The neurobiology and neurocognition of gender dysphoria

Abstract

Background: Gender Dysphoria (GD) is a psychological distress characterized by an incongruence between an individual's internal gender identity and the sex assigned at birth. This phenomenon has gained increased attention due to its rising prevalence, particularly among adolescents in Western societies. Objectives: This narrative literature review examines the neurocognitive, neurobiological, and neurodevelopmental aspects of GD, aiming to provide insights for the assessment of transgender adults. The growing epidemiology requires an informed and inclusive medical system. Methods: Hand searches across PubMed and Google Scholar were performed to study the neurobiological and neurocognitive aspects of Gender Dysphoria. Results: Neuroimaging studies reveal distinct brain structures in transgender women compared to cisgender men, particularly in regions like the putamen, which is involved in emotions and learning. The intricate interplay of genetic, hormonal, and neurobiological factors is implicated in GD. Differences in gray and white matter volumes, cortical thickness, and brain activation patterns have been observed in individuals with GD, implying a multifactorial basis for this condition. Neuroendocrine factors, including testosterone and estrogen levels, play a role in the development of brain structures related to sexual differentiation. Genetic contributions, such as allelic variations in genes associated with sex steroid production, have also been linked to transgenderism. The findings underscore the complexity of GD and its underlying mechanisms, contributing to a deeper understanding of this phenomenon and offering insights into assessment and support for transgender individuals.