Psychosocial Correlates of Gender-Affirming Hormone and Medically Necessary Surgical Intervention (MNSI) Use among Transgender and Gender Diverse Youth and Young Adults.

Gender-affirming hormone therapy (GAHT) and medically necessary surgical interventions (MNSI) play vital roles in helping transgender and gender diverse (TGD) individuals align their bodies with their gender identity. However, research in this area has primarily focused on TGD adults, leaving TGD youth and young adults (TGD-YYA)'s experiences understudied. Even less is known about demographic and psychosocial correlates of hormone and MNSI utilization among TGD-YYA, which is the focus of this cross-sectional study. From 2020 to 2021, 284 TGD-YYA in the U.S. (M age=21.7 years) reported recent hormone use, MNSI engagement, depression, lifetime experiences of discrimination, and gender congruence. Participants were categorized into three mutually exclusive groups for analysis: Group 1: MNSI and hormone use in the past three months (26.1%), Group 2: Hormones only (26.4%), and Group 3: Neither (no hormone or MNSI use; 47.5%). ANOVA models examined group differences in psychosocial correlates of hormone and MNSI use. Overall, 26.1% of the sample reported receiving MNSI and 51.1% reported using hormones. Depression scores were significantly higher in Groups 2 and 3 than Group 1, ps < .05. Lifetime discrimination scores were significantly higher in Groups 1 and 2 than Group 3, ps < .001. Finally, gender congruence was significantly higher in Group 1 than Group 2, which was higher than Group 3, ps < .001. Our findings suggest that the use of gender-affirming care-whether hormones, MNSI, or both-is associated with significantly lower depression and greater gender congruence. These findings highlight a beneficial role of including MNSI with recent hormone use on TGD-YYA's mental health and experiences of gender congruence.