Campbell et al in the most recent AEA Papers and Proceedings examined the effect of hormone replacement therapy as a form of gender affirming care for transgender individuals in the US. Shockingly they found that when people got good medical care, they did better than when they did not. Their key outcome of interest was an initial suicide attempt which is an extreme outcome but a highly relevant outcome:
By using the US Transgender Survey (USTS) and recently developed estimation techniques, our study aims to contribute new evidence on the relationship between the uptake of HRT and the outcomes of transgender youth. Our event study approach compares youth who started HRT (treated group) with those who initiated HRT a year later (control group). Results indicate that HRT is associated with a 5.7 percentage point reduction in the risk of attempting suicide, which amounts to a 14.4 percent decrease in the risk of attempting suicide relative to the pretreatment mean. Moreover, the effect is largest when HRT began at younger ages (i.e., 14–15).
WOW — appropriate medical care leads to a better health outcome.
Scout211
Thanks for posting this. I had no idea that economists were so woke!
Good on them. After decades in the mental health profession, I know these things to be true but it’s nice to have published studies to that effect.
Mike in Pasadena
Shocking. And impressive. Thanks for posting this study’s finding.
Victor Matheson
@Scout211: Yeah, people think we are all Art Laffer or Peter Navarro. The reality is academic economists are almost certainly Democratic voters by a large margin and study tons of cool stuff.
Roger Moore
@Victor Matheson:
Having those people around- not to mention the whole University of Chicago economics department- doesn’t do you any favors.
Baud
Dr. Nick disagrees.
bbleh
@Roger Moore: the profession frowns upon Soviet-style purges.
Percysowner
We’ll shit! Tina Turner died https://www.cnn.com/2023/05/24/entertainment/tina-turner-death/index.html
She was one Hell of a talent.
Juju
One more reason to be sick to death of modern fascist republicans. Really. I am so sick of them.
Dog Dawg Damn
This is a pretty tame study. Retrospective, not Randomly controlled, and not strong evidence. I’ve seen better studies show no effect on same question. Personally think initiating HRT at a young age is ethically fraught, but regardless, we need more and better studies (as every major organization that has looked into this believes).
Dan B
Thanks for posting this. The attacks on young trans people are horrifying. Any bit of good news is important.
rikyrah
Thank you for posting this. It’s good to see that being decent also is economical.
schrodingers_cat
@Victor Matheson: Did you see Krugman’s Twitter thread on Lucas?
Eolirin
@Roger Moore: There’s not a profession in the world that would look good if it was judged by it’s worst members. The problem economists have is that those voices get signal boosted out of all proportion because they justify the predilections of the wealthy.
Roger Moore
@Eolirin:
That’s only part of it. The flip side of that is that the economists who disagree aren’t doing enough to push back in the public sphere. When a handful of doctors pushed crazy COVID treatments and argued against vaccination, they got signal boosted way beyond their actual significance in the medical community, but other doctors pushed back. It wasn’t enough to drown out the COVID deniers and anti-vaxxers completely, but it was enough to let people who weren’t already set on believing them what the real experts thought. I think mainstream economists need to push back harder on the Art Laffers and Peter Navarros of their community.
I understand the desire not to have your academic disputes in the public eye, but it’s too late. Their only choices are to have disputes in the public eye or allowe the worst members of their profession define its public image. IMO, Paul Krugman is a good example of what more economists should be doing.
planet eddie
Shocking ! ♥️
Omnes Omnibus
@Eolirin: True, look at the damage Steve in the WTF does to the reputation of lawyers.
C Stars
Oh hey, maybe there’s some kind of reason behind all the guidance for affirming care backed by the AMA and AAP!! Hm, perhaps doctors do know what is best for their patients after all!
Goku (aka Amerikan Baka)
@C Stars:
I didn’t think the AMA and AAP would have been so toothless as they’ve turned out to be re: women’s and trans health care
David Anderson
@Dog Dawg Damn: Nah, I’ll take a staggered difference in difference design as a fairly robust way to evaluate something that is ethically almost impossible to randomize prospectively.
C Stars
@Goku (aka Amerikan Baka): How have they been toothless?
Anyway
@Goku (aka Amerikan Baka):
They’ve been terrible at speaking up on the effect of new red state laws on women’s health. Same with care of trans folk.
Sister Golden Bear
@Dog Dawg Damn:
That’s simply false. Puberty blockers (and HRT) for trans teens have been extensively studied, are safe and appropriate trans healthcare treatment, as endorsed by numerous medical associations. The “just asking questions” groups are not legit medical associations, they’re anti-trans lobbying groups that have adopted misleading names.
Omnes Omnibus
@Goku (aka Amerikan Baka): Toothless? They are professional associations. They don’t do licensing or discipline. What do you expect from them?
C Stars
@Anyway: I had noticed that they’ve issued several press releases asserting the claims of the anti-trans folks as baseless and harmful. But maybe they could do more. Maybe everyone could. Feels like we are getting steamrolled by the hate.
Chetan Murthy
Since somebody has already gone off topic, friend of the blog (no not really) joe Morrissey is getting divorced.
I for one am shocked shocked shocked.
C Stars
@Sister Golden Bear: Yes, this idea that Joe Public sitting in his armchair has “concerns” that are somehow as valid as the lived experiences and preferences of doctors and patients…so awful.
Sister Golden Bear
@C Stars: There’s also plenty of evidence that providing trans healthcare to trans kids saves lives.
Geminid
@Chetan Murthy: Joe Morrisey is always a big story in Richmond. The news that his wife filed for divorce garnered a banner headline in the Richmond Times-Dispatch this winter, and some 30 column inches of copy.
Morrissey faces a strong primary challenger and there is a good chance he’ll be knocked out of his Senate district that includes Petersburg a land much of Chesterfield County.
Six female state Senators have endorsed his opponent, Ms. Aird. The primary is June 11.
bbleh
@Sister Golden Bear: it’s exasperating, isn’t it? Well, how do we KNOW that providing medical care — not to mention simple acknowledgement and basic human empathy — to people dealing with one of the most difficult personal issues short of imminent death that a human can face, at a particularly vulnerable time of life, could AKSHULLY have positive effects unless we have RIGOROUS STATISTICAL EVIDENCE?
< /rant >
Omnes Omnibus
@Sister Golden Bear: I would also say that it’s just fucking logical. Providing care helps people. Why trans people would be an exception to that escapes me.
bbleh
@Chetan Murthy: and yes we need a new thread ASAP.
— Tina Turner, rest her magnificent soul
— (And also the fact that she booted DeSantis off ALL the front pages, with which I think she would have been thoroughly pleased)
— @sshole 1/6 rioter photographed with feet on Nancy Smash’s desk sentenced to 4-1/2 years.
C Stars
@Omnes Omnibus: I think the kind of “care” that they want to provide involves shame, guilt, depression, suicidality, etc etc. In other words, hate.
Kyle Rayner
Speaking of LGBT health, my local queer clinic texted me today to remind me that mpox is moving about the country and there is a safe, effective, and free 2-dose vaccine for mpox. Recommended for anyone who suspects being exposed, men who have high-risk sex with men, people who have recently been diagnosed with an STD, anticipate engaging in risky sexual behavior, etc. Keep it safe and proud out there!
Goku (aka Amerikan Baka)
@C Stars:
@Omnes Omnibus:
I admit I don’t know what they could’ve done differently.
I assumed, being the preeminent, respected, non-partisan expert organizations they are, that any pushback they offered would’ve dissuaded conservatives. In all honesty, I guess that was naive of me
Sister Golden Bear
@C Stars:
They want trans genocide. They want trans people to simply not exist. Making life so unbearable that trans kids/adults commit suicide furthers that goal. As a ND legislator said, she’s rather her own child be dead than be (an out) trans kid.
Frankensteinbeck
@Sister Golden Bear:
Unfortunately, every word of that is true.
Steve in the ATL
@Omnes Omnibus: I was about to decry your libel of me but then a competent lawyer told me that truth is an absolute defense to defamation claims, so you won this round!
What Have The Romans Ever Done for Us?
@Roger Moore: I feel like there are a several other guys like Krugman – Reich being one and there’s a labor economist that writes op ed pieces whose name escapes me. But they don’t get the same signal boosting in the business news media system because they’re not saying what Wall Street wants to hear.
bbleh
@Sister Golden Bear: @Frankensteinbeck: at the very least, they want a purge. They want anyone who does not conform to their narrow moralistic code to be gone (or if not gone then silent and invisible). And if that happens to involve their deaths, then something something the Lord’s Will something.
What they don’t realize is that, as “relentless boundary maintainers,” they must always invent new categories of people to condemn and exclude, which ultimately leaves them forlorn in a dying town wondering “how could this have happened to US?”
Hob
@Sister Golden Bear:
About 20 years ago I worked as a nurse in a San Francisco clinic where a lot of the doctors specialized in primary care of trans patients. Besides the huge importance to the patients of having a doctor who was familiar with their specific concerns and wouldn’t treat them like a mysterious space alien, the staff also did a lot of outreach to other healthcare providers in terms of saying “If you’re not very familiar with people being on hormone therapy, you might have concerns about what is safe, what a typical protocol is, what interactions there may be with other health issues… well, we have extensive experience with this and here are our own published studies and here’s all the research from the last 20 years that we’ve based our practice on.” They’d been doing that for years and still it was a very, very, very slow process to raise the level of awareness in the field of stuff that was not new knowledge at all; lots of people (and I mean not just the general public, but doctors) still persisted in thinking that hormone therapy was this super experimental thing that we couldn’t possibly know the long-term effects of.
That was all for adult patients— they didn’t have a pediatric practice and in those days I don’t think they would’ve been able to. But it sounds like the same pattern, where you have to tell people thousands of times about the work that’s already been done and the knowledge that already exists, and often run into a suspicious reaction of “Well maybe that’s not real research and experience, because I think all the people at the forefront of this work have a bias toward thinking it’s OK.”