Social Functioning in Female-to-Male Individuals: Gender- Affirming Care and Social Supports

Objective: This study aimed to evaluate the effect of gender-affirming hormone therapy (GAHT) on social functioning in individuals with female-to-male (FtM) gender dysphoria (GD) and to examine the roles of social support, bilateral mastectomy, and real-life experience.
Methods: This cross-sectional study included 77 individuals with FtM GD, 41 of whom were receiving GAHT. The Social Functioning Scale (SFS) was used to evaluate participants’ social functioning. Data on family support, partner status, history of bilateral mastectomy, and duration of real-life experience were collected.
Results: Individuals receiving GAHT had higher overall social functioning, particularly in social engagement, interpersonal behavior, and pro-social activities, respectively (P = .01, P = .001, P = .002, P = .027). There were no significant differences in the recreation, independence–competence, independence–performance, and employment/occupation subscales (for all P > .05). Family support was associated with better social functioning across several domains, whereas having a partner was linked to improvements in specific areas. Participants who had undergone bilateral mastectomy also demonstrated higher social functioning scores. In addition, longer real-life experience was positively associated with overall social functioning, pro-social activities, and recreation.
Conclusion: Gender-affirming hormone therapy is associated with improved social functioning in individuals with FtM GD, especially in interpersonal domains. Bilateral mastectomy, social support, and real-life experience also appear to contribute to better social adaptation. These findings highlight the combined role of medical interventions and supportive social environments in shaping social functioning.  

Cite this article as: Durcan G, Durcan E, Turan Ş, et al. Social Functioning in female-to-male Individuals: gender-affirming care and social supports. Cerrahpaşa Med J 2026, 50, 0071, doi: 10.5152/cjm.2026.26071.