Skorska Malvina N, Chavez Sofia, Devenyi Gabriel A, Patel Raihaan, Thurston Lindsey T, Lai Meng-Chuan, Zucker Kenneth J, Chakravarty M Mallar, Lobaugh Nancy J, VanderLaan Doug P
Child and Youth Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada.
Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON M5T 1R8, Canada.
J Clin Med. 2021 Jan 18;10(2):345. doi: 10.3390/jcm10020345.
Gender dysphoria (GD) is characterized by distress due to an incongruence between experienced gender and sex assigned at birth. Sex-differentiated brain regions are hypothesized to reflect the experienced gender in GD and may play a role in sexual orientation development. Magnetic resonance brain images were acquired from 16 GD adolescents assigned female at birth (AFAB) not receiving hormone therapy, 17 cisgender girls, and 14 cisgender boys (ages 12-17 years) to examine three morphological and microstructural gray matter features in 76 brain regions: surface area (SA), cortical thickness (CT), and T1 relaxation time. Sexual orientation was represented by degree of androphilia-gynephilia and sexual attraction strength. Multivariate analyses found that cisgender boys had larger SA than cisgender girls and GD AFAB. Shorter T1, reflecting denser, macromolecule-rich tissue, correlated with older age and stronger gynephilia in cisgender boys and GD AFAB, and with stronger attractions in cisgender boys. Thus, cortical morphometry (mainly SA) was related to sex assigned at birth, but not experienced gender. Effects of experienced gender were found as similarities in correlation patterns in GD AFAB and cisgender boys in age and sexual orientation (mainly T1), indicating the need to consider developmental trajectories and sexual orientation in brain studies of GD.
性别焦虑症（GD）的特征是由于所经历的性别与出生时被指定的性别不一致而产生的痛苦。有假说认为，性别分化的脑区反映了GD中所经历的性别，并且可能在性取向发展中起作用。对16名出生时被指定为女性（AFAB）且未接受激素治疗的GD青少年、17名顺性别女孩和14名顺性别男孩（年龄在12至17岁之间）进行了磁共振脑图像采集，以检查76个脑区的三个形态学和微观结构灰质特征：表面积（SA）、皮质厚度（CT）和T1弛豫时间。性取向由男性偏好-女性偏好程度和性吸引力强度表示。多变量分析发现，顺性别男孩的SA大于顺性别女孩和GD AFAB。较短的T1反映了更密集、富含大分子的组织，在顺性别男孩和GD AFAB中，它与年龄较大和更强的女性偏好相关，在顺性别男孩中还与更强的吸引力相关。因此，皮质形态测量（主要是SA）与出生时被指定的性别有关，而与所经历的性别无关。在所经历的性别方面的影响表现为，GD AFAB和顺性别男孩在年龄和性取向（主要是T1）的相关模式上存在相似性，这表明在GD的脑研究中需要考虑发育轨迹和性取向。
