Friday Shorts: GLP-1s, transgender care, measles and food insecurity

April 4, 2025

A. GLP-1s not associated with increased suicide risk and associated with lower risk of major depression.

JAMA Psychiatry published a meta-analysis of 27 randomized controlled trials that included about 33,000 patients who were treated with GLP-1s and found that they were about 24% less likely to consider suicide or self-harm. This difference did not reach statistical significance. An earlier huge observational study in Europe that showed a statistically significantly lower risk of suicidal ideation with GLP-1 medications.

Another study published this month in Annals of Internal Medicine shows that in those being treated for diabetes, patients taking GLP-1 medications were less likely to have major depression than those taking DPP4 medications, and about as likely as those taking SGLT2 medications. Both SGLT2 and GLP-1 medications improve kidney and cardiac outcomes, so they are likely to continue to be more frequently prescribed than other diabetes medications.

B. Gender affirming hormone prescription associated with lower risk of major depression

JAMA Network Open published an observational study of almost 3,600 transgender people cared for at two LGBTQ-focused community health centers in New York City and Boston which found that major depression was substantially less common in transgender patients treated with gender affirming hormones (14.8%) compared to those who were not treated with hormonal therapy (19.8%). There was no report on the use of anti-depressants or anxiolytic medications in either population.

This does not prove that gender affirming hormone treatment lessens incidence of depression, as it is only an observational study, and those requesting hormonal therapy at these centers might have had lower mental health risk.

The Trump Administration has proposed a rule to prohibit marketplace plans from covering gender affirming care as an essential benefit as of 2026.

C. Over 500 measles cases reported

The Texas measles outbreak is up to over 400 cases (some in New Mexico and Oklahoma), and a new cluster in Kansas could be related, too. There are also imported measles cases reported in Maryland, Virginia, California, Ohio and Washington State. I continue to appreciate Katelyn Jetelina’s Your Local Epidemiologist newsletter, and if you are looking for more in-depth reporting on current status here’s a link to a resource published by Yale School of Public Health students. The link downloads a PDF file.

Here’s a link to a post from earlier this month on what this means for employers.

D. Food insecurity is common

This U.S. Preventive Services Task Force last week recommended that primary care physicians screen their patients for food insecurity. Although we live in a wealthy country based on our GDP, each year about one in eight households experiences food insecurity, and one in twenty experiences severe food insecurity. Food insecurity is higher in Black and Hispanic households than in White households.

Here’s a link to a past post on this issue that includes employer implications.

Thanks for reading. You can find previous posts in the Employer Coverage archive

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4/11/25 Correction: In section E, the correct prevalence of severe insecurity is 5.1% (one in twenty). This statistic was correct in the September post. The text above is corrected.