International psychogeriatrics · 2025
Mental health outcomes and loneliness in older transgender individuals receiving long-term gender-affirming hormone therapy compared with older cisgender individuals.
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van Heesewijk Jason O, de Groot Inge L, Dreijerink Koen M A, Wiepjes Chantal M, Kok Almar A L, van Schoor Natasja M, Huisman Martijn, Heijer Martin den, Kreukels Baudewijntje P C
Аннотация
OBJECTIVES: Many older adults experience mental health challenges and loneliness which negatively affect other health aspects. This data is largely lacking in older transgender adults. This study aimed to determine differences in depressive symptoms, anxiety and loneliness between older transgender individuals receiving gender-affirming hormone therapy (GHT), and cisgender (non-transgender) individuals, and to assess the contribution of financial, psychological, somatic, and social-contact related factors.
DESIGN: Cross-sectional.
SETTING: Gender identity clinic; general population.
PARTICIPANTS: Seventy-two transgender women and 39 transgender men (56-84 y) receiving GHT for ≥ 10 y, age-matched 1:3 with cisgender women and men from the general population.
MEASUREMENTS: Depressive symptoms, anxiety and loneliness were assessed with questionnaires. Differences were compared using linear regression analyses with log-transformed variables, and back-transformed for presentation. Additionally, models were adjusted for financial, psychological, somatic and social-contact related factors.
RESULTS: Transgender women scored higher than cisgender women and cisgender men, respectively, on depressive symptoms (1.92, 95 % confidence interval (CI) 1.52-2.42; 2.66, CI 2.11-3.37), anxiety (1.43, CI 1.17-1.75; 1.89, CI 1.54-2.32) and loneliness (2.42, CI 1.96-2.97; 2.32, CI 1.92-2.82). Transgender men scored higher than cisgender men on depressive symptoms (2.10, CI 1.50-2.94), anxiety (1.67, CI 1.27-2.19) and loneliness (1.50, CI 1.16-1.93), and higher than cisgender women on loneliness (1.57, CI 1.20-2.05). These differences were largely explained by differences in financial, psychological, somatic and social-contact related factors.
CONCLUSIONS: Mental health outcomes and loneliness are compromised in older transgender individuals compared to cisgender individuals, particularly in transgender women. The socio-economic, psychological and somatic risk factors identified warrant further research and awareness.
DESIGN: Cross-sectional.
SETTING: Gender identity clinic; general population.
PARTICIPANTS: Seventy-two transgender women and 39 transgender men (56-84 y) receiving GHT for ≥ 10 y, age-matched 1:3 with cisgender women and men from the general population.
MEASUREMENTS: Depressive symptoms, anxiety and loneliness were assessed with questionnaires. Differences were compared using linear regression analyses with log-transformed variables, and back-transformed for presentation. Additionally, models were adjusted for financial, psychological, somatic and social-contact related factors.
RESULTS: Transgender women scored higher than cisgender women and cisgender men, respectively, on depressive symptoms (1.92, 95 % confidence interval (CI) 1.52-2.42; 2.66, CI 2.11-3.37), anxiety (1.43, CI 1.17-1.75; 1.89, CI 1.54-2.32) and loneliness (2.42, CI 1.96-2.97; 2.32, CI 1.92-2.82). Transgender men scored higher than cisgender men on depressive symptoms (2.10, CI 1.50-2.94), anxiety (1.67, CI 1.27-2.19) and loneliness (1.50, CI 1.16-1.93), and higher than cisgender women on loneliness (1.57, CI 1.20-2.05). These differences were largely explained by differences in financial, psychological, somatic and social-contact related factors.
CONCLUSIONS: Mental health outcomes and loneliness are compromised in older transgender individuals compared to cisgender individuals, particularly in transgender women. The socio-economic, psychological and somatic risk factors identified warrant further research and awareness.