Changes in affect variability after starting gender-affirming hormone therapy.

In the masculinizing hormone (MH) group, variability in tense feelings decreased after 3 months of GAHT.

• The MH group consisted of 47 persons starting testosterone.
• Participants completed up to 7 consecutive daily diaries at each of three time points: before GAHT, and after 3 and 12 months.
• Decrease in variability of tense feelings was observed at the 3-month measurement point.
• Linear mixed models were used to compare negative affect variability, corrected for mean negative affect.

In the masculinizing hormone (MH) group, variability in restless feelings decreased after 12 months of GAHT.

• The MH group consisted of 47 persons starting testosterone.
• The decrease in restless feelings variability was observed at the 12-month measurement point.
• Daily diaries collected reports on low mood, less interest, tense feelings, and restless feelings.
• Results were corrected for mean negative affect in the linear mixed models.

In the feminizing hormone (FH) group, variability in low mood increased after both 3 and 12 months of GAHT.

• The FH group consisted of 45 persons starting estrogens and anti-androgens.
• Increases in low mood variability were observed at both the 3-month and 12-month measurement points.
• Symptom measures included experienced low mood, less interest, tense feelings, and restless feelings collected via daily diaries.
• Linear mixed models compared variability between groups and across measurement time points.

In the feminizing hormone (FH) group, variability in restless feelings increased after 12 months of GAHT.

• The FH group consisted of 45 persons starting estrogens and anti-androgens.
• The increase in restless feelings variability was observed at the 12-month measurement point.
• Participants completed up to 7 consecutive daily diaries per measurement time point.
• Results were corrected for mean negative affect.

Group comparisons showed significant differences in changes in variability of low mood and restless feelings between the MH and FH groups.

• The FH group showed stronger increases in variability of negative affect compared to the MH group.
• Significant group differences were found for both low mood and restless feelings variability.
• Differences were significant at both 3 and 12 months of GAHT.
• The study included 92 total participants: 47 in the MH group and 45 in the FH group.

The study found that GAHT-related changes in affect variability move transgender participants toward profiles resembling their gender-affirmed sex, paralleling known cisgender sex differences in affect variability.

• Cisgender women are known to report greater variability in affect than cisgender men.
• MH participants (testosterone) moved toward a profile resembling cisgender men (decreased variability).
• FH participants (estrogens and anti-androgens) moved toward a profile resembling cisgender women (increased variability).
• It has been suggested that sex hormone changes may influence affect variability, and these findings provide empirical support for that hypothesis in a transgender sample.

The study design involved three measurement time points using ecological momentary assessment via daily diaries over one week per time point.

• Participants completed up to 7 consecutive daily diaries at baseline (before GAHT), 3 months, and 12 months after starting GAHT.
• Daily diaries assessed symptoms related to negative affect: low mood, less interest, tense feelings, and restless feelings.
• Data came from 92 participants in the RESTED study.
• Affect variability was operationalized as variability during one week, corrected for mean negative affect.