Does Gender Minority Stress Decrease After Gender-Affirming Hormone Therapy?

Does Gender Minority Stress Decrease After Gender-Affirming Hormone Therapy?

Gender minority individuals, including transgender people, experience higher rates of mental health problems than the general public. Discrimination, violence, and the enduring stigma around gender diversity can all contribute to the increased rate of mental health problems in the gender diverse community. This phenomenon is known in some circles as gender minority stress.

Minority stressors fall into two main categories: distal stressors and proximal stressors. Distal stressors are caused by an external source. Some examples of distal stressors are discrimination, violence, microaggressions, rejection, exclusion, and non-affirmation of one’s gender identity.

Proximal stressors, on the other hand, are caused by internal sources. These stressors may include the concealment of one’s gender identity, a negative expectation of future events, and an internalized transphobia for some transgender individuals.

Fortunately, gender-affirming care such as gender-affirming hormone therapy (GAHT) has been shown to have an overall positive effect on transgender individuals’ mental health. Given this information, the researchers of a recent study decided to examine whether gender minority stress decreased for transgender individuals after starting GAHT.

A total of 85 transgender people with a desire to begin GAHT and 65 cisgender people participated in this study. The cisgender individuals formed the control group.

All of the participants completed a self-report survey. The survey included the Beck Depression Inventory II, the State-Trait Anxiety Inventory, the Scale for Suicide Ideation, questions on suicidal thoughts/attempts, the Stigma Consciousness Questionnaire, and the Perceived Stress Scale, all to assess the participants’ proximal stressors.

To assess the participants’ distal stressors, the researchers used the Everyday Discrimination Scale. Lastly, they assessed the participants’ coping constructs with the Resilience Scale, the Marlowe Crowne Social Desirability Scale, and questions about their social network and social standing.

The researchers found that transgender people had higher rates of proximal stressors and lower protective factors (social standing) before and during GAHT than the cisgender participants. Before starting GAHT, the transgender participants were lower in social network and resilience than the cisgender participants. However, the researchers saw decreasing trait anxiety in the transgender individuals over the course of the study. A strong social network was shown to play a major role in lessening suicidal thoughts and attempts.

The results of this study indicate the importance of social network in potentially reducing some stressors and/or supporting transgender (or gender diverse) individuals. Additionally, beginning GAHT may be helpful for lowering trait anxiety in transgender people.


  • Collet, S., Kiyar, M., Martens, K., Vangeneugden, J., Simpson, V.G., Guillamon, A., Mueller, S.C., & T’Sjoen, G. (2023). Gender minority stress in transgender people: a major role for social network. The Journal of Sexual Medicine20(6), 905-917.

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