Gender-affirming surgery cuts utilization of mental health treatment among transgenders

Gender-affirming surgery leads to a reduction in the likelihood of mental health treatment among transgender individuals with a gender incongruence diagnosis, lending support to the decision to provide such procedures to those who seek them, according to a Swedish study.

Individuals with a gender incongruence diagnosis had about a sixfold chance of having had a healthcare visit due to a mood and anxiety disorder compared with the general population. They also had more than a threefold likelihood of having been prescribed antidepressant and anxiolytics and more than a sixfold probability of having been hospitalized following a suicide attempt.

No significant association existed between years since initiating hormone treatment and likelihood of mental health treatment (adjusted odds ratio [OR], 1.01, 95 percent CI, 0.98–1.03), but increased time since last gender-affirming surgery correlated with reduced mental health treatment (adjusted OR, 0.92, 0.87–0.98).

This study determined the prevalence of mood and anxiety disorder healthcare visits and antidepressant and anxiolytic prescriptions in 2015 as a function of gender incongruence diagnosis and gender-affirming hormone and surgical treatment.

The authors used the Swedish Total Population Register (n=9,747,324) and linked to the National Patient Register and the Prescribed Drug Register. They then examined mental health treatment as a function of length of time since gender-affirming hormone and surgical treatment among individuals who received a diagnosis of gender incongruence (ie, transsexualism or gender identity disorder) between 2005 and 2015 (n=2,679).

The following were the outcome measures: mood and anxiety disorder healthcare visits, antidepressant and anxiolytic prescriptions, and hospitalization after a suicide attempt.