Sven C Mueller1, Antonio Guillamon2, Leire Zubiaurre-Elorza3, Carme Junque4, Esther Gomez-Gil5, Carme Uribe4, Behzad S Khorashad6, Behnaz Khazai7, Ali Talaei8, Ute Habel9, Mikhail Votinov9, Birgit Derntl10, Rupert Lanzenberger11, Rene Seiger11, Georg S Kranz12, Baudewijntje P C Kreukels13, Peggy T Cohen Kettenis13, Sarah M Burke14, Nils B Lambalk15, Dick J Veltman16, Mathilde Kennis17, Francisco J Sánchez18, Eric Vilain19, Alessandra Daphne Fisher20, Mario Mascalchi21, Gioele Gavazzi22, Stefano Orsolini23, Jiska Ristori24, Udo Dannlowski25, Dominik Grotegerd25, Carsten Konrad26, Maiko Abel Schneider27, Guy T'Sjoen28, Eileen Luders29. 1. Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium; Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain. Electronic address: Sven.Mueller@UGent.be. 2. Deparment of Psychobiology, National Distance Education University, Madrid, Spain. 3. Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Spain. 4. Department of Medicine, Institute of Neuroscience, IDIBAPS, University of Barcelona. 5. Gender Identity Unit, Clinic Hospital, Barcelona, Spain. 6. Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Women's and Children's Health, Karolinska University Hospital, Karolinska Institute, Solna, Stockholm, Sweden. 7. Keck School of Medicine, Mark and Mary Stevens Neuroimaging and Informatics Institute, USC, Los Angeles, CA, USA. 8. Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 9. Department of Psychiatry, Psychotherapy, and Psychosomatics, University Clinic RWTH, Aachen, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-10), Jülich, Germany. 10. Deptarment of Psychiatry and Psychotherapy, University of Tuebingen, Germany. 11. Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria. 12. Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hongkong. 13. Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands. 14. Psychology, Developmental and Educational Psychology, University of Leiden, Leiden, The Netherlands. 15. Obstetrics and Gynaecology, Amsterdam University Medical Center, Amsterdam, The Netherlands. 16. Psychiatry, Amsterdam University Medical Center, Amsterdam, The Netherlands. 17. Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands. 18. College of Education, University of Missouri, MO, USA. 19. Center for Genetic Medicine Research, Children's National Hospital, Washington DC, USA; Department of Genomics and Precision Medicine, George Washington University, Washington, DC, USA. 20. Andrology, Women's Endocrinology, Gender Incongruence Unit, Careggi University Hospital, Florence, Italy. 21. Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy. 22. Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy. 23. Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy. 24. Center for Genetic Medicine Research, Children's National Hospital, Washington DC, USA. 25. Institute for Translational Psychiatry, University of Muenster, Muenster, Germany. 26. Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany. 27. McMaster University, Hamilton, Canada. 28. Department of Endocrinology & Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium. 29. School of Psychology, University of Auckland, Auckland, New Zealand.
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.
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.
Authors: Noor Khalifeh; Adam Omary; Devyn L Cotter; Mimi S Kim; Mitchell E Geffner; Megan M Herting Journal: J Child Neurol Date: 2022-06-23 Impact factor: 2.363
Authors: Leire Zubiaurre-Elorza; Sebastian Cerdán; Carme Uribe; Carmen Pérez-Laso; Alberto Marcos; Ma Cruz Rodríguez Del Cerro; Rosa Fernandez; Eduardo Pásaro; Antonio Guillamon Journal: Androg Clin Res Ther Date: 2021-12-23
Authors: Karla Ramirez; Rosa Fernández; Sarah Collet; Meltem Kiyar; Enrique Delgado-Zayas; Esther Gómez-Gil; Tibbert Van Den Eynde; Guy T'Sjoen; Antonio Guillamon; Sven C Mueller; Eduardo Pásaro Journal: Front Neurosci Date: 2021-08-19 Impact factor: 4.677