Relationship between gender-affirming hormone therapy and quality of life among transgender individuals

Transgender and gender diverse (TGD) individuals face numerous challenges in their daily lives, including a higher prevalence of mental health issues and lower quality of life (QoL) levels compared to cisgender individuals. A common intervention shown to have a positive effect on mental well-being and QoL of TGD individuals is gender-affirming hormone therapy (GAHT). However, the short- and long-term outcomes of GAHT on mental health and QoL are not yet fully explored. Therefore, this study aimed to investigate QoL both in individuals assigned male at birth (AMAB) and individuals assigned female at birth (AFAB) receiving GAHT, and control groups not receiving GAHT. Additionally, this study aimed to investigate the relationship between sex hormone levels and QoL outcomes.This study used a cross-sectional design. TGD individuals were recruited from the Centre for Gender Identity, Aalborg University Hospital. The WHOQOL-BREF questionnaire was used to investigate four QoL domains. MANOVA and post-hoc t-tests were performed to analyse QoL domain scores between the GAHT- and control groups. Additionally, linear regression analyses were performed to examine the relationship between QoL scores and levels of oestradiol and testosterone for AMAB and AFAB individuals, respectively.360 individuals were included in the study. Individuals receiving GAHT had significantly higher QoL scores than controls for both the AMAB (p = 0.005) and AFAB (p = 0.021) group, with the largest differences observed in the psychological domain (D2). AFAB individuals had significantly higher QoL scores than AMAB individuals in both the GAHT and control groups (p = 0.010; p = 0.042, respectively), with a notable difference in the social domain (D3) within the GAHT group. No significant linear relationship was found between sex hormone levels and QoL scores.TGD individuals receiving GAHT had significantly higher QoL than those not receiving GAHT. Also, a higher QoL was found for individuals AFAB compared to individuals AMAB. This study highlights the advantages of offering GAHT to TGD individuals and differences based on assigned sex at birth. However, future longitudinal studies are crucial to investigate the short- and long-term effects of GAHT.None.