Morphological Differences in Adolescent Female to Male Transsexuals before Cross-Hormone Treatment

Early-onset gender identity disorder (EO-GID) describes a strong and persistent development of cross-gender identification. Using structural magnetic resonance imaging (sMRI) and blood samples, we studied 13 female to male patients with EO-GID and compared them to 11 biological female controls. We found that the EO-GID group in comparison to its control group showed several significant differences in regional brain volumes. These include an increase in cerebral gray matter and a decrease in volume of cerebellar white matter in the mid anterior and posterior part of the corpus callosum. Furthermore, we showed statistically significant relationships between hormone levels and regional brain volume. These include relationships between the free thyroid hormone thyroxine (T4) and volumes of the frontal lobe, the temporal lobe and cerebral white matter; between sex-hormone binding globulin (SHGB) and the frontal lobe; as well as between thyroid-stimulating hormone (TSH) and cerebral gray matter. The results of regression analyses indicate that brain volume (outcome variables) decreases with the lower thyroid hormone levels (predictor variables). We propose that abnormal hormonal development of thyroid hormones influences white matter volume in our EO-GID group. Such an abnormal development further might affect both structural and functional properties of the brain

Neuroscience in transgender people : an update

Transgender persons identify with a gender different from the one they were assigned at birth. Although describing oneself as transgender is not a new phenomenon, media attention has lately been increasing exponentially, thanks to progressive changes in laws and change in societal attitudes. These changes also allow more people nowadays to (openly) identify as transgender and/or seek gender-affirming treatment. However, simultaneously, not much is presently understood about the underlying neurobiology, and specifically the brain structure and brain function of transgender persons. One major question in neuroimaging and neuroscience has been to determine whether, at the brain level, transgender people resemble more their gender identity, their sex assigned at birth, or have a unique neural profile. Although the evidence is presently inconsistent, it suggests that while the brain structure, at least before hormonal treatment, is more similar to sex assigned at birth, it may shift with hormonal treatment. By contrast, on “sex-stereotypical tasks,” brain function may already be more similar to gender identity in transgender persons, also before receiving gender-affirming hormone treatment. However, studies continue to be limited by small sample sizes and new initiatives are needed to further elucidate the neurobiology of a ‘brain gender’ (sex-dimorphic change according to one’s gender).Transgender-Personen identifizieren sich mit einem anderen Geschlecht als dem bei der Geburt zugewiesenen. Obwohl Menschen, die sich mit einem anderen Geschlecht identifizieren, kein neues Phänomen sind, so ist die mediale Aufmerksamkeit in den letzten Jahren diesbezüglich exponentiell gestiegen. Dies ist auch den gesetzlichen Verbesserungen und einer Veränderung in der gesellschaftlichen Einstellung zu dem Thema zu verdanken. Zur gleichen Zeit aber weiß man noch nicht viel über die Gehirnstruktur und Gehirnfunktion bei transgender Menschen. Eine Hauptfrage in den Neurowissenschaften ist es, ob die Gehirne von Transgender-Personen jenen ähneln des Geschlechtes, dem sie bei der Geburt zugewiesen wurden, des Geschlechtes mit dem sie sich identifizieren, oder ob sie ein unabhängiges neuronales Profil aufzeigen. Obwohl die Befunde derzeit widersprüchlich sind, zeigen sie in die Richtung, dass sich die Gehirnstruktur vor der hormonellen Behandlung nur unwesentlich verändert. Auf der anderen Seite gleicht die neuronale Aktivität bei “geschlechtstypischen Aufgaben” von Transgender-Personen der neuronalen Aktivität ihres identifizierten Geschlechts (auch schon vor der Hormonbehandlung). Trotzdem sind Studien weiterhin limitiert, da sie oft mit kleinen Stichproben auskommen müssen und neue Initiativen zur Bestätigung der ersten Befunde nötig sind

Bone Modification in Male to Female Transgender Surgeries: Considerations for the Forensic Anthropologist

No forensic anthropological standards exist for the identification of transsexual individuals from skeletal material. In fact, current standards produce inaccurate biological profiles for transsexuals. The reason being that current standard for ascription of sex from skeletal remains relies on pelvic morphology. Positive identification of unidentified individuals relies on the accuracy of the biological profile, which includes sex, provided by the forensic anthropologist. In the case of male-to-female (MTF) transsexuals, ascription of sex based on pelvic morphology will result in an inaccurate assessment of sex. This study, therefore, attempts to determine whether or not there exists evidence in the skeleton of facial feminization surgeries (FFS) that are almost solely utilized to aid in the feminine appearance of MTF transsexuals. Survey research established that a large portion of the MTF transsexual community, approximately 64% of MTF individuals surveyed, either already had bone-modifying FFS or planned to in the future. Large and small oscillating saw blades as well as dome-shaped dental burrs were used on fleshed pig skulls to recreate the marks left during two popular FFS procedures, the mandibular angle shave/taper and the forehead contour. Analysis revealed that the marks made on wet bone are distinct enough to catalyze remodeling, which, when seen on unidentified remains, can indicate having undergone FFS. Each of the surgical tools was also utilized on a dried pig skull; comparative analysis of the tool marks made on wet bone and dry bone demonstrated that there would be discernable differences between surgical marks made antemortem and postmortem. Finally, surveys distributed to forensic anthropologists revealed that laboratories across the US and outside of the US have already had to consider transgenderism in certain forensic cases and that knowledge of the tool marks created during FFS can aid in the consideration that an unidentified skeleton may have belonged to a MTF transsexual

They Need Labels : Contemporary Institutional and Popular Frameworks for Gender Variance

This study addresses the complex issues of etiology and conceptualization of gender variance in the modern West. By analyzing medical, psychological, and popular approaches to gender variance, I demonstrate the highly political nature of each of these paradigms and how gender variant individuals engage with these discourses in the elaboration of their own gender identities. I focus on the role of institutional authority in shaping popular ideas about gender variance and the relationship of gender variant individuals who seek medical intervention towards the systems that regulate their care. Also relevant are the tensions between those who view gender variance as an expression of an essential cross-sex gender (as in traditional transsexual narrative) and those who believe that gender is socially constructed and non-binary. I finally argue that the standards of treatment for gender variant individuals pertains more to the medical legitimization of their identities than with necessarily improving outcomes

Estudio citogenético y molecular en personas con conducta transexual

[Resumen]La transexualidad es un desorden de la identidad de género con etiología multifactorial en donde están implicados tanto factores del neurodesarrollo como genéticos. En esta investigación se analizó la vulnerabilidad genética de la transexualidad en un grupo de transexuales FtM (female to male) y MtF (male to female) mediante el estudio del cariotipo y el análisis de cuatro regiones polimórficas de los genes ERβ, AR, CYP19A1 y CYP17A1 en una población de 715 transexuales y 844 controles. Resultados: No se encontró una alteración cariotípica específica de la transexualidad, aunque la aneuploidía fue 4,5 veces mayor en la población transexual (2,4%) que en la población general (0,53%) (p = 1E-06). La prevalencia del síndrome de Klinefelter fue significativamente mayor que la esperada (p = 0,022031). El polimorfismo del ERβ fue significativamente más largo en FtM que en el grupo control femenino (p = 0,002). La probabilidad de desarrollo de la transexualidad fue mayor en los individuos FtM homocigotos LL (odds ratio: 2,001 [1,15-3,46]). El polimorfismo CYP17 MspA1 mostró una distribución alélica dependiente del sexo en la población transexual FtM>MtF (p = 0,041), al contrario que la población control, lo que indica una asociación entre este polimorfismo y la transexualidad.[Resumo]A transexualidade é unha desorde da identidade de xénero con etioloxía multifactorial onde están implicados tanto factores do neurodesenvolvemento coma xenéticos. Nesta investigación analizouse a vulnerabilidade xenética da transexualidade nun grupo de transexuais FtM (female to male) e MtF (male to female), a través do estudo citoxenético do cariotipo e da análise molecular de catro rexións polimórficas dos xenes ERβ, AR, CYP19A1 e CYP17A1 nunha populación de 715 transexuais e 844 controis. Resultados: Non foi encontrada unha alteración cariotípica específica da transexualidade, mais a prevalencia da aneuploidía foi 4,5 veces superior na populación transexual (2,4%) que na populación xeral (0,53%) (p = 1E-06). A síndrome de Klinefelter mostrou unha prevalencia significativamente maior que a esperada (p = 0,022031). Canto á análise molecular, o número de repeticións do polimorfismo ERβ foi significativamente maior en FtM que no grupo control feminino (p = 0,002) e a probabilidade de desenvolvemento da transexualidade foi maior nos individuos FtM homocigotos para o alelo longo (LL) (odds ratio: 2,001 [1,15-3,46]). A respecto do polimorfismo CYP17 MspA1, foi achada unha distribución alélica dependente do sexo FtM>MtF (p = 0,041), ao contrario do que na populación control, o que indica unha asociación entre este polimorfismo e a transexualidade.[Abstract]Transsexualism is a gender identity disorder with a multifactorial etiology. Both neurodevelopmental and genetic factors seem to be implicated. The aim of this study was to investigate the possible influence of genetic factors on the etiology of FtM (female to male) and MtF (male to female) transsexualism by analysing the karyotypes and performing the molecular analysis of four polymorphisms on genes ERβ, AR, CYP19A1 and CYP17A1. We carried out the analysis in 715 transsexuals and 844 controls. Results: No karyotype aberration has been linked to transsexualism but aneuploidy prevalence (2.4%) appears to be higher than in the general population (0.53%) (p = 1E-06). The prevalence of Klinefelter syndrome is also significantly higher (p = 0.022031) than in the general population. FtMs differed from control females with respect to ERβ (p = 0.002). Repeats in ERβ were significantly higher in FtMs than in female controls, and the likelihood of developing transsexualism was higher in the subjects (LL) (odds ratio: 2.001 [1.15-3.46]). Regarding CYP17 MspA1, the allelic frequencies differed significantly between FtMs and MtFs (p = 0.041) but were not sex-dependent in the control population. The data support the association between this polymorphism and transsexualism

Causes of transsexualism

Most significant scientific publications in the field of transsexualism which provide basic knowledge on this issue and its causes were analyzed in this article since the lack of education in the matters of transsexualism can cause stigmatisation and discrimination of transsexual patients.В данной статье был произведен анализ наиболее значимых научных публикаций в области транссексуализма, предоставляющих основные знания о данном явлении и его причинах, поскольку недостаточный уровень образованности в этих вопросах может стать причиной стигматизации и дискриминации пациентов-транссексуалов