4.7 Article

Brain Sex in Transgender Women Is Shifted towards Gender Identity

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 6, Pages -

Publisher

MDPI
DOI: 10.3390/jcm11061582

Keywords

brain; gender identity; machine learning; MRI; sex classifier; transgender

Funding

  1. National Institutes of Health [5 T32 HD07228:26]
  2. Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health [R01HD081720]

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This study analyzed the relationship between brain structure and physiological sex as well as gender identity in transgender individuals. The results showed that the brain structure of transgender women fell between cisgender men and cisgender women, but was closer to cisgender men. These findings support the idea that the underlying brain anatomy in transgender individuals is more aligned with their gender identity.
Transgender people report discomfort with their birth sex and a strong identification with the opposite sex. The current study was designed to shed further light on the question of whether the brains of transgender people resemble their birth sex or their gender identity. For this purpose, we analyzed a sample of 24 cisgender men, 24 cisgender women, and 24 transgender women before gender-affirming hormone therapy. We employed a recently developed multivariate classifier that yields a continuous probabilistic (rather than a binary) estimate for brains to be male or female. The brains of transgender women ranged between cisgender men and cisgender women (albeit still closer to cisgender men), and the differences to both cisgender men and to cisgender women were significant (p = 0.016 and p < 0.001, respectively). These findings add support to the notion that the underlying brain anatomy in transgender people is shifted away from their biological sex towards their gender identity.

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