English summary 303 In Chapter 9, I summarize the answers to our research questions and give multiple recommendations for future studies on sex hormones, sleep and mood. My research results show that changes in sex hormones can lead to small changes in depressive symptoms that are in line with prevalence differences in the population: feminizing hormones, including OAC and GAHT, can lead to modest increases in depressive symptoms and masculinizing GAHT can lead to modest decreases in depression symptoms. The effects of sex hormones on subjective sleep vary, and GAHT was found to have strongest effects on sleep architecture and chronotype. The hypothesis that sex hormones cause poor sleep, which would then lead to increases in depressive symptoms, was not supported by our findings. For future studies on mood, I emphasize the importance of examining shortterm changes in mood, since changes in daily moods and mood variability have been described after sex hormone changes. For future studies on sleep, I recommend to further study the role of previous and current sex hormone status (i.e., OC use, menopause status) on sleep architecture and chronotype. Lastly, I advocate for the inclusion of sex and sex hormones in psychiatric research and in clinical practice, to provide knowledge and techniques for prevention, early detection and treatment of sex hormonerelated problems in sleep and mood.
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