Gender-affirming hormone therapy does not only change the body: it also influences emotional state. A new prospective study from Charles University in Prague (Czech Republic) has followed 30 transgender people designated female at birth who were starting testosterone treatment for four months, and has observed that, even in that early period, anxiety and trauma-related symptoms decrease and quality of life improves.
Participants were assessed on three occasions: before starting treatment, at two months and at four months. At each visit, the researchers measured hormonal parameters —oestradiol, testosterone and prolactin— and, at the same time, applied clinical questionnaires on anxiety (HAM-A), trauma-related symptoms (TSC-40) and quality of life (MANSA).
The results showed the expected endocrine changes: oestradiol fell and testosterone rose. In parallel, anxiety and trauma-related symptoms decreased significantly, and quality of life improved over the follow-up period (p < 0.05). The authors interpret that starting hormone therapy is associated with a favourable psychological adaptation in the first months.
A particularly relevant finding: the associations between hormones and psychological state became more evident from the fourth month onwards, above all in the relationship between oestradiol, anxiety and quality of life. But the psychological improvements were not directly proportional to the magnitude of the hormonal changes. This suggests that psychosocial factors and factors linked to the transition process itself also contribute to that early adaptation, and that the relationship between hormones and wellbeing is complex and time-dependent.
The authors stress the exploratory nature of the work and its small sample, and therefore call for larger studies, with comparison groups and longer follow-ups, to confirm the mechanisms. Even so, the study adds one more piece to understanding how gender-affirming hormone treatment is associated with the psychological wellbeing of people with gender dysphoria, and supports the idea that its benefits go beyond the purely physiological.
Source: Early biopsychological changes during masculinizing gender-affirming hormone therapy in AFAB transgender individuals: a 4-month prospective study. Fiala L, Kestlerova D, Nespor J, Lenz J. Frontiers in Psychiatry 2026;17:1847778. DOI: 10.3389/fpsyt.2026.1847778.
Read the publication: Frontiers in Psychiatry.
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