What the study found
Mental healthcare use increased around the time transgender and gender diverse people started gender affirming hormone therapy, then fell substantially over time. The pattern was seen for both oestradiol-based hormone therapy and testosterone-based hormone therapy.
Why the authors say this matters
The authors conclude that gender affirming hormone therapy may help address unmet mental health needs and may contribute to longer-term reductions in mental healthcare use and associated costs among trans people. They also say the pattern fits with assessment and support requirements around treatment initiation.
What the researchers tested
The researchers used Australian whole-of-population administrative data from 2012 to 2024 to identify people starting oestradiol-based or testosterone-based gender affirming hormone therapy. They applied a dynamic difference-in-differences model, comparing each person's mental health service use and prescriptions before and after initiation, with future hormone therapy recipients used as controls.
What worked and what didn't
Among 20,358 people who started oestradiol-based therapy and 11,883 who started testosterone-based therapy, mental healthcare use rose at initiation and then declined sharply. Five years after initiation, people on oestradiol-based therapy used 0.29 fewer mental health services and 0.53 fewer mental health prescriptions, while people on testosterone-based therapy used 2.59 fewer mental health services and 1.02 fewer prescriptions; reductions were more pronounced for people with higher baseline mental healthcare engagement, and for older recipients of oestradiol-based therapy.
What to keep in mind
The abstract does not describe the study's limitations in detail. The findings are based on administrative data from Australia and on the service use measures reported in the study.
Key points
- Mental healthcare use increased around the start of gender affirming hormone therapy and then declined over time.
- The pattern was observed for both oestradiol-based and testosterone-based hormone therapy.
- Five years after initiation, mental health service use was lower for both groups.
- Reductions were larger among people with higher baseline mental healthcare engagement.
- The authors say the findings may indicate unmet mental health needs are being addressed over time.
Disclosure
- Research title:
- Mental health service use changes after hormone therapy
- Authors:
- Karinna Saxby, Tom Buchmueller, Christopher S. Carpenter, Clue Coman, Brendan J. Nolan
- Institutions:
- Austin Health, Monash University, Ross School, The University of Melbourne, UNSW Sydney, Vanderbilt University
- Publication date:
- 2026-02-01
- OpenAlex record:
- View
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