Evidence map›Paper›PMID 38312454›Full record

ArticleTransgender health2024

Required Mental Health Evaluation Before Initiating Gender-Affirming Hormones: Trans and Nonbinary Perspectives.

Daphna Stroumsa, Mariam Maksutova, Leah A Minadeo, Gnendy Indig, Rafael Neis, Jesse Y Ballard, Elliot E Popoff, Racquelle Trammell, Justine P Wu

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Transgender health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Gatekeeping gender-affirming care is detrimental to detrans people.International journal of transgender health · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Daphna StroumsaDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
Mariam MaksutovaMedical School, University of Michigan, Ann Arbor, Michigan, USA.
Leah A MinadeoSchool of Information Sciences, Wayne State University, Detroit, Michigan, USA.
Gnendy IndigDepartment of Obstetrics, Gynecology, and Reproductive Services, University of Vermont, Burlington, Vermont, USA.
Rafael NeisDepartment of History, University of Michigan, Ann Arbor, Michigan, USA.
Jesse Y BallardIndependent Researcher and Community Activist, Detroit, Michigan, USA.
Elliot E PopoffSchool of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Racquelle TrammellSchool of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Justine P WuDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
University of Michigan–Ann Arbor · USUniversity of Vermont · USWayne County Community College District · USWayne State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Gender-affirming hormones (hormones)-the use of sex hormones to induce desired secondary sex characteristics in transgender and nonbinary (TGNB) individuals-are vital health care for many TGNB people. Some hormone providers require a letter from a mental health provider before hormone initiation. We explore the perspectives of TGNB individuals regarding the impact of the letter requirement on their experience of care. Methods: We conducted semistructured interviews with 21 TGNB individuals who have sought or are receiving hormones. We purposively sampled respondents who were ( Results: We identified three themes related to the letter requirement: (1) Mental health: While participants appreciated the importance of therapy, the letter requirement did not serve this purpose; (2) Trans identity: The process of obtaining a letter created doubt in participants' own transness, along with a resistance to the pathologization and conflation of mental illness with transness; and (3) Care relationships: The letter requirement negatively impacted the patient-provider relationship. Participants felt the need to self-censor or to perform a version of transness they thought the provider expected; this process decreased their trust in care professionals. Conclusion: A letter requirement did not improve mental health and had several negative consequences. Removal of this requirement will improve access to hormones and may paradoxically improve mental health.

Indexed as

accessgender-affirming hormoneslettersmental healthnonbinarytransgender

Identifiers

PMID38312454
PMCPMC10835159
OpenAlexW4308144642

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.