Sleep and Mental Health Disorders in Transgender Individuals on Gender-Affirming Hormone Therapy at a Tertiary Care...

The transgender populations have a higher rate of sleep disorders, secondary to psychosocial stressors, anxiety, mood disturbances, and hormonal influences. The role of gender-affirming hormonal therapy (GAHT) on sleep has not yet been explored. The current study was done to estimate the burden of sleep disorders and mental health among the transgender population receiving GAHT.

This was a single-centre cross-sectional study done in transgender individuals aged greater than 18 years at the Endocrinology department at a tertiary care centre. Demographic characteristics and response to various validated questionnaires like Pittsburgh sleep quality index (PSQI), Epworth sleepiness score, Berlin Sleep questionnaire, Hamilton anxiety rating scale, Hamilton depression rating scale, Montreal Cognitive Assessment, and Patient health questionnaire were analysed.

The total number of participants was 45; 26 were transgender women and 19 were transgender men. The mean score of the PSQI among transgender women was 8.88 ± 1.98, and that among the transgender men was 8.58 ± 1.00 indicating poor sleep quality. Depression was seen in 68.42% of transgender men and 53.48% transgender women. Around 10% among both the groups had severe depression. Among transgender women, 88.46% had mild anxiety, while 11.54% had mild to moderate anxiety. Among transgender men, 78.94% had mild anxiety, and 21.05% had mild to moderate anxiety.

Sleep disorders are very common in transgender people on GAHT. Interventions should focus on a multidimensional approach, encompassing gender-affirming care, mental health support, and strategies for managing stress and discrimination.