Psychosocial Correlates of Gender-Affirming Hormone and Medically Necessary Surgical Intervention Use Among Transgender and Gender Diverse Youth and Young Adults

Gender-affirming hormone therapy and medically necessary surgical interventions (MNSI) help transgender and gender-diverse (TGD) individuals align their bodies with their gender identity. However, most research focuses on TGD adults, leaving TGD youth and young adults (TGD-YYA)’s experiences understudied. Even less is known about demographic and psychosocial correlates of hormone and MNSI utilization among TGD-YYA, which this cross-sectional study examines. From 2020 to 2021, 284 TGD-YYA in the United States (M_age = 21.7 years) reported recent hormone use, MNSI engagement, depression, lifetime discrimination, and gender congruence. Participants were categorized into three mutually exclusive groups: (1) MNSI and hormone use (26.1%), (2) hormones only (26.4%), and (3) neither (47.5%). Analysis of variance models assessed group differences in psychosocial correlates of hormone and MNSI use. Overall, 26.1% of the sample reported receiving MNSI, and 51.1% reported using hormones. Depression scores were significantly higher in Groups 2 and 3 than in Group 1, ps<.05. Lifetime discrimination scores were significantly higher in Groups 1 and 2 than in Group 3, ps<.001. Finally, gender congruence was significantly higher in Group 1 than in Group 2, which was higher than in Group 3, ps<.001. Our findings suggest that the use of gender-affirming care—whether hormones, MNSI, or both—is associated with significantly lower depression and greater gender congruence. These findings highlight the beneficial role of including MNSI with recent hormone use on TGD-YYA’s mental health and experiences of gender congruence.