2023 has been challenging as the trans community face unprecedented levels of anti-trans discrimination and violence. With so much of the harmful rhetoric based in misinformation and disinformation, this year we have prioritised science communication and have spent significant time and energy engaging with government, community organisations and other key stakeholders such as sporting bodies, to ensure accurate, evidence-based information directs policies that impact trans people.
Through the challenges we have also seen some significant milestones in the trans health landscape in Australia that instil hope for a better future. This includes the announcement of $26 million Medical Research Future Fund (MRFF) funding for LGBTIQA+ focused research, a new NHMRC/MRFF Statement on Sex, Gender, Variations of Sex Characteristics and Sexual Orientation in Health and Medical Research, the largest ever Australian Professional Association for Trans Health (AusPATH) Conference, and a submission to the Medical Services Advisory Committee, which, if successful, will provide life-changing access to medical gender affirmation for trans Australians.
Below are some of the highlights from our year of research, education, and advocacy.
Dr Lachlan Angus, with his Bryan Hudson Clinical Endocrinology Award, with colleagues A/Prof Ada Cheung and Dr Brendan Nolan.
In 2023, Trans Health Research remains at the forefront of clinical research into the effects of gender-affirming hormone therapy (GAHT) on physical and mental health.
Dr Lachlan Angus conducted a randomised controlled trial (RCT) to compare differences in breast development for people using cyproterone and spironolactone, two different antiandrogens. Lachlan was invited to present study findings at the Endocrine Society of Australia Annual Scientific Meeting, where he was awarded the prestigious Bryan Hudson Clinical Endocrinology Award for 2023.
Dr Brendan Nolan led a world-first RCT to assess the mental health impacts of immediate access to testosterone GAHT, compared to a standard 3-month waitlist period. Demonstrating clear reductions in depression and suicidality after three months of testosterone treatment, Brendan’s study has gained significant media and community attention internationally, including articles by CNN, The Guardian, Healio, PinkNews, and Endocrine Society.
Dr Toan Tang published a review into gender-affirming hormone therapy and hair growth. In follow up, Toan is currently conducting a RCT in collaboration with Sinclair Dermatology, to explore the effectiveness of Minoxidil (a common medication for treating hair loss) taken under the tongue, in improving hair density and quality of life for trans people using testosterone.
Working with researchers at Victoria University we have published reviews on the impacts of gender-affirming hormones on physical performance and sport participation. Together, we have also been running GAME, a world-first study that is following people over the first 12 months of gender-affirming hormones, to monitor muscle strength, fitness and power, with recruitment ongoing (Melbourne-based).
In addition to our clinical research, our TRANSform longitudinal project, led by Dr Sav Zwickl, marked its third anniversary in May. With over 2,000 trans people involved from all over Australia and 7 sub-studies, TRANSform has become the largest ever trans research project in Australia. Highlights from TRANSform in 2023 include publications on oestradiol levels and mental health, pelvic pain with testosterone GAHT, and healthcare during the pandemic, and the launch of a survey exploring sport participation and mental health.
Tomi Ruggles presenting at the LGBTIQ+ Women’s Health Conference.
Education and advocacy
In 2023, we published 12 research blogs, with a total of over 13,000 views. Our focus this year was on filling information gaps for the trans community. Prompted by common questions seen in trans social media spaces around how to access gender-affirming hormones, the common changes experiences on GAHT and the different forms of GAHT available in Australia, we published a handful of GAHT-focused blogs: Accessing Gender-Affirming Hormone Therapy in Australia; Options for Oestrogen, Anti-Androgen, and Progesterone Hormone Therapy in Australia; Oestradiol Implants in Australia; Do Higher Oestradiol Levels Result in Better Mental Health and Wellbeing?; Options for Testosterone Hormone Therapy in Australia; and Genital Changes, Periods, and Pelvic Pain in People Using Testosterone.
To address the lack of guidance for researchers on how to accurately and meaningfully capture demographic data which includes trans people in any form of population research, we developed new Australian Research Guidelines - Including Trans People in Research: A Practical Guide to Collecting Data on Gender and Sex. We were thrilled to share these with research ethics committees from many Universities and hospitals across Australia, leading to over 100 attendees at our online launch. In the first week since the launch, over 1000 people have viewed the guidelines.These free-to-download resources include written guidelines, a 3-minute guideline video, and 30-minute webinar recording, and are now available from our website.
To ensure maximal research reach and impact, our team regularly engages with federal and state governments, community organisations, and sporting bodies.
Throughout 2023, A/Prof Ada Cheung has worked with international, national, and state-based sporting bodies to educate decision-makers on the scientific evidence of the impact of gender affirming hormone therapy on physical performance and provided advise around trans inclusion policies.
In terms of trans mental health, Dr Sav Zwickl worked with the Australian Institute of Health and Welfare in highlighting LGBTIQA+ suicidal thoughts and behaviours, and provided evidence to the Victorian Coronial Inquest into trans suicide deaths. We also joined forces with other researchers and leading community organisations to present at the National Suicide Prevention Conference in what ACON's Teddy Cook described as "one of the biggest opportunities the trans community have ever had to talk to an audience of service providers and decision-makers".
Trans Health Research team members, volunteers, and collaborators.
Learn about more of our work
Our research covers three main areas – healthcare access and delivery, gender-affirming hormone therapy, and mental health and wellbeing. In 2023 we published 11 peer-reviewed research papers - you can access all our publications here.
We continue to recruit for our research. All our clinical research (Melbourne-based) and online studies (Australia-wide) that are currently recruiting, can be found here.
All this work would not be possible without the involvement of trans community members and the tireless work of our many collaborators.
Thank you to the over 2,000 trans people involved in our research during 2023 – whether you filled out a single survey or attended numerous clinical research visits – we greatly appreciate your time and willingness to share your experiences with us. Thank you to our many collaborators, particularly trans individuals who have volunteered their time working with us, our wonderful trans community advisory group, as well as community organisations, advocacy groups, fellow researchers and scientists, and clinicians treating trans folk who we have the pleasure of working with. We see you, we celebrate you, and it is only together that we are able to work towards our goal to improve the health and wellbeing of the trans community on a global level.
All our research is only possible because of competitive grant funding, and we are so grateful for funding support from NHMRC, MRFF, the Endocrine Society of Australia, Royal Australasian College of Physicians, Heart Foundation, Paul G Allen Foundation, National Institutes of Health, Austin Medical Research Foundation and The University of Melbourne.
Thank you for sharing this journey with us and we look forward to working together to improving the health and wellbeing of the trans community in 2024 and beyond!
The Trans Health Research Team