Trans Health Research

27/04/2026

Congratulations to THR Research Fellow Dr Brendan Nolan, who was recently invited to present on gender-affirming hormone therapy (GAHT) for trans and gender diverse adults at the 19th Asia Oceania Congress of Endocrinology in Taiwan.

Combining his recent groundbreaking study on the mental health benefits of GAHT with clinical experience, Dr Nolan was proud to present practical and evidence-based education to an international audience alongside colleagues from Hong Kong and Taiwan, in an informative and inspiring multidisciplinary symposium.

To read more peer-reviewed research about GAHT, mental health, and other trans health topics, head to the publications page on our website: https://www.transresearch.org.au/publications

Image description: Text displayed alongside three photos. The text reads, “International education: Data on the mental health benefits of gender-affirming hormone therapy and approaches to prescribing. Research Presentation by Dr Brendan Nolan at the Asia Oceana Congress of Endocrinology in Taiwan.” Left photo shows Brendan standing at a podium and smiling happily, wearing a blue suit and glasses. A sign on the podium reads, “Brendan Nolan (Australia)”. Top right photo shows a large screen displaying a bar graph with the heading, “Increasing numbers seeking gender-affirming hormone therapy”. Bottom right photo shows Brendan being presented with a printed certificate and a bear onstage. End description.

07/04/2026

As community members and clinicians, we've seen an increasing number of trans and gender diverse people–particularly non-binary people–opting for gender-affirming testosterone (T) at lower doses than the “standard” guidelines, which were based on cisgender male reference ranges.

International best practice guidelines emphasise that all gender-affirming care needs to be tailored to the individual's unique goals and healthcare needs. Our team's recent retrospective audit looked into how low-dose T is being utilised in practice locally; which formulations are prescribed, at which doses, how this affects the amount of testosterone in the body, and how common it is to remain on this lower dose.

This paper provides much-needed information for the sector, supporting clinicians and community members alike to make informed decisions about low-dose T options. We also specify areas where further research is needed.

You can read more here: https://onlinelibrary.wiley.com/doi/10.1111/cen.70110

Image description: Three photos displayed above text. The text references low-dose T, as previously discussed. The top left photo shows a non-binary person with curly black hair, bleached white eyebrows, and dark red lipstick, laughing and wearing a white shirt. The lower left photo shows a person with short, wavy black hair, wearing transparent glasses and a yellow hoodie, smiling happily. The right photo shows a mature-aged non-binary person with partly-shaved blond hair, wearing a brown vest, white suit shirt, and a patterned blue tie. They are smiling peacefully. End description.

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02/04/2026

Many people in this country are currently dealing with increased levels of stress, anxiety, depression, and worry about the future. We also know that, in addition to other stressors, holiday periods can be tough for trans and gender diverse people, particularly folks whose families are unaccepting.

Over the following days and weeks, we want you to know that you are not alone. There is a wide range of support services you can access, some which are LGBTQ-specific, and we have compiled a list on our website: https://www.transresearch.org.au/community/mental

We hope that you can find support and strength in your chosen family, friends, partners, or fellow community members. If you do need extra support, please remember that you can always reach out for help, even if it’s hard.

We know that many community members may be providing support to other trans and gender diverse people, which can be tiring. We hope that you can take care of yourself, and show yourself the same compassion that you offer to others.

Image description: Text displayed alongside a photo. The text reads, “If you are struggling right now, you are not alone. If you are dealing with anxiety, depression, stress, or other difficult feelings, support is available,” followed by, “Collated resources: https://bit.ly/thr-mental-health”. The photo shows an androgynous person sitting in a bus stop, looking down at their phone, wearing white headphones. They have short, shaved hair, dyed bright green. They are wearing a black-and-white chequered hoodie over a black hoodie and black shirt. End description.

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30/03/2026

Today is Trans Day of Visibility. It’s a day to celebrate those who are visible, while also acknowledging people for whom visibility isn’t a choice or a celebration, and those who are non-disclosing. At Trans Health Research, we’re proud to be working to improve the health and wellbeing of all trans and gender diverse people, regardless of how visible their gender diversity is. We’re also proud to centre the lived experience, research contributions, and insights of gender diverse team members and collaborators.

Dr. Sav Zwickl, lead researcher of TRANSform, the largest trans-led trans health research project in Australia, said, “For a long time, research was done about trans people, not with them. It has been incredible to see a shift over the last few years, of increasing numbers of trans researchers and greater value placed on involving trans people in research design. Over half of our research team are trans, I am so proud and honoured to be one of them!”

Image description: A photo displayed alongside text. The text reads, “Over half of our team are trans or gender diverse. We are proud to be working towards greater visibility and trans leadership in research, today and every day,” followed by, “Trans Day of Visibility.” The photo shows Trans Health Research team members sitting indoors, wearing casual clothing, all smiling happily. End description.

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27/03/2026

The International Olympic Committee (IOC) has announced a new policy mandating genetic s*x testing of women and girl athletes. This policy will ban all trans women and inters*x women, unless they undergo further testing to prove testosterone insensitivity.

In February, the United Nations Joint Statement on Fairness, Inclusion, and Non-Discrimination in Sport warned against genetic s*x testing, presumption of uniform advantage, and blanket bans. In defiance of this, the IOC has chosen administrative simplicity and political ideology over scientific nuance.

The s*x-determining screening is blunt. The engagement with the endocrine evidence on gender-affirming hormone therapy is absent. The bundling of trans and inters*x athletes is clinically unjustifiable. The process lacked the transparency expected for a policy affecting fundamental rights. The select group of members of the "protecting women's sport" committee are unknown.

The 2021 Framework, for all its imperfections, at least acknowledged complexity and underwent extensive stakeholder engagement. This policy retreats from that. It will be presented as "following the science”, but it is more accurately described as following selective science filtered through political expediency.

As the UN wrote; “Where eligibility decisions may have far-reaching and foreseeable human rights impacts, opaque processes and limited stakeholder engagement risk undermining the legitimacy of outcomes and eroding trust. Decision-making processes should therefore be transparent, participatory, and inclusive, with meaningful opportunities for engagement by affected athletes and independent experts.” That has not been followed, in this case.

It's important to remember that this IOC policy applies only to elite Olympic competition and explicitly does not apply to grassroots or recreational sport. In Australia, sport, especially community sport, is for everyone. Trans, gender diverse, and inters*x Australians are protected from discrimination under federal law (the S*x Discrimination Act 1984) and state and territory anti-discrimination legislation, and have the right to participate in sport free from exclusion, harassment and discrimination.

If you would like to learn more about trans participation in sport, see this collation of evidence: https://www.transresearch.org.au/post/trans-women-in-sport

If you’re feeling distressed by this news, you can access support here: https://www.transresearch.org.au/community/mental

Image description: Text displayed alongside a photo. The text emphasises the right of trans, gender diverse, and inters*x people to participate in sport without being discriminated against, as previously written. The photo shows three women gathered together, cheering happily, wearing mouth guards and sportswear. End description.

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19/03/2026

Dr. Brendan Nolan, along with other researchers, conducted research examining how access to gender-affirming care affects both health outcomes and public spending.

https://theconversation.com/funding-surgery-and-hormones-for-trans-people-can-save-medicare-millions-new-research-274125

The findings are clear. Before receiving gender-affirming hormones or surgery, trans and gender diverse people had higher use of mental health services and medications. After care was accessed, this use declined, indicating improved mental health and reduced need for ongoing clinical support.

By analysing a decade of de-identified Medicare records for thousands of people, researchers found that providing gender-affirming care is not only clinically beneficial, but economically responsible. The reduction in mental health service use and prescriptions could translate into millions of dollars in savings for Medicare.

Despite this, gender-affirming surgery remains inconsistently subsidised, leaving many people to face significant out-of-pocket costs.

This research reinforces what gender diverse communities and clinicians have long made clear: Access to timely, affordable gender-affirming care is essential, improving lives while also reducing pressure on the healthcare system.

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Until now, we haven’t had research that tracks how accessing hormones or surgeries affects how much trans people use mental health services and medications.

17/03/2026

Late last year, we celebrated a huge milestone. Dr Lachlan Angus officially graduated from his PhD!

Lachie’s doctoral thesis, Optimising The Use Of Anti-Androgens In Trans People, was a landmark randomised controlled trial comparing two commonly-used anti-androgens, spironolactone and cyproterone. His work showed that both agents are effective, with no difference in breast development or body fat distribution, providing strong evidence that anti-androgen choice should be individualised, guided by patient preference and side-effect profile, rather than assumptions about physical outcomes.

Beyond this, Lachie’s PhD delivered a series of world-class contributions showing that estradiol and anti-androgens alter heart conduction and shift the plasma proteome toward patterns more closely aligned with cisgender women than cisgender men.

His work has been recognised nationally, including the Endocrine Society of Australia Bryan Hudson Clinical Endocrinology Award and the AusPATH Best Paper by an Early Career Researcher Award (2025).

On the same day, Den Celestra graduated from his Master of Biomedical Science, using Lachie’s RCT data to examine immune cell changes with GAHT. Den showed that estradiol and cyproterone influence immune pathways linked to autoimmune disease risk, including Th17 CCR4- cells. This is an important step toward understanding immune modulation in trans and gender diverse health.

We’re incredibly proud of both Lachie and Den for this rigorous science, these clinically meaningful questions, and the real-world impact which follows.

LINKS:

Breast development: https://doi.org/10.1210/clinem/dgae650

Body composition: https://doi.org/10.1080/26895269.2025.2531421

Heart conduction: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2816835

Plasma proteome patterns: https://www.nature.com/articles/s41591-025-04023-9

Image description: Text displayed alongside a photo of Doctor Lachlan Angus and Den Celestra at their graduation ceremonies, accompanied by Professor Ada Cheung. Lachie and Den are smiling happily, holding graduation certificates in blue tube containers, Ada standing between them and smiling happily. Lachie is wearing a white suit shirt, dark blue trousers, a red-and-black academic gown, and a black Tudor bonnet. Den is wearing a white suit shirt, black trousers, a red-and-black academic gown, and a black mortarboard cap. Ada is wearing a pink-and-blue shirt, black trousers, a red-and-black academic gown, glasses, and a black Tudor bonnet. End description.

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11/03/2026

Are you trans or gender diverse, aged 16 or older, and living in Australia? If you haven't already, now is the time to join TRANSform, Australia's largest trans-led research project!

By sharing your experiences, you can contribute to the evidence base used to guide trans-related policy and programs in Australia. Together, we can improve the health and wellbeing of trans communities!

For more info and to join TRANSform: https://www.transresearch.org.au/participate/transform

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An ongoing research project designed to investigate the health and wellbeing experiences of the Australian trans and gender diverse community.

05/03/2026

Trans and gender diverse people are more likely to experience Long COVID, compared to cisgender people. You can reduce the risk of COVID-19 infection to you, your loved ones, and vulnerable community members (such as immunocompromised people) by:

✓ Keeping up-to-date with your COVID-19 vaccinations.

✓ Wearing masks where possible.

✓ Holding gatherings in well-ventilated areas or outdoors.

✓ Avoiding high-risk settings such as crowded indoor areas.

✓ Maintaining good hygiene (hand sanitiser, hand-washing).

To learn more about why trans and gender diverse people are at higher risk of lasting complications from COVID-19, and what the latest research says, read our summary here: https://www.transresearch.org.au/post/long-covid

Image description: Text displayed alongside a photo. The text reads, “Research blog post: Why are trans and gender diverse people at greater risk of Long COVID? How can we protect ourselves?” The photo, as described by the photographer Gritchelle Fallesgon (for Disabled and Here), shows the following: “Six disabled people of colour sit inside an art-filled bookstore, wearing a mix of KN-95 and N-95 masks in different shades. In the centre, a Black person sits in front of a couch, wearing glasses and noise-canceling headphones, while holding up a sign reading, “Together We Mask.” On their left, a Black person rests on their rollator and an Indigenous woman sits on the couch. On their right, a Latinx person sits on the couch with their cane resting against their legs, a Latinx woman sits on the floor, and an Asian person relaxes in their mobility scooter.” End description.

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03/03/2026

Late last year, we published an article in the Internal Medicine Journal, examining referral trends to all three tertiary gender clinics in Victoria between 2020 and 2024 (Monash, Austin, and the Royal Children's Hospital).

Using state-wide data, we found that new referrals peaked in 2021 and have since plateaued and declined, with 2024 showing the lowest number of referrals observed. This directly challenges claims of an ongoing or “exponential” rise in demand driven by so-called “social contagion”.

Importantly, our findings suggest a shift in where care is delivered, rather than a surge in the number of trans people seeking care. Over this period, Victoria has deliberately expanded primary care, community-based, and private services, alongside workforce training in trans and gender diverse health. These changes appear to be easing pressure on tertiary hospital clinics while maintaining access to care.

This study provides real-world population data to inform policy at a time when referral numbers are often misrepresented in political and media debates. It highlights that decentralising gender-affirming care is both feasible and effective, and that claims of runaway demand are not supported by evidence.

As always, good healthcare planning depends on accurate data, not ideology.

View publication: https://doi.org/10.1111/imj.70265.

Image description: Text displayed alongside a photo. Text reads, “Healthcare research: No surge, no “contagion” in gender clinic referrals. State-wide data tell a different story to political rhetoric on trans and gender diverse healthcare”. Photo shows a woman standing at a receptionist desk, listening as the receptionist talks and gestures to a clipboard with a pen. The woman is wearing a flower-patterned top and clear-rimmed glasses, with a short, closely-cropped, undercut afro. She is smiling slightly. End description.

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Photo: PixelCatchers, iStock.

25/02/2026

Finding safe and secure housing is a major challenge for many trans and gender diverse (trans) people, only made harder by the housing and cost-of-living crisis.

We are incredibly grateful to the 800+ trans people from across Australia who shared their housing experiences with us. We hope that that the statistics and stories captured in our recently-published research report can be used by policy-makers, housing services, and community organisations, to advocate for safer homes and neighbourhoods for trans people.

View the full report, accompanying 1-page summaries, and report launch webinar here: https://www.transresearch.org.au/reports/housing-26

This research was conducted as part of the TRANSform project, Australia's largest and longest-running trans adult health study. Find out more: https://www.transresearch.org.au/participate/transform

Image description: Stats displayed alongside a photo of a trans woman, her non-binary partner, and their son. Stats: 6% moved due to feeling unsafe. 7% experienced anti-trans discrimination, threats, or violence from neighbours. 52% experienced housing insecurity. 11% experienced abuse or controlling behaviour at home. 10% did not have the option to leave an unsafe home. 12% experienced homelessness. Accompanying text reads, “Trans and gender diverse housing statistics in the previous 12 months,” and, “Want to know more? Check out the housing report”.

Photo: rparobe, iStock.

19/02/2026

Improving health care access and reducing health disparities for trans and gender diverse (trans) communities is an urgent priority.

As highlighted in our recent research report, trans-related discrimination in health care settings remains prevalent, and often results in delays to health care seeking. For example, we heard from Danny*, a trans man whose negative experiences prevented him from seeking medical care when he fractured his ankle, and Drew*, a non-binary person whose skin cancer went undetected until more invasive treatments were required.

We hope this new report can support trans communities and stakeholders in their advocacy efforts to strengthen trans and LGBTIQA+ community-controlled services, and boost inclusion of trans health training in university curriculums and health services.

View the full report and accompanying summaries: https://www.transresearch.org.au/reports/healthcare-26

On the same page, you can also watch the launch event recording.

Image description: Health care statistics and a quote displayed alongside three photos. Stats: 57% experienced anti-trans discrimination from a health care professional, 81% had access to supportive professional, 40% had delayed seeking care due to anticipated discrimination. Quote from trans man: “I experienced trans discrimination from two different male GPs who laughed at me, refused to treat me, asked s*xually inappropriate questions, and told me that seeking hormones and surgery is wrong.” Left photo: A teenager in an appointment, looking into the distance with a neutral or upset expression, wearing a flannel shirt. Middle photo: A trans man kissing his non-binary partner on the forehead, as they lie in a hospital bed wearing a green hospital gown. Right photo: A non-binary person standing indoors, looking into the distance with a neutral or upset expression, wearing professional clothing. End description.

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Credits: Freepik. Alexander Grey, EyeEm/Freepik. Dario Gaona, iStock.

*Pseudonyms.