Abstract
Background: In contrast to cisgender persons, transgender persons identify with a different gender than the one assigned at birth. Although research on the underlying neurobiology of transgender persons has been accumulating over the years, neuroimaging studies in this relatively rare population are often based on very small samples resulting in discrepant findings. Aim: To examine the neurobiology of transgender persons in a large sample. Methods: Using a mega-analytic approach, structural MRI data of 803 non-hormonally treated transgender men (TM, n = 214, female assigned at birth with male gender identity), transgender women (TW, n = 172, male assigned at birth with female gender identity), cisgender men (CM, n = 221, male assigned at birth with male gender identity) and cisgender women (CW, n = 196, female assigned at birth with female gender identity) were analyzed. Outcomes: Structural brain measures, including grey matter volume, cortical surface area, and cortical thickness. Results: Transgender persons differed significantly from cisgender persons with respect to (sub)cortical brain volumes and surface area, but not cortical thickness. Contrasting the 4 groups (TM, TW, CM, and CW), we observed a variety of patterns that not only depended on the direction of gender identity (towards male or towards female) but also on the brain measure as well as the brain region examined. Clinical Translation: The outcomes of this large-scale study may provide a normative framework that may become useful in clinical studies. Strengths and Limitations: While this is the largest study of MRI data in transgender persons to date, the analyses conducted were governed (and restricted) by the type of data collected across all participating sites. Conclusion: Rather than being merely shifted towards either end of the male-female spectrum, transgender persons seem to present with their own unique brain phenotype. Mueller SC, Guillamon A, Zubiaurre-Elorza L, et al. The Neuroanatomy of Transgender Identity: Mega-Analytic Findings From the ENIGMA Transgender Persons Working Group. J Sex Med 2021;18:1122–1129.
| Original language | English |
|---|---|
| Pages (from-to) | 1122-1129 |
| Number of pages | 8 |
| Journal | Journal of Sexual Medicine |
| Volume | 18 |
| Issue number | 6 |
| Early online date | 2021 |
| DOIs | |
| Publication status | Published - Jun 2021 |
Keywords
- Anatomy
- ENIGMA
- MRI
- Mega-analysis
- Sex differences
- Transgender
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In: Journal of Sexual Medicine, Vol. 18, No. 6, 06.2021, p. 1122-1129.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - The Neuroanatomy of Transgender Identity
T2 - Mega-Analytic Findings From the ENIGMA Transgender Persons Working Group
AU - Mueller, Sven C.
AU - Guillamon, Antonio
AU - Zubiaurre-Elorza, Leire
AU - Junque, Carme
AU - Gomez-Gil, Esther
AU - Uribe, Carme
AU - Khorashad, Behzad S.
AU - Khazai, Behnaz
AU - Talaei, Ali
AU - Habel, Ute
AU - Votinov, Mikhail
AU - Derntl, Birgit
AU - Lanzenberger, Rupert
AU - Seiger, Rene
AU - Kranz, Georg S.
AU - Kreukels, Baudewijntje P.C.
AU - Kettenis, Peggy T.Cohen
AU - Burke, Sarah M.
AU - Lambalk, Nils B.
AU - Veltman, Dick J.
AU - Kennis, Mathilde
AU - Sánchez, Francisco J.
AU - Vilain, Eric
AU - Fisher, Alessandra Daphne
AU - Mascalchi, Mario
AU - Gavazzi, Gioele
AU - Orsolini, Stefano
AU - Ristori, Jiska
AU - Dannlowski, Udo
AU - Grotegerd, Dominik
AU - Konrad, Carsten
AU - Schneider, Maiko Abel
AU - T'Sjoen, Guy
AU - Luders, Eileen
N1 - Funding Information: Funding: Data collection for S. Mueller was funded by Ghent University (Multidisciplinary Research Partnership “The integrative neuroscience of behavioural control”) and the computational resources (Stevin Supercomputer Infrastructure) and services used in this work were provided by the VSC (Flemish Supercomputer Center), and funded by Ghent University, the Hercules Foundation and the Flemish Government – Department EWI., U. Habel and B. Derntl were funded by the German Research Foundation (DFG HA 3202/7-3, 7-2), B.P.C. Kreukels was funded by the Foundation for Gynaecological Research and Education, Amsterdam, The Netherlands; Neuroscience Campus, Amsterdam, the Netherlands; Fonds Nuts-Ohra, Amsterdam, The Netherlands and Hersenstichting Nederland, the Hague, the Netherlands, A. Talaei received a scientific grant from Mashhad University of Medical Sciences, A. Guillamon was funded by Spanish Ministry of Economy, Competition and Innovation (PSI2014-58004-P and PGC2018-094919-B-C2), F. Sanchez was funded by National Institute of Health Training Grant 5 T32 HD07228 (Neural Regulation of Reproduction/Laboratory of Neuroendocrinology). This scientific project was performed with the support of the Medical Imaging Cluster of the Medical University of Vienna. This research was supported by grants of the Austrian Science Fund (FWF KLI 504, P23021) to R. Lanzenberger. R. Seiger received funding from the Hochschuljubilaeumsstiftung of the City of Vienna. Funding Information: Conflict of Interest: G. T'Sjoen has received scientific grants as principal investigator Ipsen, Bayer, Sandoz. Consulting fee as advisory board member and lecturer fee from Ipsen, Novartis, Ferring. All unrelated to this project. R. Lanzenberger received travel grants and/or conference speaker honoraria within the last three years from Bruker BioSpin MR, Heel, and support from Siemens Healthcare regarding clinical research using PET/MR. He is shareholder of BM Health GmbH since 2019. G.S. Kranz received travel grants and speaker honoraria from Pfizer, AOP Orphan and Roche. Funding: Data collection for S. Mueller was funded by Ghent University (Multidisciplinary Research Partnership ?The integrative neuroscience of behavioural control?) and the computational resources (Stevin Supercomputer Infrastructure) and services used in this work were provided by the VSC (Flemish Supercomputer Center), and funded by Ghent University, the Hercules Foundation and the Flemish Government ? Department EWI., U. Habel and B. Derntl were funded by the German Research Foundation (DFG HA 3202/7-3, 7-2), B.P.C. Kreukels was funded by the Foundation for Gynaecological Research and Education, Amsterdam, The Netherlands; Neuroscience Campus, Amsterdam, the Netherlands; Fonds Nuts-Ohra, Amsterdam, The Netherlands and Hersenstichting Nederland, the Hague, the Netherlands, A. Talaei received a scientific grant from Mashhad University of Medical Sciences, A. Guillamon was funded by Spanish Ministry of Economy, Competition and Innovation (PSI2014-58004-P and PGC2018-094919-B-C2), F. Sanchez was funded by National Institute of Health Training Grant 5 T32 HD07228 (Neural Regulation of Reproduction/Laboratory of Neuroendocrinology). This scientific project was performed with the support of the Medical Imaging Cluster of the Medical University of Vienna. This research was supported by grants of the Austrian Science Fund (FWF KLI 504, P23021) to R. Lanzenberger. R. Seiger received funding from the Hochschuljubilaeumsstiftung of the City of Vienna. Funding Information: Conflict of Interest: G. T'Sjoen has received scientific grants as principal investigator Ipsen, Bayer, Sandoz. Consulting fee as advisory board member and lecturer fee from Ipsen, Novartis, Ferring. All unrelated to this project. R. Lanzenberger received travel grants and/or conference speaker honoraria within the last three years from Bruker BioSpin MR, Heel, and support from Siemens Healthcare regarding clinical research using PET/MR. He is shareholder of BM Health GmbH since 2019. G.S. Kranz received travel grants and speaker honoraria from Pfizer, AOP Orphan and Roche. Publisher Copyright: © 2021 International Society for Sexual Medicine Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Background: In contrast to cisgender persons, transgender persons identify with a different gender than the one assigned at birth. Although research on the underlying neurobiology of transgender persons has been accumulating over the years, neuroimaging studies in this relatively rare population are often based on very small samples resulting in discrepant findings. Aim: To examine the neurobiology of transgender persons in a large sample. Methods: Using a mega-analytic approach, structural MRI data of 803 non-hormonally treated transgender men (TM, n = 214, female assigned at birth with male gender identity), transgender women (TW, n = 172, male assigned at birth with female gender identity), cisgender men (CM, n = 221, male assigned at birth with male gender identity) and cisgender women (CW, n = 196, female assigned at birth with female gender identity) were analyzed. Outcomes: Structural brain measures, including grey matter volume, cortical surface area, and cortical thickness. Results: Transgender persons differed significantly from cisgender persons with respect to (sub)cortical brain volumes and surface area, but not cortical thickness. Contrasting the 4 groups (TM, TW, CM, and CW), we observed a variety of patterns that not only depended on the direction of gender identity (towards male or towards female) but also on the brain measure as well as the brain region examined. Clinical Translation: The outcomes of this large-scale study may provide a normative framework that may become useful in clinical studies. Strengths and Limitations: While this is the largest study of MRI data in transgender persons to date, the analyses conducted were governed (and restricted) by the type of data collected across all participating sites. Conclusion: Rather than being merely shifted towards either end of the male-female spectrum, transgender persons seem to present with their own unique brain phenotype. Mueller SC, Guillamon A, Zubiaurre-Elorza L, et al. The Neuroanatomy of Transgender Identity: Mega-Analytic Findings From the ENIGMA Transgender Persons Working Group. J Sex Med 2021;18:1122–1129.
AB - Background: In contrast to cisgender persons, transgender persons identify with a different gender than the one assigned at birth. Although research on the underlying neurobiology of transgender persons has been accumulating over the years, neuroimaging studies in this relatively rare population are often based on very small samples resulting in discrepant findings. Aim: To examine the neurobiology of transgender persons in a large sample. Methods: Using a mega-analytic approach, structural MRI data of 803 non-hormonally treated transgender men (TM, n = 214, female assigned at birth with male gender identity), transgender women (TW, n = 172, male assigned at birth with female gender identity), cisgender men (CM, n = 221, male assigned at birth with male gender identity) and cisgender women (CW, n = 196, female assigned at birth with female gender identity) were analyzed. Outcomes: Structural brain measures, including grey matter volume, cortical surface area, and cortical thickness. Results: Transgender persons differed significantly from cisgender persons with respect to (sub)cortical brain volumes and surface area, but not cortical thickness. Contrasting the 4 groups (TM, TW, CM, and CW), we observed a variety of patterns that not only depended on the direction of gender identity (towards male or towards female) but also on the brain measure as well as the brain region examined. Clinical Translation: The outcomes of this large-scale study may provide a normative framework that may become useful in clinical studies. Strengths and Limitations: While this is the largest study of MRI data in transgender persons to date, the analyses conducted were governed (and restricted) by the type of data collected across all participating sites. Conclusion: Rather than being merely shifted towards either end of the male-female spectrum, transgender persons seem to present with their own unique brain phenotype. Mueller SC, Guillamon A, Zubiaurre-Elorza L, et al. The Neuroanatomy of Transgender Identity: Mega-Analytic Findings From the ENIGMA Transgender Persons Working Group. J Sex Med 2021;18:1122–1129.
KW - Anatomy
KW - ENIGMA
KW - MRI
KW - Mega-analysis
KW - Sex differences
KW - Transgender
UR - http://www.scopus.com/inward/record.url?scp=85106625265&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jsxm.2021.03.079
DO - https://doi.org/10.1016/j.jsxm.2021.03.079
M3 - Article
C2 - 34030966
SN - 1743-6095
VL - 18
SP - 1122
EP - 1129
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
IS - 6
ER -