Results Summary

What was the research about?

People who are transgender have a gender identity that differs from the male or female sex assigned to them at birth. Some transgender people get gender-affirming therapies to change their bodies to match their gender identity. For example, they may take hormones such as estrogen or testosterone.

Gender-affirming therapies can improve mental health and quality of life for transgender adults. These improved outcomes may help transgender adults focus on other health concerns.

In this study, the research team wanted to learn if gender-affirming hormone therapy improved sexual health outcomes and symptoms of depression in transgender adults.

What were the results?

Compared with transgender patients who didn’t receive hormone therapy, those who did were less likely to have sexually transmitted infections and symptoms of depression.

Transgender adults who did and didn’t receive hormone therapy didn’t differ in:

  • Whether they filled a prescription for medicine to prevent HIV. HIV weakens the body's immune system and makes it hard for the body to fight off infections.
  • The amount of HIV in the blood being so low that a test can't detect it among patients with HIV.
  • New cases of HIV.

Who was in the study?

The study included health records for 6,330 transgender patients from 2016 to 2019. All received care at one of two clinics in Massachusetts and New York. In 2016, 86 percent took hormone therapy and 14 percent did not. Also, 7 percent of patients were living with HIV. Among patients, 63 percent were White, 20 percent Black, 8 percent were multiracial, 7 percent were Asian or Pacific Islander, and 2 percent identified as another race; 21 percent were Hispanic or Latinx. The average age was 28. Also, 47 percent were transgender female, 36 percent were transgender male, 16 percent were nonbinary, and 1 percent identified as another gender identity. In addition, 54 percent had private insurance, 42 percent had public insurance, and 4 percent didn’t have insurance.

What did the research team do?

The research team compared health records for transgender patients who did and didn’t receive hormone therapy over three years.

Transgender adults, researchers, and clinicians, such as doctors and nurses, helped design the study.

What were the limits of the study?

The study used records from two clinics that specialized in gender-affirming therapies. Results may differ for adults receiving care at other clinics. Most patients had public or private health insurance; results may differ for adults without health insurance.

Future research could include adults who seek care at clinics that don’t focus on gender-affirming therapies. It could also include more adults without health insurance.

How can people use the results?

Clinics can use the results when considering how to improve sexual health and mental health outcomes for transgender patients.

Conflict of Interest Disclosures

Project Information

Sari L. Reisner, ScD
Brigham and Women's Hospital
Transgender Cohort Study of Gender Affirmation and HIV-related Health

Key Dates

November 2017
April 2023

Study Registration Information


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Last updated: October 18, 2023