Department of Experimental Clinical and Health Psychology,Ghent University,9000 Ghent,Belgium.
Department of Endocrinology,Center for Sexology and Gender,Ghent University Hospital,9000 Ghent,Belgium.
Psychol Med. 2018 Oct;48(14):2313-2320. doi: 10.1017/S0033291717003828. Epub 2018 Jan 15.
Stigmatization in society carries a high risk for development of psychopathology. Transgender persons are at particularly high risk for such stigmatization and social rejection by others. However, the neural correlates of ostracism in this group have not been captured.
Twenty transgender men (TM, female-to-male) and 19 transgender women (TW, male-to-female) already living in their gender identity and 20 cisgender men (CM) and 20 cisgender women (CW) completed a cyberball task assessing both exclusion and re-inclusion during functional magnetic resonance imaging (fMRI).
During psychosocial stress between-group differences were found in the dorsal and ventral anterior cingulate cortex (ACC) and the inferior frontal gyrus (IFG). Patterns were consistent with sex assigned at birth, i.e. CW showed greater activation in dorsal ACC and IFG relative to CM and TW. During re-inclusion, transgender persons showed greater ventral ACC activity relative to CW, possibly indicating persistent feelings of exclusion. Functional connectivity analyses supported these findings but showed a particularly altered functional connectivity between ACC and lateral prefrontal cortex in TM, which may suggest reduced emotional regulation to the ostracism experience in this group. Depressive symptoms or hormonal levels were not associated with these findings.
The results bear implications for the role of social exclusion in development of mental health problems in socially marginalized groups.
社会中的污名化会给心理病理的发展带来很高的风险。跨性别者尤其面临着这种污名化和被他人社会排斥的高风险。然而，该群体中被排斥的神经相关性尚未被捕捉到。
20 名跨性别男性（TM，女变男）和 19 名跨性别女性（TW，男变女）已经按照他们的性别认同生活，以及 20 名顺性别男性（CM）和 20 名顺性别女性（CW）完成了一项网络球任务，该任务在功能磁共振成像（fMRI）中评估了排斥和重新包容。
在社会心理压力下，背侧和腹侧前扣带皮层（ACC）和下额回（IFG）存在组间差异。这些模式与出生时的性别一致，即 CW 相对于 CM 和 TW，在背侧 ACC 和 IFG 中表现出更大的激活。在重新包容期间，跨性别者相对于 CW 表现出更大的腹侧 ACC 活动，这可能表明他们仍然感到被排斥。功能连接分析支持了这些发现，但在 TM 中发现了 ACC 和外侧前额叶皮层之间特别改变的功能连接，这可能表明该组对排斥体验的情绪调节能力降低。抑郁症状或激素水平与这些发现无关。
这些结果表明，社会排斥在社会边缘化群体心理健康问题的发展中起着重要作用。
