IMPORTANCE Gender affirming treatment aims to improve mental health. OBJECTIVE To investigate longitudinal mental health outcomes in Danish transgender persons. DESIGN National register-based cohort study in Danish transgender persons with diagnosis code of "gender identity disorder" during the period 2000-2021. PARTICIPANTS Five age-matched controls of the same sex at birth and five age-matched controls of the other sex at birth were included for each transgender person. MAIN OUTCOMES Diagnosis codes of mental and behavioral disorders and/or prescription of psychopharmacological agents until June 2022. RESULTS The cohort included 3812 transgender persons with median age (interquartile range) 19 (15; 24) years for persons assigned female at birth (AFAB, N = 1993) and 23 (19; 33) years for persons assigned male at birth (AMAB, N = 1819) and 38 120 controls. Follow up duration was up to 10 years with mean (standard deviation) 4.5 (4.3) years. In transgender persons AFAB compared to control women, the odds ratio (OR) (95% confidence interval) for mental and behavioral disorders was 6.7 (5.5; 8.1) before the index date, 9.9 (8.4; 11.7) at 1 year, 5.8 (4.4; 7.7) at 5 years, and 3.4 (2.1; 7.5) at 8 years follow up. In transgender persons AMAB compared to control men, corresponding ORs were 5.0 (4.0; 6.4), 11.3 (9.3; 13.7), 4.8 (3.5; 6.5), and 6.6 (4.2; 10.3) at 8 years follow up (all P < .001). CONCLUSION The OR for mental health disorders was higher in transgender persons compared to controls and remained elevated throughout follow up, especially in transgender persons AMAB.

中文翻译：

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丹麦跨性别者的性别肯定治疗和心理健康诊断：一项全国性的基于登记的队列研究。

重要性 性别肯定治疗旨在改善心理健康。目的 调查丹麦跨性别者的纵向心理健康结果。设计 2000 年至 2021 年期间针对诊断代码为“性别认同障碍”的丹麦跨性别者进行的基于国家登记的队列研究。参与者 对于每个跨性别者，包括五名出生时年龄匹配的同性对照和五名出生时年龄匹配的异性对照。主要成果 精神和行为障碍的诊断代码和/或精神药理学药物的处方，直至 2022 年 6 月。 结果 该队列包括 3812 名跨性别者，出生时被指定为女性的人的中位年龄（四分位距）为 19（15；24）岁（AFAB， N = 1993) 和 23 (19; 33) 岁出生时被指定为男性的人 (AMAB, N = 1819) 和 38 120 名对照。随访时间长达 10 年，平均（标准差）4.5（4.3）年。与对照组女性相比，跨性别者 AFAB 中精神和行为障碍的比值比 (OR)（95% 置信区间）在索引日期前为 6.7 (5.5; 8.1)，1 年时为 9.9 (8.4; 11.7)，1 年时为 5.8 (95% 置信区间)。 5 年随访时为 4.4；7.7），8 年随访时为 3.4（2.1；7.5）。在跨性别者 AMAB 中，与对照男性相比，8 年随访时相应的 OR 分别为 5.0 (4.0; 6.4)、11.3 (9.3; 13.7)、4.8 (3.5; 6.5) 和 6.6 (4.2; 10.3)（所有 P < 0.01）。 001）。结论 与对照组相比，跨性别者心理健康障碍的 OR 较高，并且在整个随访过程中保持较高水平，尤其是跨性别者 AMAB。