ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2020) 17 6.18 | DOI: 10.1530/ey.17.6.18

ESPEYB17 6. Differences/Disorders of Sex Development and Transgender Medicine Transgender Medicine: Brain and Psychology (3 abstracts)

6.18. Cross sex hormone treatment is linked with a reversal of cerebral patterns associated with gender dysphoria to the baseline of cisgender controls

Kilpatrick LA , Holmberg M , Manzouri A & Savic I



To read the full abstract: Eur J Neurosci. 2019, Oct; 50: 3269-81. doi: https://onlinelibrary.wiley.com/doi/full/10.1111/ejn.14420

This longitudinal study investigated the effects of cross-sex hormone treatment on brain morphology in 40 transgender men and 24 transgender women with gender dysphoria. The MRI changes were related to body perception as assessed by questionnaire. Interestingly, after correction for treatment-related changes in grey and white matter volumes, a different picture emerged. Cortical thickness in mesial prefrontal and parietal cortex decreased during treatment in both transgender men and women. The thinning of left parietal cortex correlated with increased perception of body congruence with treatment. The authors conclude that gender dysphoria may be associated with specific brain differences related to body perception, and that the pattern reverses to the pattern in individuals without gender dysphoria with treatment in both sexes. Similarly, other brain MRI studies provide evidence that transgender individuals have structural brain alterations with a different pattern than the sex differences seen in cisgender individuals (1).

Structural and functional brain organization in gender dysphoria and the development of gender is unclear. The brain differences and changes are complex and difficult to interpret. Both a neurodevelopmental cortical hypothesis based on different sex-related structural brain phenotypes and genetic polymorphisms of sex hormone receptors, and a functional-based hypothesis related to regions involved in the own body perception are plausible (2).

References:

1. Biological sex classification with structural MRI data shows increased misclassification in transgender women. Flint C, Forster K, Koser SA, Konrad C, Zwitserlood P, Berger K, Hermesdorf M, Kircher T, Nenadic I, Krug A, Baune BT, Dohm K, Redlich R, Opel N, Arolt V, Hahn T, Jiang X, Dannlowski U, Grotegerd D. Neuropsychopharmacology. 2020, Apr 9; 10.1038/s41386-020-0666-3; DOI 10.1038/s41386-020-0666-3, PMID 32272482. https://www.ncbi.nlm.nih.gov/pubmed/32272482.

2. Brain network interactions in transgender individuals with gender incongruence. Uribe C, Junque C, Gomez-Gil E, Abos A, Mueller SC, Guillamon A. Neuroimage. 2020, May 1; 211: 116613; DOI 10.1016/j.neuroimage.2020.116613, PMID 32057995. https://www.ncbi.nlm.nih.gov/pubmed/32057995.

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