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Limited prospective outcome data exist regarding transgender and nonbinary youth receiving gender-affirming hormones. A total of 315 transgender and nonbinary participants, 12 to 20 years of age, were enrolled in the study. A total of 190 participants (60.3%) were transmasculine, 185 (58.7%) were non-Latinx or non-Latine White, and 25 (7.9%) had received previous pubertal suppression treatment. During the study period, appearance congruence, positive affect, and life satisfaction increased, and depression and anxiety symptoms decreased. In addition, increases in appearance congruence were associated with concurrent increases in positive affect and life satisfaction and decreases in depression and anxiety symptoms. The most common adverse event was suicidal ideation; death by suicide occurred in 2 participants. In this 2-year study involving transgender and nonbinary youth, GAH improved appearance congruence and psychosocial functioning.
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