Sex on the brain: Are gender-dependent structural and functional differences associated with behavior?

A substantial number of studies provide evidence documenting a variety of sex differences in the brain. It remains unclear whether sexual differentiation at the neural level is related to that observed in daily behavior, cognitive function, and the risk of developing certain psychiatric and neurological disorders. Some investigators have questioned whether the brain is truly sexually differentiated and support this view with several arguments including the following: (1) brain structural or functional differences are not necessarily reflected in appropriate differences at the behavioral level, which might suggest that these two phenomena are not linked to each other; and (2) sex-related differences in the brain are rather small and concern features that significantly overlap between males and females. This review polemicizes with those opinions and presents examples of sex-related local neural differences underpinning a variety of sex differences in behaviors, skills, and cognitive/emotional abilities. Although male/female brain differentiation may vary in pattern and scale, nonetheless, in some respects (e.g., relative local gray matter volumes) it can be substantial, taking the form of sexual dimorphism and involving large areas of the brain (the cortex in particular). A significant part of this review is devoted to arguing that some sex differences in the brain may serve to prevent (in the case where they are maladaptive), rather than to produce, differences at the behavioral/skill level. Specifically, some differences might result from compensatory mechanisms aimed at maintaining similar intellectual capacities across the sexes, despite the smaller average volume of the brain in females compared with males.