–7. CrossRefPubMedPubMedCentral

11.

Bakker J, Baum MJ. Role for estradiol in female-typical brain and behavioral sexual differentiation. Front Neuroendocrinol. 2008;29(1):1–16. CrossRefPubMed

12.

•• Joel D, Berman Z, Tavor I, Wexler N, Gaber O, Stein Y, et al. Sex beyond the genitalia: the human brain mosaic. Proc Natl Acad Sci U S A. 2015;112(50):15468–73 This article proposes the idea of the mosaic human brain, which cannot be distinctly categorized into either a female brain or a male brain. CrossRefPubMedPubMedCentral

13.

Satterthwaite TD, Vandekar S, Wolf DH, Ruparel K, Roalf DR, Jackson C, et al. Sex differences in the effect of puberty on hippocampal morphology. J Am Acad Child Adolesc Psychiatry. 2014;53(3):341–350.e1. CrossRefPubMed

14.

Shanmugan S, Epperson CN. Estrogen and the prefrontal cortex: towards a new understanding of estrogen’s effects on executive functions in the menopause transition. Hum Brain Mapp. 2014;35(3):847–65. CrossRefPubMed

15.

Grant JM, Mottet LA, Tanis J, Herman JL, Harrison J, Keisling M. National transgender discrimination survey report on health and health care. Natl Cent Transgender Equal Natl Gay Lesbian Task Force. 2010;1:1–23.

16.

Gouchie C, Kimura D. The relationship between testosterone levels and cognitive ability patterns. Psychoneuroendocrinology. 1991;16(4):323–34. CrossRefPubMed

17.

Miller DI, Halpern DF. The new science of cognitive sex differences. Trends Cogn Sci. 2014;18(1):37–45. CrossRefPubMed

18.

Luders E, Sánchez FJ, Tosun D, Shattuck DW, Gaser C, Vilain E, et al. Increased cortical thickness in male-to-female transsexualism. J Behav Brain Sci. 2012;2(3):357–62. CrossRefPubMedPubMedCentral

19.

• Zubiaurre-Elorza L, Junque C, Gómez-Gil E, Guillamon A. Effects of cross-sex hormone treatment on cortical thickness in transsexual individuals. J Sex Med. 2014;11(5):1248–61 This article is one of the few longitudinal studies assessing the effects of testosterone on the brain structure of FTM transgender individuals. CrossRefPubMed

20.

Simon L, Kozák LR, Simon V, Czobor P, Unoka Z, Szabó Á, et al. Regional grey matter structure differences between transsexuals and healthy controls--a voxel based morphometry study. PLoS One. 2013;8(12):e83947. CrossRefPubMedPubMedCentral

21.

Rametti G, Carrillo B, Gómez-Gil E, Junque C, Zubiaurre-Elorza L, Segovia S, et al. Effects of androgenization on the white matter microstructure of female-to-male transsexuals. A diffusion tensor imaging study. Psychoneuroendocrinology. 2012;37(8):1261–9. CrossRefPubMed

22.

Kranz GS, Hahn A, Kaufmann U, Küblböck M, Hummer A, Ganger S, et al. White matter microstructure in transsexuals and controls investigated by diffusion tensor imaging. J Neurosci. 2014;34(46):15466–75. CrossRefPubMedPubMedCentral

23.

• Hahn A, Kranz GS, Küblböck M, Kaufmann U, Ganger S, Hummer A, et al. Structural connectivity networks of transgender people. Cereb Cortex. 2015;25(10):3527–34 This report is the first cross-sectional study reporting on the structural connectivity networks of transgender patients before onset of gender-affirming hormone therapy. CrossRefPubMed

24.

Yokota Y, Kawamura Y, Kameya Y. Callosal shapes at the midsagittal plane: MRI differences of normal males, normal females, and GID. Conf Proc IEEE Eng Med Biol Soc. 2005;3:3055–8. PubMed

25.

Lin C-S, Ku H-L, Chao H-T, Tu P-C, Li C-T, Cheng C-M, et al. Neural network of body representation differs between transsexuals and cissexuals. PLoS One. 2014;9(1):e85914. CrossRefPubMedPubMedCentral

26.

Cohen-Kettenis PT, van Goozen SH, Doorn CD, Gooren LJ. Cognitive ability and cerebral lateralisation in transsexuals. Psychoneuroendocrinology. 1998;23(6):631–41. CrossRefPubMed

27.

Bradley SJ, Zucker KJ. Gender identity disorder and psychosexual problems in children and adolescents. Can J Psychiatr Rev Can Psychiatr. 1990;35(6):477–86. CrossRef

28.

Soleman RS, Schagen SEE, Veltman DJ, Kreukels BPC, Cohen-Kettenis PT, Lambalk CB, et al. Sex differences in verbal fluency during adolescence: a functional magnetic resonance imaging study in gender dysphoric and control boys and girls. J Sex Med. 2013;10(8):1969–77. CrossRefPubMed

29.

Hunt DD, Carr JE, Hampson JL. Cognitive correlates of biologic sex and gender identity in transsexualism. Arch Sex Behav. 1981;10(1):65–77. CrossRefPubMed

30.

Bäckström T, Bixo M, Johansson M, Nyberg S, Ossewaarde L, Ragagnin G, et al. Allopregnanolone and mood disorders. Prog Neurobiol. 2014;113:88–94. CrossRefPubMed

31.

Shanmugan S, Loughead J, Nanga RPR, Elliott M, Hariharan H, Appleby D, et al. Lisdexamfetamine effects on executive activation and neurochemistry in menopausal women with executive function difficulties. Neuropsychopharmacology. 2017;42(2):437–45. CrossRefPubMed

32.

Epperson CN, Wisner KL, Yamamoto B. Gonadal steroids in the treatment of mood disorders. Psychosom Med. 1999;61(5):676–97. CrossRefPubMed

33.

• Colizzi M, Costa R, Todarello O. Transsexual patients’ psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: results from a longitudinal study. Psychoneuroendocrinology. 2014;39:65–73 This publication is a recent and comprehensive longitudinal study of both MTF and FTM transgender populations, reporting the positive effects after one year of gender-affirming hormone therapy on behavioral health parameters such as depression and anxiety. CrossRefPubMed

34.

Heylens G, Verroken C, De Cock S, T’Sjoen G, De Cuypere G. Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with a gender identity disorder. J Sex Med. 2014;11(1):119–26. CrossRefPubMed

35.

• Fisher AD, Castellini G, Ristori J, Casale H, Cassioli E, Sensi C, et al. Cross-sex hormone treatment and psychobiological changes in transsexual persons: two-year follow-up data. J Clin Endocrinol Metab. 2016;101(11):4260–9 This study is one of few that focuses on how body changes, induced by gender-affirming hormone therapy, impact psychobiological well-being in transgender and gender dysphoric people. CrossRefPubMed

36.

• Colizzi M, Costa R, Pace V, Todarello O. Hormonal treatment reduces psychobiological distress in gender identity disorder, independently of the attachment style. J Sex Med. 2013;10(12):3049–58 This longitudinal study assesses stress in a fairly large number of transgender patients. CrossRefPubMed

37.

Keo-Meier CL, Herman LI, Reisner SL, Pardo ST, Sharp C, Babcock JC. Testosterone treatment and MMPI-2 improvement in transgender men: a prospective controlled study. J Consult Clin Psychol. 2015;83(1):143–56. CrossRefPubMed

38.

Oda H, Kinoshita T. Efficacy of hormonal and mental treatments with MMPI in FtM individuals: cross-sectional and longitudinal studies. BMC Psychiatry. 2017;17(1):256. CrossRefPubMedPubMedCentral

39.

Turan Ş, Aksoy Poyraz C, Usta Sağlam NG, Demirel ÖF, Haliloğlu Ö, Kadıoğlu P, et al. Alterations in body uneasiness, eating attitudes, and psychopathology before and after cross-sex hormonal treatment in patients with female-to-male gender dysphoria. Arch Sex Behav. 2018.

40.

Motta G, Crespi C, Mineccia V, Brustio PR, Manieri C, Lanfranco F. Does testosterone treatment increase anger expression in a population of transgender men? J Sex Med. 2018;15(1):94–101. CrossRefPubMed

41.

• Defreyne J, T’Sjoen G, Bouman WP, Brewin N, Arcelus J. Prospective evaluation of self-reported aggression in transgender persons. J Sex Med. 2018;15(5):768–76 This report is the first prospective study assessing the effects of long-term administration of testosterone in transgender men. CrossRefPubMed

42.

Manieri C, Castellano E, Crespi C, Di Bisceglie C, Dell’Aquila C, Gualerzi A, et al. Medical treatment of subjects with gender identity disorder: the experience in an Italian public health center. Int J Transgenderism. 2014;15:53–65. CrossRef

43.

Corda E, Bandecchi C, Deiana V, Pintore S, Pinna F, Pusceddu R, et al. Body image and gender role perceived in gender dysphoria: cross-sex hormone therapy effects. Eur Psychiatry. 2016;33:S589. CrossRef

44.

Gorin-Lazard A, Baumstarck K, Boyer L, Maquigneau A, Penochet J-C, Pringuey D, et al. Hormonal therapy is associated with better self-esteem, mood, and quality of life in transsexuals. J Nerv Ment Dis. 2013;201(11):996–1000. CrossRefPubMed

45.

Davis SA, Meier SC. Effects of testosterone treatment and chest reconstruction surgery on mental health and sexuality in female-to-male transgender people. Int J Sex Health. 2014;26(2):113–28. CrossRef

46.

• Bouman WP, Claes L, Marshall E, Pinner GT, Longworth J, Maddox V, et al. Sociodemographic variables, clinical features, and the role of preassessment cross-sex hormones in older trans people. J Sex Med. 2016;13(4):711–9 This study is one of the rare investigations into how gender-affirming hormone therapy affects the behavioral health of older transgender people. CrossRefPubMed

47.

Glynn TR, Gamarel KE, Kahler CW, Iwamoto M, Operario D, Nemoto T. The role of gender affirmation in psychological well-being among transgender women. Psychol Sex Orientat Gend Divers. 2016;3(3):336–44. CrossRefPubMedPubMedCentral

48.

Owen-Smith AA, Gerth J, Sineath RC, Barzilay J, Becerra-Culqui TA, Getahun D, et al. Association between gender confirmation treatments and perceived gender congruence, body image satisfaction, and mental health in a cohort of transgender individuals. J Sex Med. 2018;15(4):591–600. CrossRefPubMed

49.

Witcomb GL, Bouman WP, Claes L, Brewin N, Crawford JR, Arcelus J. Levels of depression in transgender people and its predictors: results of a large matched control study with transgender people accessing clinical services. J Affect Disord. 2018;235:308–15. CrossRefPubMed

50.

• Gooren LJ, Sungkaew T, Giltay EJ, Guadamuz TE. Cross-sex hormone use, functional health and mental well-being among transgender men (Toms) and transgender women (Kathoeys) in Thailand. Cult Health Sex. 2015;17(1):92–103 This study is the first to explore gender-affirming hormone therapy use in transgender populations of Southeast Asia, specifically Thailand. CrossRef

51.

Bonierbale M, Baumstarck K, Maquigneau A, Gorin-Lazard A, Boyer L, Loundou A, et al. MMPI-2 profile of French transsexuals: the role of sociodemographic and clinical factors. A cross-sectional design. Sci Rep. 2016;6:24281. CrossRefPubMedPubMedCentral

52.

de Vries ALC, McGuire JK, Steensma TD, Wagenaar ECF, Doreleijers TAH, Cohen-Kettenis PT. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134(4):696–704. CrossRefPubMed

53.

Gómez-Gil E, Zubiaurre-Elorza L, de Antonio IE, Guillamon A, Salamero M. Determinants of quality of life in Spanish transsexuals attending a gender unit before genital sex reassignment surgery. Qual Life Res Int J Qual Life Asp Treat Care Rehab. 2014;23(2):669–76.

54.

Fisher AD, Castellini G, Bandini E, Casale H, Fanni E, Benni L, et al. Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria. J Sex Med. 2014;11(3):709–19. CrossRefPubMed

55.

Testa RJ, Rider GN, Haug NA, Balsam KF. Gender confirming medical interventions and eating disorder symptoms among transgender individuals. Health Psychol. 2017;36(10):927–36. CrossRefPubMed

56.

Jones BA, Haycraft E, Bouman WP, Brewin N, Claes L, Arcelus J. Risk factors for eating disorder psychopathology within the treatment seeking transgender population: the role of cross-sex hormone treatment. Eur Eat Disord Rev. 2018;26(2):120–8. CrossRefPubMed

57.

• Pol H, Cohen-Kettenis P, Haren NEM, Peper J, Brans R, Cahn W, et al. Changing your sex changes your brain: influences of testosterone and estrogen on adult human brain structure. Eur J Endocrinol 2006;155. This article is a longitudinal study of both FTM and MTF transgender populations, using neuroimaging methods to report the effects of brain structures before and during gender-affirming hormone therapy.

58.

Seiger R, Hahn A, Hummer A, Kranz GS, Ganger S, Woletz M, et al. Subcortical gray matter changes in transgender subjects after long-term cross-sex hormone administration. Psychoneuroendocrinology. 2016;74:371–9. CrossRefPubMed

59.

Burke SM, Manzouri AH, Dhejne C, Bergström K, Arver S, Feusner JD, et al. Testosterone effects on the brain in transgender men. Cereb Cortex. 2018;28(5):1582–96. CrossRefPubMed

60.

Kranz GS, Hahn A, Kaufmann U, Tik M, Ganger S, Seiger R, et al. Effects of testosterone treatment on hypothalamic neuroplasticity in female-to-male transgender individuals. Brain Struct Funct. 2018;223(1):321–8. CrossRefPubMed

61.

Gómez-Gil E, Cañizares S, Torres A, de la Torre F, Halperin I, Salamero M. Androgen treatment effects on memory in female-to-male transsexuals. Psychoneuroendocrinology. 2009;34(1):110–7. CrossRefPubMed

62.

Shanmugan S, Loughead J, Cao W, Sammel MD, Satterthwaite TD, Ruparel K, et al. Impact of tryptophan depletion on executive system function during menopause is moderated by childhood adversity. Neuropsychopharmacology. 2017;42(12):2398–406. CrossRefPubMedPubMedCentral

63.

Epperson CN, Shanmugan S, Kim DR, Mathews S, Czarkowski KA, Bradley J, et al. New onset executive function difficulties at menopause: a possible role for lisdexamfetamine. Psychopharmacology. 2015;232(16):3091–100. CrossRefPubMedPubMedCentral

64.

Fertility preservation and restoration for patients with complex medical conditions | Allison Goetsch | Springer [Internet]. [cited 2018 Aug 19]. Available from: https://www.springer.com/us/book/9783319523156.

Titel: Gender-Affirming Hormone Use in Transgender Individuals: Impact on Behavioral Health and Cognition
Autoren:: Hillary B. Nguyen
Alexis M. Chavez
Emily Lipner
Liisa Hantsoo
Sara L. Kornfield
Robert D. Davies
C. Neill Epperson
Publikationsdatum: 01.12.2018
DOI: https://doi.org/10.1007/s11920-018-0973-0
Verlag: Springer US
Zeitschrift: Current Psychiatry Reports
Ausgabe 12/2018
Print ISSN: 1523-3812
Elektronische ISSN: 1535-1645

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Gender-Affirming Hormone Use in Transgender Individuals: Impact on Behavioral Health and Cognition

Abstract

Purpose of Review

Recent Findings

Summary

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Recent Findings

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