Patient-reported outcomes and satisfaction with gender-affirming hormone therapy among transgender and gender-diverse individuals in South Korea: A multicenter prospective study.

Abstract

Introduction: Knowledge of gender-affirming hormone therapy (GAHT) among transgender and gender-diverse (TGD) individuals outside Western countries remains limited. This study aimed to investigate GAHT-related experiences and patient-reported outcomes and related factors among TGD individuals in South Korea.

Methods: A multicenter prospective study was conducted at eight gender-affirming care-providing clinics in Korea. TGD individuals who underwent GAHT were included. An online survey was administered between January and October 2024. Demographic characteristics and satisfaction and self-perceived GAHT effects were measured on a Likert scale; regret was assessed on a 0 (no regret) to 100 (total regret) scale. Multivariable logistic regression analysis was conducted to investigate the associated factor with satisfaction.

Results: Among 824 participants, 437 (53.0%), 253 (30.7%), 98 (11.9%), and 36 (4.4%) were trans women, trans men, non-binary individuals assigned male at birth (NB-AMAB), and non-binary individuals assigned female at birth (NB-AFAB), respectively. The median age was 28 years (interquartile range [IQR] 24-33). Median age at GAHT initiation was 24 years (IQR 21-29), and median duration was 2.9 years (IQR 1.1-5.8). Most respondents (90.7%) were satisfied with GAHT; 9.3% reported moderate-to-low satisfaction. Moderate-to-low satisfaction rate was the highest among NB-AMAB (16.3%) and lowest among trans men (5.9%). Approximately 80.8% reported no regrets. GAHT improved gender congruence (89.6%), gender expression (87.2%), quality of life (85.2%), self-esteem (82.3%), and mental health (82.1%).

Discussion: Most TGD individuals who underwent GAHT in Korea were satisfied and exhibited a very low rate of regret. To improve the health and well-being of TGD individuals in Korea, accessibility to GAHT should be expanded.