Effect of Medical Interventions on Body Satisfaction in Gender-Dysphoric Adolescents

Body dissatisfaction contributes to distress in gender dysphoria, but longitudinal evidence on factors alleviating this discomfort is limited. This naturalistic study examined the effect of gender-affirming hormone therapy (GAHT) alone and in combination with gender-affirming surgery (GAHT + GAS) on body satisfaction. Eighty-two adolescents (mean age, 15.77 ± 1.37) referred to a specialist clinic were examined at two time points and classified into three groups at follow-up (mean interval, 1.93 ± 0.72 years): (1) no medical interventions or puberty blocking (n = 15; counts of birth-assigned females and males: 11F/4M); (2) GAHT (n = 40; 28F/12M); and (3) GAHT + GAS (n = 27; 26F/1M). Group-level changes in Body Image Scale over time, nonmedical predictors, and associations between different facets of body dissatisfaction and life satisfaction were examined. Compared to the no-intervention/puberty blocking group, adolescents showed significantly reduced body dissatisfaction after gender-affirming interventions with no statistically significant difference between the GAHT and GAHT + GAS groups. Although there were no predictors of change in body dissatisfaction, social transitioning and satisfying family functioning at baseline were associated with lower body dissatisfaction at follow-up. Body dissatisfaction and life satisfaction were negatively correlated. These results suggest gender-affirming interventions can alleviate body dissatisfaction, at least in the short term. Moreover, social transitioning and family support were factors linked to body satisfaction. Future research should further investigate the benefit-risk profile of gender-affirming interventions in the psycho-functional and somatic domains, applying more robust study designs that minimize selection and response bias, with longer observation periods and larger sample sizes.