title: Is hormonal therapy associated with better quality of life in transsexuals? A cross-sectional study.
abstract: BACKGROUND
  Although the impact of sex reassignment surgery on the self-reported outcomes of transsexuals has been largely described, the data available regarding the impact of hormone therapy on the daily lives of these individuals are scarce.
  
  
  OBJECTIVE
  The objectives of this study were to assess the relationship between hormonal therapy and the self-reported quality of life (QoL) in transsexuals while taking into account the key confounding factors and to compare the QoL levels between transsexuals who have, vs. those who have not, undergone cross-sex hormone therapy as well as between transsexuals and the general population (French age- and sex-matched controls).
  
  
  METHODS
  This study incorporated a cross-sectional design that was conducted in three psychiatric departments of public university teaching hospitals in France. The inclusion criteria were as follows: 18 years or older, diagnosis of gender identity disorder (302.85) according to the Diagnostic and Statistical Manual, fourth edition text revision (DSM-IV TR), inclusion in a standardized sex reassignment procedure following the agreement of a multidisciplinary team, and pre-sex reassignment surgery.
  
  
  METHODS
  QoL was assessed using the Short Form 36 (SF-36).
  
  
  RESULTS
  The mean age of the total sample was 34.7 years, and the sex ratio was 1:1. Forty-four (72.1%) of the participants received hormonal therapy. Hormonal therapy and depression were independent predictive factors of the SF-36 mental composite score. Hormonal therapy was significantly associated with a higher QoL, while depression was significantly associated with a lower QoL. Transsexuals' QoL, independently of hormonal status, did not differ from the French age- and sex-matched controls except for two subscales of the SF-36 questionnaire: role physical (lower scores in transsexuals) and general health (lower scores in controls).
  
  
  CONCLUSIONS
  The present study suggests a positive effect of hormone therapy on transsexuals' QoL after accounting for confounding factors. These results will be useful for healthcare providers of transgender persons but should be confirmed with larger samples using a prospective study design.
authors.affiliation: Department of Psychiatry, Sainte-Marguerite University Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Gorin-Lazard
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
authors.forename: Aurélie
authors.initials: A
authors.lastname: Maquigneau
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Gebleux
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Penochet
authors.forename: Dominique
authors.initials: D
authors.lastname: Pringuey
authors.forename: Frédérique
authors.initials: F
authors.lastname: Albarel
authors.forename: Isabelle
authors.initials: I
authors.lastname: Morange
authors.forename: Anderson
authors.initials: A
authors.lastname: Loundou
authors.forename: Julie
authors.initials: J
authors.lastname: Berbis
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.forename: Christophe
authors.initials: C
authors.lastname: Lançon
authors.forename: Mireille
authors.initials: M
authors.lastname: Bonierbale
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014189:Transsexualism / Q000188:drug therapy*; D016896:Treatment Outcome