From the Guidelines
Male-to-female (MTF) gender transition can provide significant mental health benefits for individuals with gender dysphoria, including reduced gender dysphoria, decreased rates of depression and anxiety, improved self-esteem, and enhanced overall quality of life, as supported by the most recent and highest quality study 1.
Key Benefits of MTF Transition
The primary advantages of MTF transition include:
- Reduced gender dysphoria
- Decreased rates of depression and anxiety
- Improved self-esteem
- Enhanced overall quality of life Many transgender women report feeling a profound sense of relief and authenticity after transitioning, which can alleviate psychological distress that may have persisted for years.
Hormone Therapy and Mental Health
Hormone therapy, typically involving estrogen and anti-androgens, can produce physical changes that better align the body with gender identity, further improving mental wellbeing, as reported in a systematic review that found a 20% decrease in depression in trans men and women after 1 year of hormone treatment 1.
Social Transition and Mental Health
Social transition elements such as name changes, gender-affirming clothing, and being recognized as female also contribute significantly to positive outcomes.
Comprehensive Care and Psychological Support
Comprehensive care should include psychological support throughout the transition process, as adjusting to social changes and managing expectations can present challenges.
Regret and Satisfaction
Research shows that there is little evidence of significant numbers of transgender individuals suffering regret after gender-affirming treatment, with one systematic review reporting only 1% regret following gender-affirming surgery 1.
From the Research
Mental Health Outcomes
- The mental health outcomes of male-to-female (MTF) gender transition are a crucial aspect of the transition process, with various studies indicating improved mental health and well-being after transition 2, 3.
- A 40-year follow-up study found that gender-affirming surgery (GAS) leads to significant improvements in mental health outcomes, including reduced suicidal ideation and resolution of mental health comorbidities secondary to gender dysphoria 2.
- Another study found that occupational performance, health, and life satisfaction are impacted by the transition process, with transgender women reporting lower performance scores compared to cisgender women 3.
Hormone Therapy
- Hormone therapy is a common aspect of MTF transition, with anti-androgens such as cyproterone acetate and spironolactone used to suppress testosterone levels 4, 5.
- A randomized controlled trial found that cyproterone acetate had a higher testosterone suppression efficacy than spironolactone, with 90% of participants achieving female range testosterone levels (<50 ng/dL) compared to 19% in the spironolactone group 4.
- Another study found that cyproterone acetate was more effective in lowering testosterone concentrations compared to spironolactone, with significantly lower total testosterone concentrations in the cyproterone acetate group 5.
Body Satisfaction and Gender Affirming Treatments
- Body satisfaction and desire for gender-affirming treatments vary among assigned-female-at-birth trans masculine and non-binary individuals, with non-binary individuals reporting less need to undergo body modifications 6.
- A study found that trans masculine and non-binary participants who had undergone gender-affirming treatments mostly identified as trans and expressed similar ranking of treatment preferences, while non-physically affirmed cohorts differed in strength of intention to modify their body and desired treatments 6.