A secondary analysis of a randomized clinical trial demonstrated that early testosterone access led to an 11.6-point improvement in self-rated health scores among transgender and gender-diverse adults, while delayed-treatment controls showed no significant change.

In the study, published in JAMA Network Open, researchers included 62 participants (of 64 enrolled) equally divided between immediate testosterone commencement and a standard care waiting list group. The participants in the study had a median age of 23 years in the intervention group and 22 years in the standard care group. The cohort was composed of both binary (55% in the intervention group, 48% in the standard care group) and nonbinary (45% in the intervention group, 52% in the standard care group) participants. Depression and anxiety were common comorbidities among participants.

Over a 3-month period, those receiving early access to testosterone therapy reported a mean improvement of 11.6 points on the EuroQol Visual Analogue Scale (EQ-VAS), compared with no significant change in the control group (mean difference = 11.6 points, 95% confidence interval [CI] = 4.9–18.3 points, P = .02). In contrast, the study did not find significant changes in the EuroQol 5-Dimension 5-Level (EQ-5D-5L) utility index (mean difference = 0.07 points, 95% CI = –0.07 to 0.21 points, P = .06).

No statistically significant between-group differences were observed in the individual dimensions of the EQ-5D-5L utility index, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The researchers utilized analysis of covariance to estimate mean differences between groups, adjusting for baseline measures.

Study limitations included the short follow-up period, the open-label design, and the use of the EQ-5D-5L utility index, which has not been validated specifically for transgender and gender-diverse populations. The researchers noted that some dimensions of the EQ-5D-5L utility index, such as mobility or pain, would not necessarily be expected to improve with testosterone therapy.

These findings aligned with previous observational studies that have shown associations between testosterone therapy and improved quality of life. Further research is needed to determine the optimal quality-of-life measures for transgender and gender-diverse populations.

Conflict of interest disclosures are available in the study.