Frontiers in Neuroendocrinology · Nov 2026
Long-term effects of gender-affirming hormone therapy on cognition: A narrative review
By Thurston LT, Galper M, Taghdisi D et al.
Short-to-medium-term studies provide robust evidence of improved psychosocial functioning but are equivocal on gender affirming hormone therapy’s (GAHT) influence on cognition and cognitive aging in transgender adults. As such, the longer-term influence of exogenous steroids on cognitive functions, and age-related decline, remains relatively unexplored. We carried out a narrative review of the literature and found 18 studies that assessed the effect of GAHT on cognition in transgender adults; only two assessed its effects on cognitive aging. There was significant variability in the studies along the lines of design, cohort, age of participants, and GAHT regimens all of which likely contributed to equivocal findings of the effect of GAHT on most cognitive tasks assessed. The paucity of studies of cognition and aging, the methodological variations across studies, and potential biases in recruitment leave an important gap in our understanding of the long-term effects of GAHT on cognitive health in transgender individuals.