Early-onset trans-sensitive therapy as part of gender dysphoria care-a pilot randomized controlled trial

Psychosocial support plays a crucial role in gender-affirming treatments. This pilot randomized controlled trial, conducted in Finland, aimed to determine whether early-onset psychotherapy affects the mental distress and well-being of individuals seeking gender-affirming treatment.

Participants (N = 58) were enrolled from individuals seeking gender-affirming treatment referred to the Gender Identity Clinic at Helsinki University Hospital. Participants were randomized into two groups: early therapy or the standard evaluation process. Evaluations using the General Health Questionnaire-12 items (GHQ-12) and Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) were conducted at baseline and at the end of the evaluation period, approximately one year after enrollment. The effectiveness of the treatment was assessed with analysis of covariance (ANCOVA). In addition, participants reported their experiences through written and oral feedback.

The group that received early-onset psychotherapy showed a significant change in GHQ-12 score compared with the control (p < 0.05). The estimated effect of the intervention was a change of -4.0 (95% Cl -7.9, -0.2), indicating lower mental distress. According to feedback collected from participants, psychotherapeutic support was perceived as significant and was particularly desired at the beginning of the gender-affirming process, where the need for self-reflection was greatest. Additionally, psychosocial support was also desired to aid the transition process.

A complete RCT study with larger intervention and control groups is needed to make definitive conclusions about the effectiveness of early- onset trans- sensitive therapy. However, the results of this pilot trial support the continuation of the current clinical use of trans-sensitive psychotherapy in Finland.