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Transgender people who start hormones as teenagers rather than adults 'have better mental health’

(492 Posts)
GagaJo Wed 12-Jan-22 19:49:33

Transgender people who start their hormones as teenagers have “far better” mental health than if they wait until adulthood, new research says.

Experts have found that transgender people who begin hormone treatment in adolescence had fewer suicidal thoughts, were less likely to experience major mental health disorders and had fewer problems with substance abuse than those who started hormones later in life.

The study, which was led by the Stanford University School of Medicine, gathered data from the largest-ever survey of US transgender adults where 27,715 people responded in 2015.

Researchers found that, as well as fewer mental health concerns when taking the drugs as teenagers, those who took the drugs at any age had better mental health than those who wanted them but had never received them.

Of the people surveyed, 21,598 reported they had received the hormones they wanted. Of these people, 119 began hormones at age 14 or 15; 362 at age 16 and 17 and 12,157 following their 18th birthday.

Some 8,860 people surveyed said they wanted but never received hormone therapy and acted as the control group for the study.

Odds of severe psychological distress were reduced by 222 per cent, 153 per cent and 81 per cent for those who began hormones in early adolescence, late adolescence and adulthood, respectively.

Odds of feeling suicidal in the previous year were 135 per cent lower in those who began hormones in early adolescence, 62 per cent lower in those who began in late adolescence and 21 per cent lower in those who began as adults, compared with the control group.

Dr Jack Turban, lead author on the study and expert in paediatric and adolescent psychiatry at Stanford Medicine, said: “This study is particularly relevant now because many state legislatures are introducing bills that would outlaw this kind of care for transgender youth.

“We are adding to the evidence base that shows why gender-affirming care is beneficial from a mental health perspective.”

In the UK, hormone drugs can only be given to people from the age of 16 who have been on puberty blockers for at least 12 months.

Last September, the UK Court of Appeal overturned a judgment that children under the age of 16 considering gender reassignment were unlikely to be mature enough to give informed consent to be prescribed puberty-blocking drugs.

paddyann54 Wed 12-Jan-22 20:03:44

The young people I know who are transgendering started hormones around age 16 ,both are well grounded happy and doing very well at university .Both are female to male trans .
It helps that they have parents who supported them and always would have and one mum says she felt she lost her little girl , but she absolutely loves her son

VioletSky Wed 12-Jan-22 20:09:53

Thank you for sharing that, it's very enlightening

GagaJo Wed 12-Jan-22 20:16:33

It synchs with what I've seen too. The students that I've had that could go to their parents, with an empathetic response, had the best mental health. The ones I had who couldn't talk to them floundered.

janeainsworth Wed 12-Jan-22 21:13:20

gagajo It synchs with what I've seen too. The students that I've had that could go to their parents, with an empathetic response, had the best mental health. The ones I had who couldn't talk to them floundered
Perhaps your observations would support the view that any teenagers, not just transgender ones, who have supportive, empathetic parents have better mental health than those who don’t.
Without reading the original research paper we don’t know whether parental attitudes were taken into account, do we?
In fact the higher incidence of severe psychological distress in those who had to wait till they were over 18 to begin hormone therapy, suggests that they might have met with some opposition, compared to those who started earlier.

The article you quote doesn’t mention family background which is clearly important.

Doodledog Wed 12-Jan-22 21:49:24


It synchs with what I've seen too. The students that I've had that could go to their parents, with an empathetic response, had the best mental health. The ones I had who couldn't talk to them floundered.

What sort of sample size are you talking about? Most teachers in mainstream schools are unlikely to come across anything like enough pupils who identify as transgender to draw meaningful conclusions.

As well as parental support (and that of the wider family), there are other variables, such as acceptance of peers, access to qualified counsellors, availability of medical treatment and so on. I don't see how it can be possible for an onlooker to factor in all of these things, as well as the mental health of the individual pupil - particularly without access to their medical and/or psychiatric records.

GagaJo Wed 12-Jan-22 22:07:53

I'm taking about the exterior demeanor Doodledog. No, of course I don't know the ins and outs or specifics. But how they act on a daily basis.

For example, the transboy I taught in Spain went from being sullen and under achieving, to being more outgoing and even getting a girlfriend who he was open about in school. It was an improvement despite the huge uphill battle he had in front of him.

But of course, naysayers will be negative.

Doodledog Wed 12-Jan-22 22:22:07

They may be, but if that was a ‘subtle’ dig at me, I wasn’t being negative at all. I was asking how you can speak with such apparent authority about something like this based on a teaching role, and wondering how many children who identify as transgender one teacher is likely to encounter.

GagaJo Wed 12-Jan-22 22:30:07

Depends on the size of school, obviously. Spanish school was small, so to the best of my knowledge, the only one. But of course, I only had 6 or 7 classes there.

Last big school, I was aware of 3. Only taught one of them though.

Teaching isn't just standing at the front imparting knowledge. It's about relationships. Students coming to sit in your room at lunchtime. Interaction. Chat. Gossip (one way, of course. Staff don'tgive away too much personal stuff.) Some students develop closer relationships than others. M2F at my last UK sc hool was a regular with her gang in my classroom at breaktime/lunchtime.

It's the positive side of teaching, those relationships. Makes it all worthwhile. Also enables the teacher to keep an eye on social and emotional well-being.

Doodledog Wed 12-Jan-22 22:41:36

Yes, I realise all of that, but I was interested to know whether the numbers formed any sort of basis for generalisation.

Much of my own career has also been in education, so I totally understand the pastoral aspects of the role; but having spent decades marking (and supervising) dissertations, my radar bleeps when I read sweeping or unsubstantiated comments, or those based on insufficient information.

GagaJo Wed 12-Jan-22 22:44:16

I'm more interested in the flesh and blood in front of me, than the paperwork. Each to their own.

Doodledog Wed 12-Jan-22 22:52:03

Oh, paperwork is the bane of everyone’s life - we can agree on that😀.

Flesh and blood people are affected by assumptions and generalisations though. I don’t think that caring about one excludes an interest in the other - it’s not a binary choice😉

VioletSky Wed 12-Jan-22 23:04:08

To understand the needs of trans people we need to listen to them. Thank goodness the people conducting this research are, and are putting their voices out there.

GagaJo Wed 12-Jan-22 23:17:55

Agree VS. Listening to them, not talking about them.

paddyann54 Wed 12-Jan-22 23:22:00

Can I add that then two young people I know had fabulous support from their schools and Medics.The level of support and virtually no anti trans nonsense was amazing .In the main young people are far more accepting of trans issues than older generations.That can only be a good thing,everyone of us is different in our own way and accepting that goes a long way towards the trans community just becoming a PART of the community without the need for the "trans" label

Doodledog Thu 13-Jan-22 07:01:52

I agree with most of your post, paddyanne. I’m less sure about the age thing though. A quick glance at Mumsnet shows that many younger women are concerned about the way that ‘trans issues’ (as opposed to trans people) are being used as a way for misogynists to eradicate women’s rights.

Being sensitive to the needs of a troubled child should, of course, be a given - I never see anyone say otherwise on these threads. There is, however a tendency for ‘some people’ on GN, who are, I guess in the ‘older’ age group (not ‘young’, at any rate) who either to fail to understand that there are two totally separate issues here, or who deliberately ’spin’ any comments about the former issue and conflate them with the latter.

It is perfectly possible to be sensitive to the needs of children without buying into the TWAW agenda. Personally (although I am not a psychologist) I would be reluctant to allow medical intervention until a child is old enough to take full responsibility for the fact that they might change their mind later.

Currently there are many reported cases of people who were given treatment at a young age and whose lives are now adversely affected by it. They ‘consented’ to the treatment before the legal age of consent, which puts the responsibility onto the adults making the decisions for them. Keira Bell is perhaps the most well known of these cases, but there are others, and their stories make heartbreaking reading. There is, in my view, a fine line between sympathetic treatment of confused children and encouragement (implicit or explicit) of their going down a path that can end so very badly.

VioletSky Thu 13-Jan-22 07:34:41

So agree with you paddyann they face enough issues, every voice supporting them has a huge positive impact on their mental health

Urmstongran Thu 13-Jan-22 07:40:55

Your post just now encapsulates how I feel about these issues Doodledog. I think it’s an absolute mine field to be honest and I swerve discussions for that reason.

I think teenagers like to rebel. To be as different as is possible. To impress their friends, to annoy their parents, to shock their peers. Some take this to extremes. They are immature, mentally, trying on ‘personas’ to see what fits. Some (not all admittedly) make a right pig’s ear of this by being encouraged to transgender (not just being supported) and mess with their lives which is heartbreaking to read about. I don’t know the answer.

Doodledog Thu 13-Jan-22 07:57:22

Agreed, VS, which is why it would be easier if everyone they spoke to was qualified to deal with such a complex issue. Obviously that’s impossible (and
could only happen in a very strange world!) which is probably why so many mistakes are made that need traumatic reversal later. I completely agree that everyone should be understanding and supportive of what the children have to say, but don’t believe that anyone other than a psychologist/psychiatrist should encourage transition when they are under age.

There is always a risk that someone inexperienced or unqualified will have their own needs filled by being the confidante of a troubled child. I remember from counselling courses that this is a named ‘thing’ - does anyone know more about it, as it’s on the tip of my tongue but I can’t remember the name?

In any case, children can be very easily influenced, particularly those who are already vulnerable, so IMO, it is better to validate the whole child, take them as they are, and leave any discussion of transitioning to the experts.

Doodledog Thu 13-Jan-22 07:58:57

Cross posted, Urmsongran. Not ignoring your post!

Urmstongran Thu 13-Jan-22 08:01:31

No worries. 😊

Lucca Thu 13-Jan-22 08:07:46


Agree VS. Listening to them, not talking about them.

I’d think it obvious that any teenager/child benefits from being listened to and from having supportive parents and teachers. This does not automatically mean that they will all make decisions which ultimately are right for them (on any issue)

GagaJo Thu 13-Jan-22 08:09:45

This leaving 'it' to the experts is surely just a polite way of pushing young people who are experiencing something huge back into a closet they've worked very hard to crack the door of.

When it comes to a group of people with a high suicide rate, silencing them for the 5 years it currently takes to see an expert could be a matter of life or death. They are children/young people. They need to be listened to. Not dismissed.

Not engaging with them when they open themselves is the very last thing we should be doing. We wouldn't do it with depression, if they came out as gay, had problems at home, were involved in violent or coercive relationships.

Silencing trans children is only good for the uncomfortable adult, not the vulnerable and frightened young person.

Urmstongran Thu 13-Jan-22 08:14:48

Agree Lucca. Listen. Have their feelings (mixed up kids) validated. Not jump in to medicate.

Lucca Thu 13-Jan-22 08:15:19

Who is suggesting silencing them ?