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Positive and negative affect changes during gender-affirming hormonal treatment : results from the European Network for the Investigation of Gender Incongruence (ENIGI)

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Abstract
Improving transgender people’s quality of life (QoL) is the most important goal of gender-affirming care. Prospective changes in affect can influence QoL. We aim to assess the impact of initiating gender-affirming hormonal treatment (HT) on affect. In the European Network for the Investigation of Gender Incongruence (ENIGI) 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. Data were analyzed cross-sectionally and prospectively. Over the first three months, we observed a decline in positive affect (PA) in both TM and TW. Thereafter, PA reached a steady state in TW, whereas in TM there was also a second decline at 18 months. In both TM and TW there was no persisting difference comparing baseline to the 36-months results. Concerning negative affect (NA), we observed a decline during the first year in TM, which sustained during the second year and was not different anymore at 36 months compared to baseline. In TW though, we did not find any change of NA during the entire follow-up. Even if some of these results show significant differences, they should be considered with caution, since there was no control group and the absolute differences are small. No association between affect and the level of sex steroids was observed. Baseline QoL and psychological burden are related to affect independently from gender but are not necessarily good predictors of the evolution of one’s affect during the gender-affirming process. Further research is necessary to investigate these preliminary results.
Keywords
affect, quality of life, gender-affirming hormonal treatment, PANAS questionnaire, estrogens, testosterone, antiandrogen therapy, transgender

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MLA
Matthys, Imke, et al. “Positive and Negative Affect Changes during Gender-Affirming Hormonal Treatment : Results from the European Network for the Investigation of Gender Incongruence (ENIGI).” JOURNAL OF CLINICAL MEDICINE, vol. 10, no. 2, 2021, doi:10.3390/jcm10020296.
APA
Matthys, I., Defreyne, J., Elaut, E., Fisher, A. D., Kreukels, B. P. C., Staphorsius, A., … T’Sjoen, G. (2021). Positive and negative affect changes during gender-affirming hormonal treatment : results from the European Network for the Investigation of Gender Incongruence (ENIGI). JOURNAL OF CLINICAL MEDICINE, 10(2). https://doi.org/10.3390/jcm10020296
Chicago author-date
Matthys, Imke, Justine Defreyne, Els Elaut, Alessandra Daphne Fisher, Baudewijntje P. C. Kreukels, Annemieke Staphorsius, Martin Den Heijer, and Guy T’Sjoen. 2021. “Positive and Negative Affect Changes during Gender-Affirming Hormonal Treatment : Results from the European Network for the Investigation of Gender Incongruence (ENIGI).” JOURNAL OF CLINICAL MEDICINE 10 (2). https://doi.org/10.3390/jcm10020296.
Chicago author-date (all authors)
Matthys, Imke, Justine Defreyne, Els Elaut, Alessandra Daphne Fisher, Baudewijntje P. C. Kreukels, Annemieke Staphorsius, Martin Den Heijer, and Guy T’Sjoen. 2021. “Positive and Negative Affect Changes during Gender-Affirming Hormonal Treatment : Results from the European Network for the Investigation of Gender Incongruence (ENIGI).” JOURNAL OF CLINICAL MEDICINE 10 (2). doi:10.3390/jcm10020296.
Vancouver
1.
Matthys I, Defreyne J, Elaut E, Fisher AD, Kreukels BPC, Staphorsius A, et al. Positive and negative affect changes during gender-affirming hormonal treatment : results from the European Network for the Investigation of Gender Incongruence (ENIGI). JOURNAL OF CLINICAL MEDICINE. 2021;10(2).
IEEE
[1]
I. Matthys et al., “Positive and negative affect changes during gender-affirming hormonal treatment : results from the European Network for the Investigation of Gender Incongruence (ENIGI),” JOURNAL OF CLINICAL MEDICINE, vol. 10, no. 2, 2021.
@article{8688161,
  abstract     = {{Improving transgender people’s quality of life (QoL) is the most important goal of gender-affirming care. Prospective changes in affect can influence QoL. We aim to assess the impact of initiating gender-affirming hormonal treatment (HT) on affect. In the European Network for the Investigation of Gender Incongruence (ENIGI) 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. Data were analyzed cross-sectionally and prospectively. Over the first three months, we observed a decline in positive affect (PA) in both TM and TW. Thereafter, PA reached a steady state in TW, whereas in TM there was also a second decline at 18 months. In both TM and TW there was no persisting difference comparing baseline to the 36-months results. Concerning negative affect (NA), we observed a decline during the first year in TM, which sustained during the second year and was not different anymore at 36 months compared to baseline. In TW though, we did not find any change of NA during the entire follow-up. Even if some of these results show significant differences, they should be considered with caution, since there was no control group and the absolute differences are small. No association between affect and the level of sex steroids was observed. Baseline QoL and psychological burden are related to affect independently from gender but are not necessarily good predictors of the evolution of one’s affect during the gender-affirming process. Further research is necessary to investigate these preliminary results.}},
  articleno    = {{296}},
  author       = {{Matthys, Imke and Defreyne, Justine and Elaut, Els and Fisher, Alessandra Daphne and Kreukels, Baudewijntje P. C. and Staphorsius, Annemieke and Den Heijer, Martin and T'Sjoen, Guy}},
  issn         = {{2077-0383}},
  journal      = {{JOURNAL OF CLINICAL MEDICINE}},
  keywords     = {{affect,quality of life,gender-affirming hormonal treatment,PANAS questionnaire,estrogens,testosterone,antiandrogen therapy,transgender}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{13}},
  title        = {{Positive and negative affect changes during gender-affirming hormonal treatment : results from the European Network for the Investigation of Gender Incongruence (ENIGI)}},
  url          = {{http://dx.doi.org/10.3390/jcm10020296}},
  volume       = {{10}},
  year         = {{2021}},
}

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