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Hormone therapy, gender affirmation surgery, and their association with recent suicidal ideation and depression symptoms in transgender veterans

Published online by Cambridge University Press:  14 January 2018

Raymond P. Tucker ,
Rylan J. Testa ,
Tracy L. Simpson ,
Jillian C. Shipherd ,
John R. Blosnich  and
Keren Lehavot
Raymond P. Tucker*
Affiliation:
Louisiana State University, Baton Rouge, LA, USA
Rylan J. Testa
Affiliation:
Rhodes College, Memphis, TN, USA
Tracy L. Simpson
Affiliation:
VA Puget Sound Health Care System, Seattle, WA, USA University of Washington, USA
Jillian C. Shipherd
Affiliation:
National Center for PTSD, VA Boston Healthcare System, Boston University, Veterans Health Administration
John R. Blosnich
Affiliation:
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
Keren Lehavot
Affiliation:
VA Puget Sound Health Care System, Seattle, WA, USA University of Washington, USA
*
Author for correspondence: Raymond P. Tucker, E-mail: rtucker1@lsu.edu
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Abstract

Background

Access to transition-related medical interventions (TRMIs) for transgender veterans has been the subject of substantial public interest and debate. To better inform these important conversations, the current study investigated whether undergoing hormone or surgical transition intervention(s) relates to the frequency of recent suicidal ideation (SI) and symptoms of depression in transgender veterans.

Methods

This study included a cross-sectional, national sample of 206 self-identified transgender veterans. They self-reported basic demographics, TRMI history, recent SI, and symptoms of depression through an online survey.

Results

Significantly lower levels of SI experienced in the past year and 2-weeks were seen in veterans with a history of both hormone intervention and surgery on both the chest and genitals in comparison with those who endorsed a history of no medical intervention, history of hormone therapy but no surgical intervention, and those with a history of hormone therapy and surgery on either (but not both) the chest or genitals when controlling for sample demographics (e.g., gender identity and annual income). Indirect effect analyses indicated that lower depressive symptoms experienced in the last 2-weeks mediated the relationship between the history of surgery on both chest and genitals and SI in the last 2-weeks.

Conclusions

Results indicate the potential protective effect that TRMI may have on symptoms of depression and SI in transgender veterans, particularly when both genitals and chest are affirmed with one's gender identity. Implications for policymakers, providers, and researchers are discussed.

Keywords

Gender affirmationhormone therapysuicidetransgenderveteran
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 14 , October 2018 , pp. 2329 - 2336
Copyright
Copyright © Cambridge University Press 2018 

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