Chapter 3 90 that rates of regret are very low (Wiepjes et al., 2018). Therefore, the increase in low mood in the transfeminine group should be interpreted with caution, and replication and further research on underlying causes is necessary. Our results reveal distinct changes in the depression symptom profiles between masculinizing GAHT users compared to feminizing GAHT users, aligning with prevalence differences found in cisgender populations. These findings support the hypothesis that masculinizing or feminizing hormones could affect depressive symptoms differently. They also raise new questions on possible mechanisms related to depressive symptoms and sex hormone use, which could also be relevant for other populations using exogenous sex hormones. Future research on GAHT and depression should focus on interactions with psychosocial factors (e.g. stress, discrimination, or support) and biological changes (e.g. genetic and neurobiological factors). This will eventually aid in developing more gender-sensitive mental health care.
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