A new study by researchers at Southern Oregon University and Rutgers University found that transgender adolescents who received hormone replacement therapy, or HRT, were less likely to run away from home, adding to a growing body of research linking gender-affirming care to improved mental health outcomes among transgender youth.
The paper, titled “Hormone Replacement Therapy is Associated with Decreased Risk of Running Away Among Transgender Adolescents,” examined data from the 2015 United States Transgender Survey, a nationwide survey of more than 27,000 transgender adults. Researchers Travis Campbell and Yana van der Meulen Rodgers analyzed responses from 1,101 individuals who began HRT between ages 14 and 18 and whose families were aware of their transgender identity.
According to the study, transgender individuals in the United States “face pervasive stigma, discrimination, and violence,” experiences that contribute to “gender minority stress and gender dysphoria,” which in turn are linked to poor mental health outcomes including depression, anxiety and suicidality.
The authors wrote that while prior research has examined suicide risk among transgender youth, fewer studies have focused on other indicators of distress, including running away from home. The paper notes that running away is associated with elevated risks of homelessness, drug addiction, dropping out of school, criminal activity and worsening depression.
Using an event-study methodology, the researchers compared transgender adolescents who began HRT at a given age with peers who started treatment one year later. Their analysis found that HRT initiation was associated with a 2 percentage point reduction in the likelihood of running away from home, which the authors described as “a 20 percent decrease in the risk of running away relative to the pretreatment mean.”
The study also found stronger associations among youth who began treatment at younger ages, particularly ages 14 and 15.
The authors cautioned that the data has limitations, including small sample sizes among younger cohorts and the nonrandom nature of the survey population. They emphasized that the findings should be interpreted as associations rather than definitive proof of causation.
Still, the researchers argued that the findings provide evidence supporting the benefits of gender-affirming care for transgender adolescents.
“We found that HRT is associated with a meaningful reduction in the risk that a transgender adolescent will try to run away from home,” the study concluded. “The average association between HRT and the risk of running away is a decrease of 2 percentage points, which constitutes a 20% decrease relative to the baseline rate of running away.”
The paper comes amid ongoing national political battles over transgender healthcare access, with several states enacting or considering restrictions on gender-affirming care for minors.
The authors warned that limiting access to HRT “can elevate the risk of running away and substantially undermine the mental health and overall well-being of transgender adolescents.”
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