Gender-affirming hormone treatment and cognitive function in transgender young adults: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND: Previous studies have examined whether steroid hormone treatment in transgender individuals may affect cognitive function; yet, their limited power does not allow firm conclusions to be drawn. We leveraged data from to-date literature aiming to explore the effect of gender-affirming hormone administration on cognitive function in transgender individuals. METHODS: A search strategy of MEDLINE was developed (through June 1, 2019) using the key terms transgender, hormone therapy and cognitive function. Eligible were (i) cohort studies examining the longitudinal effect of hormone therapy on cognition, and (ii) cross-sectional studies comparing the cognitive function between treated and non-treated individuals. Standardized mean differences (Hedges' g) were pooled using random-effects models. Study quality was evaluated using the Newcastle-Ottawa Scale. OUTCOMES: Ten studies (seven cohort and three cross-sectional) were eligible representing 234 birth-assigned males (aM) and 150 birth-assigned females (aF). The synthesis of cohort studies (n = 5) for visuospatial ability following hormone treatment showed a statistically significant enhancement among aF (g = 0.55, 95% confidence intervals [CI]: 0.29, 0.82) and an improvement with a trend towards statistical significance among aM (g = 0.28, 95%CI: -0.01, 0.58). By contrast, no adverse effects of hormone administration were shown. No heterogeneity was evident in most meta-analyses. INTERPRETATION: Current evidence does not support an adverse impact of hormone therapy on cognitive function, whereas a statistically significant enhancing effect on visuospatial ability was shown in aF. New longitudinal studies with longer follow-up should explore the long-term effects of hormone therapy, especially the effects on younger individuals, where there is greater scarcity of data.
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In a recent meta-analysis, HRT was found not to affect the motor coordination or visuospatial abilities of transwomen.
“in a recent meta-analysis, HRT was found not to affect the motor coordination or visuospatial abilities of transwomen [47].”
From Integrating Transwomen and Female Athletes with Differences of Sex Development (DSD) into Elite Competition: The FIMS 2021 Consensus Statement (2021) · cites this paper as [47]
Section 3.4 (page unavailable) reports a non-significant trend toward improved visuospatial ability in assigned-male transgender participants, not evidence that HRT had no effect. Its explicit finding of no significant change in motor coordination concerns assigned-female participants, not transwomen. The claim therefore overstates the visuospatial result and applies the motor-coordination finding to a different group. (LLM, conf=0.86)
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- Authors
- Karalexi, M. A., Georgakis, M. K., Dimitriou, N. G., Vichos, T., Katsimpris, A., Petridou, E. T., & Papadopoulos, F. C.
- Affiliations
- Uppsala University (SE)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Papadopoulos, Fotios C.
- ORCID
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 119
- Pages
- 104721
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W3029883418
- Cited by
- 41
- References
- 83
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 8 · 2023: 6 · 2022: 8 · 2021: 5 · 2020: 2
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychoneuroendocrinology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Keywords
- gender-affirming hormone therapy, cognitive function, transgender young adults, visuospatial ability, sex differences
- MeSH terms
- Gender Dysphoria, Cognition, Cross-Sectional Studies, Female, Humans, Male, Spatial Behavior, Transsexualism, Cohort Studies, Hormone Replacement Therapy, Young Adult, Gender-Affirming Procedures, Transgender Persons
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Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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