Cameron Adelman

Document Type


Publication Date



Purpose/Objective: Transgender (TG) people make up approximately 0.5% of the United States’ population and face barriers in healthcare. Not all TG people desire gender affirming hormone therapy (GAHT), but those who do may struggle to find a prescriber and face delays in receiving care. This paper explores the mental health impact of delayed access to GAHT on TG patients. Methods: PubMed, Medline, and Cochrane were searched using the keywords “transgender”, “gender affirming hormone therapy”, and “mental health”. A separate search string replaced “mental health” with “education” to find articles related to clinician education on GAHT. Results: TG participants not on GAHT had significantly worse depression and anxiety than cisgender people, but after six months of GAHT, depression and anxiety were comparable to the general population. TG patients on GAHT had significantly improved depression and anxiety compared to before they started GAHT and TG patients waiting to start GAHT. Depression, psychopathology, body uneasiness, and gender dysphoria improved with GAHT. A one-hour lecture on GAHT for medical students significantly increased familiarity with GAHT, which may increase future likelihood of prescribing it and improve access. Conclusions: TG patients waiting for GAHT have poorer mental health than TG patients on GAHT and the general population, but within six months of starting GAHT, there is no significant difference in depression or anxiety in TG people than cisgender people. TG patients with diagnosed gender dysphoria should not face delays in initiating GAHT. Improved access to GAHT requires more prescribers, so GAHT needs to be a required topic for clinicians to reduce health disparities for TG patients.

Faculty Mentor

Kelli Kruzel, MSPAS, PA-C

Academic Discipline

MS - Physician Assistant Studies



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