Gender-affirming care may lower depression risk, study finds, but many are losing access
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(NEW YORK) — Transgender adults who received gender-affirming hormone therapy had a significantly lower risk of moderate-to-severe depression over four years compared to those who did not receive such care, according to a new study published in the journal JAMA Network Open.
The study tracked 3,592 transgender, nonbinary, and gender-diverse adults and found that those prescribed hormones like estrogen or testosterone had a 15% lower risk of depression symptoms, reinforcing the mental health benefits of this treatment.
The findings “support the mental health-promoting role of hormones” and their status as “a medically necessary treatment,” said Sari Reisner, an associate professor of epidemiology at University of Michigan School of Public Health and one of the study’s authors. “Hormones play a vital role in the mental health of trans people who need them.”
The study acknowledges that other factors, such as mental health treatment, social support and other influences on mood, could have affected the findings. It also did not track the duration patients received gender-affirming hormone therapy or whether they underwent other forms of gender-affirming care, such as surgery.
Transgender people in the U.S. are two to three times more likely to have a history of depression, according to the Centers for Disease Control and Prevention. The study warns that mental health disparities continue to worsen in transgender and gender diverse communities, as access to gender-affirming care becomes more difficult.
Dr. Alexes Hazen, a New York City plastic surgeon specializing in gender-affirming procedures, says she has seen a rise in depression among her patients in recent months. Many have expressed concerns over the wave of state laws restricting or banning gender-affirming care, which has made finding treatment more difficult and left many feeling hopeless.
“Unfortunately, some states are not as friendly to patients and care providers,” Hazen said. “Some states have publicly stated their allegiance to trans and nonbinary folks, and those places will become safe havens for care.”
As barriers to gender-affirming care grow, the new study underscores its importance for mental health in transgender patients. These services “address the pervasive mental health inequities that trans people experience,” Reisner said, emphasizing that access to this care is both medically necessary and essential for reducing depression risk.
“Our findings underscore the importance of protecting and upholding the right to accessible healthcare for trans people,” Reisner said,
Hazen recommended community-based health centers that cater to LGBTQ+ patients as a key resource for gender-affirming care. The study also reinforced the importance of these clinics, arguing that the gender-affirming treatment they provide improves access and supports mental health, particularly for those in underserved communities.
Alice Gao, MD, MPH, is a family medicine resident at Temple Northwest Community Family Medicine and a member of the ABC News Medical Unit.
Beauty influencer Ashley Stobart discusses how she got a facelift after removing fillers from her face/ABC News
(NEW YORK) — Celebrities are increasingly opening up about reversing cosmetic procedures and swearing off dermal fillers, but some have discovered it can come with unexpected consequences.
“Friends” actress Courteney Cox spoke about removing her fillers on the “Gloss Angeles” podcast in 2023.
“I was just doing too many fillers and then having to have them removed which, thank God they are removable, but I think I’ve messed — I messed up a lot and now, luckily, I can, you know, I was able to reverse most of that,” the 60-year-old said.
“IMPACT x Nightline: Facelift: After Fillers?” streams on Hulu beginning Jan. 23.
Reality TV star Lala Kent known for “Vanderpump Rules” discussed her change of heart with BravoTV.com.
“I wanna stop with the lips, I wanna stop with the fillers, you know, it’s just enough is enough,” the 34-year-old said. “I’m starting to look at the comments and compare photos, I’m not about it anymore.”
In 2023, model Blac Chyna told “Impact x Nightline” about how losing weight prompted her to have cosmetic work reversed at age 34.
“As I started to slim down, my features started to really come out, like my cheekbones and everything. So with all the filler, that started to really protrude out now that my face has become slimmer,” she said. “It served its purpose, like I’m just, I’m cutting ties with it so I can move on to the next chapter in my life.”
UK beauty influencer and podcaster Ashley Stobart shares her reflections on cosmetic procedures with followers on her podcast “Nip, Tuck, Not Giving A…” She got nonsurgical injections of lip filler when she was 18 — the earliest age it’s legal to do so in her country.
“It was just that quick fix I needed for maybe loss of volume, wanting bigger lips, bigger cheeks, the jaw filler, the chin filler, the nose filler,” she told ABC News. “I was having all the filler.”
Hyaluronic acid, which is commonly used for fillers, is a gel-like substance that’s injected into spaces to give an appearance of plumpness, according to ABC News medical correspondent Dr. Darien Sutton.
He noted that the internet is flooded with ads for med spas offering seemingly cheap deals on fillers and Botox.
“When you scroll online, you see advertisements for things like fillers — that should be a red flag,” Sutton said. “When you see people looking for customers, aka patients, trying to do procedures that they may not be fully skilled in doing, selling it at a discount, you know, these should be red flags.”
These injectables are sometimes described as dissolving over time, but Sutton said this isn’t always the case.
“We’re learning more and more that many of these substances are persistent in people’s bodies for longer than they may think,” he said. “And that exposes people to risks that we are only beginning to understand.”
When Stobart got pregnant, it meant she took a break from topping up her filler. Then she realized it hadn’t worn off.
“There were just multiple layers of treatments that I had accumulated over the years,” she said. “I’m looking bigger and puffier than ever.”
She decided to get her fillers reversed, but dissolving more than a decade’s worth of substances she had in her face left her with sagging skin. So she opted to get a face-lift at age 34.
She’s not alone. The American Society of Plastic Surgeons said that while the overwhelming majority of facelifts are still among people over 50, their members have observed an increase among people in their 40s and younger.
Even though Stobart had some of her fillers removed already, she said the face-lift surgery was grueling.
“They found a lot of hyaluronic acid, or remnants of some injectable at some point that I had had. They were pushing it out for hours,” she told ABC News. “I was in surgery for 9.5 hours in total. That wasn’t anticipated because when he opened everything up, it turned out there was still a lot left in there.”
Dr. Darien Sutton warned that the face is among the most complicated areas in the body due to the composition of blood vessels, nerves. and muscles, so the surgery requires expertise.
“The risk of complication is so high, and the risk of disfigurement is so high, that you have to make sure you’re doing it with someone who knows exactly what they’re doing,” he said.
Some people in their 20s and 30s are also sharing their surgical lift stories on social media. Ryan Joers is 26 years old, and started his cosmetic journey almost a decade ago with fillers.
“I had always seen on social media, other influencers,” he told ABC News. “Kylie Jenner, at that time was, I think, 16 years old, getting her lips done, and just seeing that kind of noise everywhere, seeing the influencers apply products to their lips that were beautiful and full was a big motivator.”
In the years that followed, Joers enjoyed being able to address perceived imperfections with filler. However, that changed when he was around 22.
“That was when I would smile — I didn’t see anything other than my lips,” he said. “I would see photos and videos of myself and just see lips.”
He acknowledged that he didn’t fully understand how fillers work when he first started getting them.
“Our knowledge on fillers was not what it was today, it was ‘fillers aren’t permanent.’ So you need more, you need more, you need more,” he said. “So I never really got the opportunity at first to understand different types of filler, how they interact differently in the body.”
After that, Joers began to undo what he had spent thousands of dollars and years of his life doing. He had some of his fillers dissolved and got a rhinoplasty, which is a plastic surgery that reshapes the nose. Then, at 25, he got a brow and eye lift.
“It was an interesting landscape, being, you know, a younger man — it comes with a lot of judgment from plastic surgeons,” he said. “You have to admit to someone not only that you made mistakes, but that you’re not happy with the way you look. And that’s a very vulnerable thing with anyone, whether it’s a friend or a doctor.”
Joers believes surgical lifts were his best option due to the limitations of the nonsurgical options available at med spas.
“I’m happier now with the way my face looks, given that surgery was an intervention or an option of altering my chin, altering my nose, altering my face in a way that naturally would have not been possible or achievable through a med spa procedure,” he said.
He hasn’t been afraid to be open and vulnerable about his journey, posting about his recovery and before-and-after shots on TikTok. His videos have been viewed hundreds of thousands of times, and he hopes telling his story will help those who are just starting their cosmetic journeys.
“I’m grateful for my experience, even the bad of it, because that’s how I got here,” he said. “Through that, I was able to learn and make better decisions when it came to permanent solutions.”
Having followed a similar path, Ashley Stobart told ABC News she hopes others learn from her story.
“I would just say, don’t rush into anything unless you’re 100% sure and you understand all of the pros and cons,” she said.
(NEW YORK) — Outpatient health care visits for flu illnesses are at their highest levels in 15 years, according to data updated Friday by the Centers for Disease Control and Prevention.
Nearly 8% of outpatient health care visits for respiratory illnesses are due to flu-like illness, which is the highest seen since the 2009-10 flu season, during the swine flu pandemic, data shows.
During the week ending Feb. 1, 8% of emergency department visits were due to flu compared with 3.2% the same time last year, according to the CDC data.
Additionally, 31.6% of tests came back positive for flu during the week ending Feb. 1 compared to a peak of 18.2% last season, CDC data shows.
“Given the sharp rise [of flu illnesses] particularly among young children and in key regions like New York City, this is a stark reminder of how unpredictable flu seasons can be,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and an ABC News contributor.
“With [influenza-like illness] rates exceeding 10% in several states and hospitalization rates climbing in older adults, this wave could put significant pressure on our health systems in the coming weeks,” he added.
What’s more, the rate of people dying from flu is now equal to the rate of people dying from COVID-19, likely for the first time since the COVID pandemic began.
The CDC estimates there have been at least 24 million illnesses, 310,000 hospitalizations and 13,000 deaths from flu so far this season.
At least 57 pediatric flu deaths have been reported so far this season, with 10 reported during the week ending Feb. 1.
Flu vaccines are available for both children and adults, but vaccination coverage remains low, meaning “many children and adults lack protection from respiratory virus infections provided by vaccines,” according to the CDC.
Data shows only 45% of adults aged 18 and older have been vaccinated against flu this season as have 45.7% of children.
CDC data also shows that overall respiratory illness activity is listed as “very high” nationwide. Currently, 12 states are listed as “very high” and 19 states are listed as “high.”
By comparison, seven states were listed as “very high” and 20 states were listed as “high” last week.
Although COVID-19 activity is “elevated” in many areas of the U.S., CDC data shows emergency department visits are at low levels and the number of laboratory tests coming back positive is falling.
Respiratory syncytial virus activity was also described as “elevated” but declining in most areas of the U.S., according to the CDC.
Antonio Perez/Chicago Tribune/Tribune News Service via Getty Images
(GAINES COUNTY, Texas) — The number of measles cases associated with an outbreak in western Texas has grown to 198, with 40 cases reported over the last three days, according to new data released Friday.
Almost all of the cases are in unvaccinated individuals or in individuals whose vaccination status is unknown, with 80 unvaccinated and 113 of unknown status. At least 23 people have been hospitalized so far, according to the Texas Department of State Health Services (DSHS).
Just five cases have occurred in people vaccinated with one dose of the measles, mumps, rubella (MMR) vaccine.
Children and teenagers between ages 5 and 17 make up the majority of cases, followed by children ages 4 and under.
The Texas death was the first measles death recorded in the U.S. in a decade, according to data from the Centers for Disease Control and Prevention.
A possible second measles death was recorded on Thursday after an unvaccinated New Mexico resident tested positive for the virus. The New Mexico Department of Health said the official cause of death is still under investigation.
Gaines County is the epicenter of the outbreak, with 137 cases confirmed among residents, according to DSHS. More than 90% of cases have been identified in just six counties, which account for less than 1% of the state’s total population, the department said.
State health data shows the number of vaccine exemptions in Gaines County have grown dramatically.
Roughly 7.5% of kindergarteners in the county had parents or guardians who filed for an exemption for at least one vaccine in 2013. Ten years later, that number rose to more than 17.5% — one of the highest in all of Texas, according to state health data.
The CDC has separately confirmed 164 cases in nine states so far this year in Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York, Rhode Island and Texas.
The total, however, is likely an undercount due to delays in reporting from states to the federal government.
The majority of nationally confirmed cases are in people who are unvaccinated or whose vaccination status is unknown. Of the cases, 3% are among those who received one dose of the MMR shot and 2% are among those who received two doses.
Measles is one of the most contagious diseases known to humans. Just one infected patient can spread measles to up to nine out of 10 susceptible close contacts, according to the CDC.
Health officials have been urging anyone who isn’t vaccinated to receive the MMR vaccine.
The CDC currently recommends that people receive two vaccine doses, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective. Most vaccinated adults don’t need a booster.
Texas health officials are recommending — for those living in the outbreak area — that parents consider an early dose of MMR vaccine for children between ages 6 months and 11 months and that adults receive a second MMR dose if they only received one in the past.
Earlier this week, the CDC said in a post on X that it was on the ground in Texas, partnering with DSHS officials to respond to the measles outbreak.
Measles was declared eliminated from the U.S. in 2000 due to the highly effective vaccination program, according to the CDC. However, CDC data shows vaccination rates have been lagging in recent years.
ABC News’ Youri Benadjaoud contributed to this report.
