Abstract
We assessed the associations of prenatal diethylstilbestrol (DES) exposure, a potent estrogen, with sexual orientation and gender identity in 3306 women and 1848 men who participated in a study of prenatal DES exposure. Odds ratios (OR) and 95% confidence intervals (CI) were derived from logistic regression models adjusted for birth year, study cohort, and education. Among women, the OR for DES in relation to reporting sexual orientation identity as nonheterosexual was 0.61 (95% CI 0.40–0.92) primarily due to a strong inverse association with a lesbian identity (OR 0.44, 95% CI 0.25–0.76). Among men, the OR for DES in relation to reporting a nonheterosexual sexual orientation identity was 1.4 (95% CI 0.82–2.4), and ORs were similar for having a gay identity (1.4, 95% CI 0.72–2.85) and bisexual identity (1.4, 95% CI 0.57–3.5). Only five individuals reported a gender identity not conforming to that assigned at birth, preventing meaningful analysis. Women who were prenatally exposed to DES were less likely to have a lesbian or bisexual orientation, while DES-exposed men were somewhat more likely to report being gay or bisexual, but estimates were imprecise.
Highlights
Research on the biological foundations of sexual orientation, an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes (American Psychological Association, 2019) supports roles for genetics, epigenetics, and prenatal hormonal exposure, in particular testosterone (Berenbaum & Beltz, 2016; Hines, 2011a, 2020; Fisher, Ristori, Morelli, & Maggi, 2018)
Results of numerous studies of women with congenital adrenal hyperplasia (CAH) show that these women are less likely to be exclusively or almost exclusively heterosexual compared with women who do not have CAH, and some of these studies show a positive association with severity of the disorder (Hines, 2011a)
The distribution of sexual orientation and gender identity according to DES exposure status for women and men is shown in Table 2, along with Odds ratios (OR) adjusted for birth year, education, and cohort
Summary
Research on the biological foundations of sexual orientation, an enduring pattern of emotional, romantic, and/or sexual attractions to men, women, or both sexes (American Psychological Association, 2019) supports roles for genetics, epigenetics, and prenatal hormonal exposure, in particular testosterone (Berenbaum & Beltz, 2016; Hines, 2011a, 2020; Fisher, Ristori, Morelli, & Maggi, 2018). Of the few studies on complete AIS, when the external genitalia are female, most find that these individuals tend to have an androphilic sexual orientation (Hines, Ahmed, & Hughes, 2003; Wisniewski et al, 2000)
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