Highs, Lows, and Hormones: A Qualitative Metasynthesis of Transgender Individuals’ Experiences Undergoing Gender-Affirming Hormone Therapy

ABSTRACT

Gender Affirming Hormone Therapy (GAHT) is a key therapeutic approach which aims to help trans and gender diverse (or simply “trans”) individuals’ transition from their sex-presumed-at-birth to their experienced gender identity. Previous reviews have focused on synthesizing quantitative experiences; however, a qualitative lens is important to understand the personal journey of GAHT. This review provides a qualitative meta-synthesis of the experiences of trans people around the world who have undergone GAHT to elicit contextualized understanding of the changes experienced. Systematic searches of eight databases identified an initial 2670 papers, refined to a final 28 papers. Overall, findings suggested that the GAHT journey is unique and elicited a myriad of changes which, whilst challenging at times, were life-changing and brought about positive psychological, physical, and social changes. Other themes explored GAHT not being treated as a fix-all for associated mental health issues, the rules that govern appraisal of physical changes, how privilege and social identity evolve, and the power of affirmation. This work offers important recommendations to improve the care offered to trans people undergoing GAHT. Namely, person-centered support is essential, and peer-navigation may be a useful future direction to explore.

KEYWORDS:

• Hormone therapy
• transgender
• qualitative
• systematic review
• transition

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data extracted from included studies is described in Table 2 and is otherwise available in their published forms. All other resources are not publicly available.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Funding

Sexual Health Research Fund Grant (Round 2) 2019. Administered on behalf of Queensland’s Department of Health by Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). Agreements with this funding body have not limited our ability to complete and publish research. As well the researchers have full control of all the primary data and are willing to allow the journal to review data if requested.