Largest study in the world finds no detrimental effects to Hormone Therapy

A long-term study that has now reached 2600 transgender patients across four clinics in Europe has yielded conclusive evidence that Hormone Therapy does not have detrimental side effects. Quite the opposite, indications are that HT regimens measurably increase a person’s sense of well-being and lower levels of anxiety.

The European Network for the Investigation of Gender Incongruence (ENIGI) is the largest study of transgender people in the world, and it’s unique: most studies are small and look at the outcomes of people who have already undergone hormone treatment and surgery. That has left scientists and physicians with little data about the long-term effects of such treatment on health, such as cancer susceptibility, or how the brain and body change as people transition both socially and medically.

In the European Network for the Investigation of Gender Incongruence (ENIGI) initial study, we prospectively collected data of 873 participants (451 transwomen (TW) and 422 transmen (TM)). At baseline, psychological questionnaires including the Positive and Negative Affect Schedule (PANAS) were administered. The PANAS, levels of sex steroids and physical changes were registered at each follow-up visit during a 3-year follow-up period, starting at the initiation of hormonal therapy.

The numbers mean that the ENIGI researchers can finally draw some significant conclusions about the effects of standard care. So far, hormone treatments seem to be safe, with few side effects. The most common complaint from people is that they experience lowered sexual desire and for trans women no voice change. But the most significant change the researchers have measured is something positive — a decrease in anxiety and depression after treatment.

Collecting all of these different data gives the ENIGI researchers a comprehensive look at how treatment affects different people. The impacts are complex, Defreyne says, and can be difficult to parse from those associated with the psychological counseling and the personal growth that many experiences.

Dr. Guy T’Sjoen discusses his involvement in ENIGI. Interesting that he was moved into focusing his doctorate in endocrinology on trans people after watching the film “Girl“.

Additional reading:

Hormone therapy in transgender adults is safe with provider supervision; A review of hormone therapy sequelae for transgender individuals

Gender-Affirming Hormone Use in Transgender Individuals: Impact on Behavioral Health and Cognition

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