Neural Correlates of Gender Face Perception in Transgender People.

Alessandra Daphne Fisher,Emanuele Cassioli,Mario Maggi,Carlotta Cocchetti,Francesca Mazzoli,Mario Mascalchi,Carolina Sensi,Giovanni Castellini,Jiska Ristori,Gioele Gavazzi,Stefano Orsolini,Valdo Ricca,Linda Vignozzi,Agnese Cipriani,Maria Pia Viggiano,Alessia Romani

doi:10.3390/jcm9061731

Abstract

To date, MRI studies focused on brain sexual dimorphism have not explored the presence of specific neural patterns in gender dysphoria (GD) using gender discrimination tasks. Considering the central role of body image in GD, the present study aims to evaluate brain activation patterns with 3T-scanner functional MRI (fMRI) during gender face discrimination task in a sample of 20 hormone-naïve transgender and 20 cisgender individuals. Additionally, participants were asked to complete psychometric measures. The between-group analysis of average blood oxygenation level dependent (BOLD) activations of female vs. male face contrast showed a significant positive cluster in the bilateral precuneus in transmen when compared to the ciswomen. In addition, the transwomen group compared to the cismen showed higher activations also in the precuneus, as well as in the posterior cingulate gyrus, the angular gyrus and the lateral occipital cortices. Moreover, the activation of precuneus, angular gyrus, lateral occipital cortices and posterior cingulate gyrus was significantly associated with higher levels of body uneasiness. These results show for the first time the existence of a possible specific GD-neural pattern. However, it remains unclear if the differences in brain phenotype of transgender people may be the result of a sex-atypical neural development or of a lifelong experience of gender non-conformity.

Highlights

Gender incongruence (GI) is defined by a marked and persistent discrepancy between an individual’s experienced gender and the assigned sex [1]
To the best of our knowledge, no magnetic resonance imaging (MRI) study has explored the presence of possible specific neural activation pattern in transgender people by using a gender discrimination task. For this reason, considering the central role of body image in gender dysphoria (GD) development, in the present study we evaluated brain activation patterns related to face gender discrimination in a sample of hormone-naïve transgender and cisgender individuals by using functional MRI (fMRI)
In addition. no differences between transmen and transwomen were found in terms of GD intensity and onset, according the GIDYQ-AA and the clinical interview

Summary

Introduction

Gender incongruence (GI) is defined by a marked and persistent discrepancy between an individual’s experienced gender and the assigned sex [1]. When this condition is associated with a clinically significant distress or impairment in social, occupational or other important areas of functioning, it is referred to as gender dysphoria (GD) [2]. The idea of the sexual dimorphic brain as the anatomic substrate of psychosexual development has been more widely pursued and research has focused on the influence and shaping role of genes and gonadal hormones on sexual differentiation of the brain [5]. Gonadal steroids may influence the development of brain structures and circuits through an organizational effect during early development and an activational effect later in life [3,6]

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