TY  - JOUR
AU  - Corman, Jae Downing
AU  - Hughto, Jaclyn M W
AU  - Shireman, Theresa I
AU  - Baker, Kellan
AU  - Steinle, Kate
AU  - Forcier, Michelle
PY  - 2025
DA  - 2025/2/14
TI  - Mental Health Changes in US Transgender Adults Beginning Hormone Therapy Via Telehealth: Longitudinal Cohort Study
JO  - J Med Internet Res
SP  - e64017
VL  - 27
KW  - transgender
KW  - LGBT persons
KW  - telehealth
KW  - depression
KW  - anxiety
KW  - suicide
KW  - mental health
KW  - adult
KW  - virtual care
KW  - longitudinal cohort study
KW  - gender-affirming hormone therapy
KW  - United States
KW  - observational study
KW  - adolescent
KW  - mobile health
AB  - Background: Gender-affirming hormone therapy (GAHT) has shown potential for improving mental health outcomes among transgender and gender-diverse adults. How clinical outcomes change among adults receiving GAHT via telehealth across the United States is not well known. Objective: This study evaluated the relationship between initiating GAHT via a telehealth clinic and changes in depression, anxiety, and suicide ideation over a 3-month period. Methods: This cohort study evaluated the relationship between initiating GAHT via a telehealth clinic and changes in mental health over a 3-month period. Data were collected at baseline and 3 months later among adults who had their first GAHT visit between August and November 2023. The study included adults aged 18 years and older initiating GAHT for the first time, with a final sample of 342 adults across 43 states (192 initiated estrogen and 150 initiated testosterone therapy). The primary outcomes were depression symptoms using the Patient Health Questionnaire-9 (PHQ-9), anxiety symptoms using the General Anxiety Disorder-7 (GAD-7), and suicide ideation in the past 2 weeks. Results: Before GAHT initiation, 40% (136/342) of participants reported depression (PHQ-9 ≥10), 36% (120/342) reported anxiety (GAD-7 ≥8), and 25% (91/342) reported suicidal ideation. By follow-up, significant reductions were observed in PHQ-9 (−2.4, 95% CI −3.0 to −1.8) and GAD-7 scores (−1.5, 95% CI −2.0 to −1.0). Among those with elevated symptoms, 40% (48/120) to 42% (56/133) achieved a clinically meaningful response (≥50% reduction in baseline scores), and 27% (36/133) to 28% (33/120) achieved remission (PHQ-9 or GAD-7 score <5). Of those with suicide ideation at baseline, 60% (50/83) had none at follow-up. Conclusions: This study highlights the important relationship between telehealth-delivered GAHT and mental health, emphasizing the importance of accessible and timely care. 
SN  - 1438-8871
UR  - https://www.jmir.org/2025/1/e64017
UR  - https://doi.org/10.2196/64017
DO  - 10.2196/64017
ID  - info:doi/10.2196/64017
ER  -