Observations of the effect of gonadotropin-releasing hormone analog treatment on psychosocial well-being in transgender youth and their caregivers – a pilot study
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Anisha Gohil
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Kelly Donahue
Abstract
Objectives
We investigated indices of mental health in transgender youth and their primary caregiver during 12 months of GnRHa therapy.
Methods
Psychological measures were completed at baseline, 6 months, and 12 months by patients and caregivers using validated questionnaires from the Patient Reported Outcomes Measurement Information System and National Institutes of Health Toolbox. One-way repeated-measures ANOVAs were performed to evaluate differences in psychological measures across time. One-sample t-tests compared the sample mean of each measure to the population mean at each time point.
Results
Of 28 patients enrolled, 16 were treated with a GnRHa alone for 12 months. No significant main effect of time on any measure of psychological functioning in patients or caregivers was found (all ps>0.05). Compared to the general population, transgender youth reported higher levels of psychological stress and lower levels of life satisfaction at all time points, and higher levels of depression and anger at later time points, while caregivers perceived decreased well-being in their child on all measures at all time points. Caregivers reported higher levels of self-reported anxiety at all time points and higher levels of self-reported depression at baseline.
Conclusions
Transgender youth and their caregivers in the early stages of medical transition experience more challenges related to psychological well-being compared to the general population. However, all measures of psychological well-being remained stable throughout the study.
Funding source: Indiana Clinical and Translational Sciences Institute
Award Identifier / Grant number: UL1TR001108
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Research ethics: The protocol was approved on 2/20/2018 by the Indiana University Institutional Review Board, protocol number 1710815864R00. Written informed consent was obtained from caregivers and patients. Our study was conducted in accordance with the Declaration of Helsinki (as revised in 2013).
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Informed consent: Written informed consent was obtained from caregivers and patients.
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Author contributions: AG, KD, and EE contributed to conceptualization and design. AG and KD contributed to the data analysis. AG wrote the original draft of the manuscript. KD and EE critically reviewed and edited the manuscript. KD and EE provided supervision and oversight of the manuscript. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Use of Large Language Models, AI, and Machine Learning Tools: None declared.
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Conflict of interest: The authors state no conflict of interest, real or perceived.
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Research funding: This project was funded, in part, with support from the Indiana Clinical and Translational Sciences Institute, in part by Award Number UL1TR001108 from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical, and Translational Sciences Award.
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Data availability: All data generated or analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.
References
1. Coyne, CA, Yuodsnukis, BT, Chen, D. Gender dysphoria: optimizing healthcare for transgender and gender diverse youth with a multidisciplinary approach. Neuropsychiatric Dis Treat 2023;19:479–93. https://doi.org/10.2147/ndt.s359979.Suche in Google Scholar
2. Connolly, MD, Zervos, MJ, Barone, IICJ, Johnson, CC, Joseph, CL. The mental health of transgender youth: advances in understanding. J Adolesc Health 2016;59:489–95. https://doi.org/10.1016/j.jadohealth.2016.06.012.Suche in Google Scholar PubMed
3. Tordoff, DM, Wanta, JW, Collin, A, Stepney, C, Inwards-Breland, DJ, Ahrens, K. Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Netw Open 2022;5:e220978. https://doi.org/10.1001/jamanetworkopen.2022.0978.Suche in Google Scholar PubMed PubMed Central
4. Kuper, LE, Stewart, S, Preston, S, Lau, M, Lopez, X. Body dissatisfaction and mental health outcomes of youth on gender-affirming hormone therapy. Pediatrics 2020;145:e20193006. https://doi.org/10.1542/peds.2019-3006.Suche in Google Scholar PubMed
5. Hembree, WC, Cohen-Kettenis, PT, Gooren, L, Hannema, SE, Meyer, WJ, Murad, MH, et al.. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metabol 2017;102:3869–903. https://doi.org/10.1210/jc.2017-01658.Suche in Google Scholar PubMed
6. Coleman, E, Radix, A, Bouman, W, Brown, G, De Vries, A, Deutsch, M, et al.. Standards of care for the health of transgender and gender diverse people, version 8. Int J Transgend Health 2022;23:S1–259. https://doi.org/10.1080/26895269.2022.2100644.Suche in Google Scholar PubMed PubMed Central
7. Rosenthal, SM. Approach to the patient: transgender youth: endocrine considerations. J Clin Endocrinol Metabol 2014;99:4379–89. https://doi.org/10.1210/jc.2014-1919.Suche in Google Scholar PubMed
8. Olson, KR, Durwood, L, DeMeules, M, McLaughlin, KA. Mental health of transgender children who are supported in their identities. Pediatrics 2016;137:e20153223. https://doi.org/10.1542/peds.2015-3223.Suche in Google Scholar PubMed PubMed Central
9. Quinn, H, Thissen, D, Liu, Y, Magnus, B, Lai, J-S, Amtmann, D, et al.. Using item response theory to enrich and expand the PROMIS® pediatric self report banks. Health Qual Life Outcome 2014;12:160. https://doi.org/10.1186/s12955-014-0160-x.Suche in Google Scholar PubMed PubMed Central
10. Bevans, KB, Gardner, W, Pajer, KA, Becker, B, Carle, A, Tucker, CA, et al.. Psychometric evaluation of the PROMIS® pediatric psychological and physical stress experiences measures. J Pediatr Psychol 2018;43:678–92. https://doi.org/10.1093/jpepsy/jsy010.Suche in Google Scholar PubMed PubMed Central
11. Forrest, CB, Devine, J, Bevans, KB, Becker, BD, Carle, AC, Teneralli, RE, et al.. Development and psychometric evaluation of the PROMIS pediatric life satisfaction item banks, child-report, and parent-proxy editions. Qual Life Res 2018;27:217–34. https://doi.org/10.1007/s11136-017-1681-7.Suche in Google Scholar PubMed PubMed Central
12. Pilkonis, PA, Choi, SW, Reise, SP, Stover, AM, Riley, WT, Cella, D, et al.. Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS®): depression, anxiety, and anger. Assessment 2011;18:263–83. https://doi.org/10.1177/1073191111411667.Suche in Google Scholar PubMed PubMed Central
13. Kupst, MJ, Butt, Z, Stoney, CM, Griffith, JW, Salsman, JM, Folkman, S, et al.. Assessment of stress and self-efficacy for the NIH Toolbox for neurological and behavioral function. Anxiety Stress Coping 2015;28:531–44. https://doi.org/10.1080/10615806.2014.994204.Suche in Google Scholar PubMed PubMed Central
14. Irwin, DE, Gross, HE, Stucky, BD, Thissen, D, DeWitt, EM, Lai, JS, et al.. Development of six PROMIS pediatrics proxy-report item banks. Health Qual Life Outcome 2012;10:22. https://doi.org/10.1186/1477-7525-10-22.Suche in Google Scholar PubMed PubMed Central
15. HealthMeasures northwestern University2023 Available from: https://www.healthmeasures.net.Suche in Google Scholar
16. Chen, M, Fuqua, J, Eugster, EA. Characteristics of referrals for gender dysphoria over a 13-year period. J Adolesc Health 2016;58:369–71. https://doi.org/10.1016/j.jadohealth.2015.11.010.Suche in Google Scholar PubMed PubMed Central
17. Turban, JL, King, D, Carswell, JM, Keuroghlian, AS. Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics 2020;145:e20191725. https://doi.org/10.1542/peds.2019-1725.Suche in Google Scholar PubMed PubMed Central
18. Kuvalanka, KA, Weiner, JL, Munroe, C, Goldberg, AE, Gardner, M. Trans and gender-nonconforming children and their caregivers: gender presentations, peer relations, and well-being at baseline. J Fam Psychol 2017;31:889–99. https://doi.org/10.1037/fam0000338.Suche in Google Scholar PubMed
19. Durwood, L, McLaughlin, KA, Olson, KR. Mental health and self-worth in socially transitioned transgender youth. J Am Acad Child Adolesc Psychiatry 2017;56:116–23.e2. https://doi.org/10.1016/j.jaac.2016.10.016.Suche in Google Scholar PubMed PubMed Central
20. Hawke, LD, Hayes, E, Darnay, K, Henderson, J. Mental health among transgender and gender diverse youth: an exploration of effects during the COVID-19 pandemic. Psychol Sex Orientat Gend Divers 2021;8:180–7. https://doi.org/10.1037/sgd0000467.Suche in Google Scholar
21. Ormiston, CK, Williams, F. LGBTQ youth mental health during COVID-19: unmet needs in public health and policy. Lancet (London, England) 2022;399:501–3. https://doi.org/10.1016/s0140-6736-21-02872-5.Suche in Google Scholar
22. Jones, BA, Bowe, M, McNamara, N, Guerin, E, Carter, T. Exploring the mental health experiences of young trans and gender diverse people during the Covid-19 pandemic. Int J Transgend Health 2021;24:292–304. https://doi.org/10.1080/26895269.2021.1890301.Suche in Google Scholar PubMed PubMed Central
23. Oldehinkel, AJ, Verhulst, FC, Ormel, J. Mental health problems during puberty: Tanner stage-related differences in specific symptoms. The TRAILS study. J Adolesc 2011;34:73–85. https://doi.org/10.1016/j.adolescence.2010.01.010.Suche in Google Scholar PubMed
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Artikel in diesem Heft
- Frontmatter
- Mini Review
- Transition of care from childhood/adolescence to adulthood in familial hypercholesterolemia
- Original Articles
- Performance of adult height prediction methods in 6 to 8-year-old girls with GnRH-dependent precocious puberty
- Height velocity in the detection of growth disorders reconsidered: a retrospective analysis of the DONALD study
- Differentiating transient and permanent congenital hypothyroidism: predictive clues from Istanbul, Türkiye
- Evaluation of thyrotrophic and lactotrophic reserves in patients with pituitary dwarfism with and without empty sella turcica
- Exploring the impact of androgen levels on depression and anxiety in adolescent females: a clinical perspective
- The diagnostic value of stimulated androgen ratios in 5-alpha reductase type 2 (SRD5A2) deficiency: a case series and review of the literature
- Prolonged symptom duration and the potential for gradual progression in pediatric adrenocortical tumors: observations from the MET studies
- Distinguishing organic from idiopathic central precocious puberty: clinical characteristics and predictive factors for organic etiology in a multicenter Italian cohort study
- Endocrinopathies associated with pediatric common variable immunodeficiency
- Genetic, neuroimaging, and clinical characteristics of a cohort of individuals with L-2-hydroxyglutaric aciduria from Türkiye
- Short Communications
- Stress hyperglycemia in pediatric patients as a risk factor for type 1 diabetes – a single center experience
- Observations of the effect of gonadotropin-releasing hormone analog treatment on psychosocial well-being in transgender youth and their caregivers – a pilot study
- Letter to the Editor
- GNB1 haploinsufficiency presents as monogenic obesity syndrome
- Case Reports
- Rare pediatric insulinoma case diagnosed by endoscopic ultrasonography: insights into endogenous hyperinsulinemic hypoglycemia
- Caudal epidural steroid injection as a novel therapy for treatment-induced neuropathy of diabetes in children: report of two cases
- A novel homozygous missense DNAJC3 variant in syndromic juvenile-onset diabetes
- 3-Hydroxy-3-methylglutaryl-coenzyme A lyase deficiency: case report of a child with rare HMGCL gene variants
Artikel in diesem Heft
- Frontmatter
- Mini Review
- Transition of care from childhood/adolescence to adulthood in familial hypercholesterolemia
- Original Articles
- Performance of adult height prediction methods in 6 to 8-year-old girls with GnRH-dependent precocious puberty
- Height velocity in the detection of growth disorders reconsidered: a retrospective analysis of the DONALD study
- Differentiating transient and permanent congenital hypothyroidism: predictive clues from Istanbul, Türkiye
- Evaluation of thyrotrophic and lactotrophic reserves in patients with pituitary dwarfism with and without empty sella turcica
- Exploring the impact of androgen levels on depression and anxiety in adolescent females: a clinical perspective
- The diagnostic value of stimulated androgen ratios in 5-alpha reductase type 2 (SRD5A2) deficiency: a case series and review of the literature
- Prolonged symptom duration and the potential for gradual progression in pediatric adrenocortical tumors: observations from the MET studies
- Distinguishing organic from idiopathic central precocious puberty: clinical characteristics and predictive factors for organic etiology in a multicenter Italian cohort study
- Endocrinopathies associated with pediatric common variable immunodeficiency
- Genetic, neuroimaging, and clinical characteristics of a cohort of individuals with L-2-hydroxyglutaric aciduria from Türkiye
- Short Communications
- Stress hyperglycemia in pediatric patients as a risk factor for type 1 diabetes – a single center experience
- Observations of the effect of gonadotropin-releasing hormone analog treatment on psychosocial well-being in transgender youth and their caregivers – a pilot study
- Letter to the Editor
- GNB1 haploinsufficiency presents as monogenic obesity syndrome
- Case Reports
- Rare pediatric insulinoma case diagnosed by endoscopic ultrasonography: insights into endogenous hyperinsulinemic hypoglycemia
- Caudal epidural steroid injection as a novel therapy for treatment-induced neuropathy of diabetes in children: report of two cases
- A novel homozygous missense DNAJC3 variant in syndromic juvenile-onset diabetes
- 3-Hydroxy-3-methylglutaryl-coenzyme A lyase deficiency: case report of a child with rare HMGCL gene variants
