Young trans people with specialized care have fewer suicidal thoughts

Transgender and nonbinary teens who received specialized health care, including gender-affirming hormone treatment and puberty blockers, had a 60% reduction in depression and a 73% reduction in suicidal thoughts one year after initiating care.

In addition, youth who did not have access to these services were twice as likely to develop moderate to severe depression three months after starting medical follow-up and almost three times more likely to develop suicidal thoughts or attempts at self-harm six months after follow-up. .

The results are from a study published in the medical scientific journal Jama Network Open in February of this year. The 31st of March is the International Day of Transgender Visibility, a date dedicated to raising awareness of the prejudice and discrimination faced by this group of individuals.

The research sought to assess the effect of affirmative therapies on the mental health of transgender and non-binary adolescents and youth aged 13 to 20 years. Patients were recruited from a specialized clinic in Seattle, United States, and followed up for one year.

Of the 104 study participants, 63 were transmale (trans men), 27 were transfemale (trans women), 10 were nonbinary, and 4 were unresponsive about their gender identity.

At baseline, 59 (56.7%) were diagnosed with moderate to severe depression, 52 (50%) had symptoms of anxiety, and 45 (43.3%) reported suicidal thoughts or self-harm.

Two-thirds of patients (66.3%) received puberty blockers, hormone therapy, or both, while one-third (33.7%) received no medication or hormone blockers.

After a year of affirmative therapy, the development of some form of depression was reduced by 60% and that of suicidal thoughts by 73%. There was no effect of treatment on perception of anxiety.

According to the authors, the study shows that specialized medical care, including the use of hormone therapy, can reduce depression and suicide attempts in transgender youth in a relatively short period of one year.

Despite the positive results, the authors state that the worsening of mental health in the first months of patient follow-up, both in terms of anxiety and depression, may also be associated with a high expectation of young people when starting an affirmative treatment to see immediate results. .

The reality is similar to the experience lived by Yu Golfetti, biologist and business intelligence leader at Pipo Saúde. She, who recognizes herself as a transgender woman, did not have adequate psychological support at the beginning of her transition, which caused her to go through a moment of strong depression.

“Today I know, but at the time I hadn’t been diagnosed, but I have depression and anxiety and without psychiatric or psychological follow-up, I started self-medication. [de hormônios]”, bill.

“It took me a while to accept myself, to accept the changes in my body and in my voice. If I had followed up, the story would have been totally different”, he says.

At the time, she was graduating from college and then starting a master’s degree in zoology — and the research grant didn’t make it possible to pay for psychological care.

“Because of my training, I can even say that I know that self-medication was wrong and that even made me stop. I went through a very difficult time, of abstinence from treatment, and at that time I had suicidal ideas”, he reports.

The situation only improved when she had access to specialized care at the Institute of Psychology at USP, from a professional who had experience in assisting LGBTQIA+ people. By doing her master’s research also at USP, she got free care with this professional.

“The fact that I had a service from a person who had the least amount of preparation about gender identity and what an LGBTQIA+ person goes through helped me in this process, because I knew I wouldn’t suffer transphobia”, he says.

According to João Guimarães Ferreira, endocrinologist and volunteer doctor at Unifesp’s Trans Center, from the point of view of mental health outcomes, the introduction of hormone therapy in young people has a high satisfaction rate.

“The hormonal treatment offered from the age of 18 in the transgender population already has well-defined ordinances and we have excellent satisfaction rates”, he says.

The doctor reinforces how the prevalence of mental illness is high in transgender people, above the average of the general population. “That’s why it’s part of the core [em que ele trabalha] to also have professional psychologists to follow up”, he says.

Other surveys already point out how transgender or non-binary people, especially teenagers, have a high risk of having their mental health affected, with depression, anxiety and suicidal thoughts.

A survey of 948 people in New Zealand and published on March 9 in the specialized magazine Family Practice found that only half of transgender people receive specialized medical care, including treatment with the proper pronoun and respect for the social name.

In the same study, about 57% of people reported being treated in the same way as another cisgender patient, and nearly half (47%) of participants said they had to teach the healthcare professional how they would like to be treated.

The main complaint from patients in the study was the use of the wrong pronoun, followed by invasive questions and discrimination.

For Ferreira, the training of health teams that intend to serve trans and non-binary populations is essential.

“Unfortunately, we have cases of professionals [nos serviços de saúde] do not use the social name or the desired pronoun, and this leads to the abandonment of treatment. This issue of reception is very important from the point of view of the evolution of cases”, he says.