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The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review

Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery ha...

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Autores principales: Costa, Rosalia, Colizzi, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977075/
https://www.ncbi.nlm.nih.gov/pubmed/27536118
http://dx.doi.org/10.2147/NDT.S95310
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author Costa, Rosalia
Colizzi, Marco
author_facet Costa, Rosalia
Colizzi, Marco
author_sort Costa, Rosalia
collection PubMed
description Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect) for the hormonal treatment-induced better mental well-being. In conclusion, this review indicates that gender dysphoria-related mental distress may benefit from hormonal treatment intervention, suggesting a transient reaction to the nonsatisfaction connected to the incongruent body image rather than a stable psychiatric comorbidity. In this perspective, timely hormonal treatment intervention represents a crucial issue in gender dysphoria individuals’ mental health-related outcome.
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spelling pubmed-49770752016-08-17 The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review Costa, Rosalia Colizzi, Marco Neuropsychiatr Dis Treat Review Cross-sex hormonal treatment represents a main aspect of gender dysphoria health care pathway. However, it is still debated whether this intervention translates into a better mental well-being for the individual and which mechanisms may underlie this association. Although sex reassignment surgery has been the subject of extensive investigation, few studies have specifically focused on hormonal treatment in recent years. Here, we systematically review all studies examining the effect of cross-sex hormonal treatment on mental health and well-being in gender dysphoria. Research tends to support the evidence that hormone therapy reduces symptoms of anxiety and dissociation, lowering perceived and social distress and improving quality of life and self-esteem in both male-to-female and female-to-male individuals. Instead, compared to female-to-male individuals, hormone-treated male-to-female individuals seem to benefit more in terms of a reduction in their body uneasiness and personality-related psychopathology and an amelioration of their emotional functioning. Less consistent findings support an association between hormonal treatment and other mental health-related dimensions. In particular, depression, global psychopathology, and psychosocial functioning difficulties appear to reduce only in some studies, while others do not suggest any improvement in these domains. Results from longitudinal studies support more consistently the association between hormonal treatment and improved mental health. On the contrary, a number of cross-sectional studies do not support this evidence. This review provides possible biological explanation vs psychological explanation (direct effect vs indirect effect) for the hormonal treatment-induced better mental well-being. In conclusion, this review indicates that gender dysphoria-related mental distress may benefit from hormonal treatment intervention, suggesting a transient reaction to the nonsatisfaction connected to the incongruent body image rather than a stable psychiatric comorbidity. In this perspective, timely hormonal treatment intervention represents a crucial issue in gender dysphoria individuals’ mental health-related outcome. Dove Medical Press 2016-08-04 /pmc/articles/PMC4977075/ /pubmed/27536118 http://dx.doi.org/10.2147/NDT.S95310 Text en © 2016 Costa and Colizzi. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Costa, Rosalia
Colizzi, Marco
The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review
title The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review
title_full The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review
title_fullStr The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review
title_full_unstemmed The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review
title_short The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review
title_sort effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977075/
https://www.ncbi.nlm.nih.gov/pubmed/27536118
http://dx.doi.org/10.2147/NDT.S95310
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