000 04197nab a22003977a 4500
999 _c9173
_d9173
005 20250625151726.0
008 250324s2025 ||||| |||| 00| 0 eng d
040 _aAFVC
100 _aReisner, Sari L.
_910381
245 _aGender-affirming hormone therapy and depressive symptoms among transgender adults
_cSari L. Reisner, David R. Pletta, Alex S. Keuroghlian, Kenneth H. Mayer, Madeline B. Deutsch, Jennifer Potter, Jaclyn M. W. Hughto, Alexander Harris, and Asa E. Radix
260 _bJAMA,
_c2025
500 _aJAMA Network Open. 2025, 8(3): e250955
520 _aImportance: In the US, transgender, nonbinary, and gender diverse (TGD) adults have high rates of depression. Gender-affirming hormone therapy (GAHT) is associated with improved mental health outcomes, yet existing US studies have short follow ups and lack sample diversity. Objective To evaluate the use of GAHT delivered in primary care as an intervention for moderate-to-severe depressive symptoms in diverse TGD adult patients. Design, Setting, and Participants: LEGACY was an observational cohort study conducted in federally qualified community health centers in Boston and New York that followed up TGD patients (N = 3592) from calendar years 2016 to 2019 (48 months). Participants included individuals aged 18 years or older, gender identity different from sex at birth, a past 12-month medical visit, and signed patient consent form in the electronic health record (EHR). Exposures: Prescriptions for GAHT obtained from EHR data, using the date of the first and last GAHT prescription in each calendar year of observation (GAHT within the year vs no GAHT during the year). Main Outcomes and Measures: A binary outcome of patient-reported moderate-to-severe depressive symptoms was obtained using the validated Patient-Health Questionnaire (PHQ), scoring 10 or greater on the PHQ-9 or scoring 3 or greater on the PHQ-2. Following multiple imputation, generalized estimating equations (GEE) longitudinally modeled GAHT and moderate-to-severe depressive symptoms (n = 20 320 observations) and adjusted for age, gender identity, race and ethnicity, health insurance, federal poverty level, HIV serostatus, number of cohort years, and clinical site. Results: The median age of the 3592 patients was 28 (IQR, 24-36) years. Race and ethnicity was diverse (1.3% Asian/Pacific Islander, 11.7% Black, 16.1% Hispanic/Latinx, 63.1% White, 6.8% multiracial, and 1.4% other). In addition, 18.9% were nonbinary, 52.1% lived below the federal poverty level, 34.2% were publicly insured, 4.1% were uninsured, and 5.1% were living with HIV. At baseline, 84.5% of the individuals were prescribed GAHT and 15.3% reported moderate-to-severe depressive symptoms. Patients prescribed GAHT had a statistically significantly lower risk of moderate-to-severe depressive symptoms over follow-up compared with those not prescribed GAHT (adjusted risk ratio, 0.85; 95% CI,  0.75-0.98). Conclusions: and Relevance In this longitudinal observational cohort study, GAHT was associated with lower rates of moderate-to-severe depressive symptoms, highlighting the importance of gender-affirming primary care models for TGD patients. (Authors' abstract). Record #9173
650 _aDEPRESSION
_9192
650 _aHAUORA HINENGARO
_95549
650 _aLGBTQIA+
_93453
650 _aMENTAL HEALTH
_9377
650 _aPROTECTIVE FACTORS
_94270
650 _aTAKATĀPUI
_94978
650 _aTRANSGENDER
_93315
650 _aTREATMENT
_9613
651 _aINTERNATIONAL
_93624
651 _aUNITED STATES
_92646
700 _aPletta, David R.
_913799
700 _aKeuroghlian, Alex S.
_913800
700 _aMayer, Kenneth H.
_913801
700 _aDeutsch, Madeline B.
_913802
700 _aPotter, Jennifer
_913803
700 _aHughto, Jaclyn M. W.
_910379
700 _aHarris, Alexander
_913804
700 _aRadix, Asa E.
_913805
773 0 _tJAMA Network Open. 2025, 8(3): e250955
830 _aJAMA Network Open
_911657
856 _zdoi:10.1001/jamanetworkopen.2025.0955 (Open access)
_uhttp://doi.org/10.1001/jamanetworkopen.2025.0955
942 _2ddc
_cARTICLE
_hnews132