Publication Title:
PTSD symptom reduction after gender-affirming medical interventions: A longitudinal study
Community Title:
Gender-affirming care helps reduce posttraumatic stress disorder (PTSD) symptoms
Lead Authors:
James Michael Brennan, PhD
What Did We Do?
In
our study, we looked at whether posttraumatic stress disorder (PTSD)
symptoms changed after people had gender-affirming care (for example,
hormones, hair removal, surgeries). We also wanted to know whether
having more care was linked to greater improvements. In other words,
does more care mean more benefit?
We were also curious about how
this care might be helping. So, we looked at factors that typically
impact trans and gender expansive (TGE) people. Factors included gender
minority stress – where someone might be discriminated against or feel
bad about themselves for having a TGE identity– and depression symptoms.
We wanted to see whether these experiences might shape the relationship
between gender-affirming care and PTSD.
We
were inspired to conduct this study because other research has shown
that TGE people often experience benefits from gender-affirming care,
such as lowering depression and anxiety. This research made us curious
if gender-affirming care could also help with PTSD symptoms, which are
fairly common among TGE people.
What Was New, Innovative, or Notable?
This was one of the first studies to test if having gender-affirming care received over time was
related to lower PTSD symptoms. We followed The PRIDE Study
participants over time instead of just at a single snapshot in time,
which is called a longitudinal study. This way we could see what
happened to PTSD symptoms in the years after a participant had some type
of gender-affirming care. We also looked at what happened as
participants received multiple forms of care.
What Did We Learn?
About
2,500 participants from The PRIDE Study were included, and each
participant had at least one form of gender-affirming care between
2019-2022. Over half of the participants showed signs of having a PTSD
diagnosis.
We learned a few things:
- There
was an immediate and short-term drop in PTSD symptoms after the
participants had gender-affirming care back-to-back over three years.
- Having more gender-affirming care resulted in fewer PTSD symptoms over time.
- These
relationships disappeared when we also considered gender minority
stress and depression symptoms. Through a follow-up analysis, we saw
gender-affirming care improved PTSD symptoms with the help of reductions
in gender minority stress and depression.
- Overall,
what this means is that gender-affirming care may help reduce PTSD
symptoms, but mostly indirectly by improving mood and reducing gender
minority stress.
What Does This Mean for Our Communities?
Gender-affirming
care can be helpful for the impact of PTSD symptoms, but it’s not a
magic fix. It’s important that TGE folks with PTSD who are pursuing
gender-affirming care also get support through affirmative and
trauma-informed mental health care. There’s no one-size-fits-all path.
TGE people benefit from resources in different ways, so TGE people might
want to find the path that is best for them. Having pride in your TGE
identity along with connection to vibrant TGE communities are key to
reducing depression and minority stress and to giving TGE people a safe
space to heal from trauma.
What’s Next?
A
big question remains as to whether gender-affirming care might be more
helpful for TGE people with trauma related to their identities (for
example, being discriminated against or experiencing a hate crime for
being TGE). In this study, we did not assess whether PTSD symptoms were
related to identity-based trauma or other types of trauma. We hope to
continue exploring TGE experiences of PTSD and identifying what can help
TGE communities heal from trauma.
Action Steps:
See http://www.pridestudy.org/study for more information and to share this study with your friends and family.
If
you are interested in conducting research related to LGBTQIA+ health,
please learn more about collaborating with The PRIDE Study at http://pridestudy.org/collaborate.
Citation:
Brennan
JM, Lisha NE, Tran NK, Davis K, Obedin-Maliver J, Lunn MR, Flentje A.
Posttraumatic stress symptom reduction after gender-affirming medical
interventions: A longitudinal study. J Trauma Stress. 2026 Apr 9. Epub ahead of print. doi: http://doi.org/10.1002/jts.70065.
Read the full paper at: https://onlinelibrary.wiley.com/share/author/VFCMJHZNGJTYVVKXTTYB

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being conducted by The PRIDE Study, check out the table showing the
progress of our multiple Ancillary Studies.
→ Click here to get quarterly news about LGBTQIA+ health research.
We are so grateful for your contributions to our research. We couldn’t broaden our knowledge about LGBTQIA+ health without you.
Together in community,
The PRIDE Study team
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