Skip to main content
SpringerLink
Log in

Transsexualism (“Gender Identity Disorder”) – A CNS-Limited Form of Intersexuality?

  • Conference paper
  • First Online:
Book cover Hormonal and Genetic Basis of Sexual Differentiation Disorders and Hot Topics in Endocrinology: Proceedings of the 2nd World Conference

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 707))

Abstract

In terms of their gender-related behavior, persons with (non-intersex) gender identity disorder (GID; aka transsexualism) of early onset resemble patients with somatic intersexuality who request a change of gender. However, there is currently no known intersex analog for GID of late onset. Neuroanatomy studies of somatic intersex are too few for providing any guidance on what brain effects to expect in a putative CNS-limited form of intersexuality as the basis for (non-intersex) GID. Findings in GID patients of atypical androgen levels apply only to about one-third of female-to-male transsexuals and not at all to male-to-female transsexuals. Sex steroid-related findings of genetic polymorphisms are weak, inconsistent, and largely unreplicated. Neuroanatomic findings are few and also largely unreplicated; distributions for patients with GID overlap with those of controls and are therefore of questionable utility for GID diagnosis. Given the complexity of gendered behavior and identity, the neuroanatomic basis of GID is likely to be neural networks rather than individual brain nuclei or regions. Findings on neurofunction in persons with GID are few and unreplicated. In summary, the emerging data are interesting, but at this time insufficient to constitute a firm basis for the recategorization of GID as a form of CNS-limited intersexuality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edn., text revision). Author: Washington, DC

    Google Scholar 

  2. Arnold AP (2009) The organizational-activational hypothesis as the foundation for a unified theory of sexual differentiation of all mammalian tissues. Horm Behav 55(5):570–578

    Article  PubMed  CAS  Google Scholar 

  3. Bentz E-K, Schneeberger C, Hefler LA et al (2007) A common polymorphism of the SRD5A2 gene and transsexualism. Reprod Sci 14(7):705–709

    Article  PubMed  CAS  Google Scholar 

  4. Bentz E-K, Hefler LA, Kaufmann U et al (2008) A polymorphism of the CYP17 gene related to sex steroid metabolism is associated with female-to-male but not male-to-female transsexualism. Fertil Steril 90:56–59

    Article  PubMed  CAS  Google Scholar 

  5. Berglund H, Lindström P, Dhejne-Helmy C et al (2008) Male-to-female transsexuals show sex-atypical hypothalamus activation when smelling odorous steroids. Cereb Cortex 18:1900–1908

    Article  PubMed  CAS  Google Scholar 

  6. Blanchard R (2008) The concept of autogynephilia and the typology of male gender dysphoria. J Nerv Ment Dis 177(10):616–623

    Google Scholar 

  7. Bosinski HA, Peter M, Bonatz G et al (1997) A higher rate of hyperandrogenic disorders in female-to-male transsexuals. Psychoneuroendocrinology 22:361–380

    Article  PubMed  CAS  Google Scholar 

  8. Ciumas C, Lindén Hirschberg A, Savic I (2009) High fetal testosterone and sexually dimorphic cerebral networks in females. Cereb Cortex 19(5):1167–1174

    Article  PubMed  CAS  Google Scholar 

  9. Cosgrove KP, Mazure CM, Staley JK (2007) Evolving knowledge of sex differences in brain structure, function, and chemistry. Biol Psychiatry 62:847–855

    Article  PubMed  CAS  Google Scholar 

  10. Dewing P, Shi T, Horvath S et al (2003) Sexually dimorphic gene expression in mouse brain precedes gonadal differentiation. Brain Res Mol Brain Res 118(1-2):82–90

    Article  PubMed  CAS  Google Scholar 

  11. First MB (2005) Desire for amputation of a limb: Paraphilia, psychosis, or a new type of identity disorder. Psychol Med 35:919–928

    Article  PubMed  Google Scholar 

  12. Garcia-Falgueras A, Swaab DF (2008) A sex difference in the hypothalamic uncinate nucleus: Relationship to gender identity. Brain 131:3132–3146

    Article  PubMed  Google Scholar 

  13. Gizewski ER, Krause E, Schlamann M et al (2009) Specific cerebral activation due to visual erotic stimuli in male-to-female transsexuals compared with male and female controls: An fMRI study. J Sex Med 6:440–448

    Article  PubMed  Google Scholar 

  14. Grumbach MM, Hughes IA, Conte FA (2003) Disorders of sex differentiation. In: Larson PR, Kronenberg HM, Melmed S, Polonsky KS (eds) Williams Textbook of Endocrinology, 10th edn (pp 842–1002). Philadelphia: W.B. Saunders

    Google Scholar 

  15. Hare L, Bernard P, Sánchez FJ et al (2009) Androgen receptor repeat length polymorphism associated with male-to-female transsexualism. Biol Psychiatry 65:93–96

    Article  PubMed  CAS  Google Scholar 

  16. Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA et al (2009) Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 94(9):3132–3154

    Article  PubMed  CAS  Google Scholar 

  17. Henningsson S, Westberg L, Nilsson S et al (2005) Sex steroid-related genes and male-to-female transsexualism. Psychoneuroendocrinology 30:657–664

    Article  PubMed  CAS  Google Scholar 

  18. Hughes IA, Houk C, Ahmed SF et al (2006) Consensus statement on management of intersex disorders. Arch Dis Child 91(7):554–563

    Article  PubMed  CAS  Google Scholar 

  19. Kruijver FP, Zhou J, Pool C et al (2000). Male-to-female transsexuals have female neuron numbers in a limbic nucleus. J Clin Endocrinol Metab 85:2034–2041

    Article  PubMed  CAS  Google Scholar 

  20. Lawrence AA (2009) Erotic target location errors: an underappreciated paraphilic dimension. J Sex Res 46:194–215

    Article  PubMed  Google Scholar 

  21. Luders E, Sánchez FJ, Gaser C et al (2009) Regional gray matter variation in male-to-female transsexualism. Neuroimage 46:904–907

    Article  PubMed  Google Scholar 

  22. Maheu FS, Merke DP, Schroth EA et al (2008) Steroid abnormalities and the developing brain: declarative memory for emotionally arousing and neutral material in children with congenital adrenal hyperplasia. Psychoneuroendocrinology 33(2):238–245

    Article  PubMed  CAS  Google Scholar 

  23. Martin CL, Ruble DN (2010) Patterns of gender development. Annu Rev Psychol 61:353–381

    Article  PubMed  Google Scholar 

  24. Merke DP, Fields JD, Keil MF et al (2003) Children with classic congenital adrenal hyperplasia have decreased amygdala volume: potential prenatal and postnatal hormonal effects. J Clin Endocrinol Metab 88(4):1760–1765

    Article  PubMed  CAS  Google Scholar 

  25. Meyer-Bahlburg HFL, Dolezal C, Baker SW et al (2004) Prenatal androgenization affects gender-related behavior but not gender identity in 5-12 year old girls with congenital adrenal hyperplasia. Arch Sex Behav 33:97–104

    Article  PubMed  Google Scholar 

  26. Meyer-Bahlburg HFL, Dolezal C, Baker SW et al (2006) Gender development in women with congenital adrenal hyperplasia as a function of disorder severity. Arch Sex Behav 35:667–684

    Article  PubMed  Google Scholar 

  27. Meyer-Bahlburg HFL, Dolezal C, Baker SW et al (2008) Sexual orientation in women with classical or non-classical congenital adrenal hyperplasia as a function of degree of prenatal androgen excess. Arch Sex Behav 37:85–99

    Article  PubMed  Google Scholar 

  28. Meyer-Bahlburg HF (2010) From mental disorder to iatrogenic hypogonadism: dilemmas in conceptualizing gender identity variants as psychiatric conditions. Arch Sex Behav 39(2):461–476

    Article  PubMed  Google Scholar 

  29. Mueller A, Gooren LJ, Naton-Schötz S et al (2008) Prevalence of polycystic ovary syndrome and hyperandrogenemia in female-to-male transsexuals. J Clin Endocrinol Metab 93(4):1408–1411

    Article  PubMed  CAS  Google Scholar 

  30. Pilgrim C, Reisert I (1992) Differences between male and female brains–developmental mechanisms and implications. Horm Metab Res 24(8):353–359

    Article  PubMed  CAS  Google Scholar 

  31. Ruble DN, Martin CL, Berenbaum SA (2006) Gender development. In: Damon W, Lerner RM (series eds), and Eisenberg N, Damon W, Lerner RM (vol eds), Handbook of child psychology: Vol. 3. Social, emotional, and personality development (6th edn, pp 858–932). New York: Wiley

    Google Scholar 

  32. Schöning S, Engelien A, Bauer C et al (2010) Neuroimaging differences in spatial cognition between men and male-to-female transsexuals before and during hormone therapy. J Sex Med 7(5):1858–1867

    Google Scholar 

  33. Ujike H, Otani K, Nakatsuka M et al (2009) Association study of gender identity disorder and sex hormone-related genes. Prog Neuropsychopharmacol Biol Psychiatry 33(7):1241–1244

    Article  PubMed  CAS  Google Scholar 

  34. Vance SR Jr, Cohen-Kettenis PT, Drescher J et al (2010) Opinions about the DSM gender identity disorder diagnosis: results from an international survey administered to organizations concerned with the welfare of transgender people. Int J Transgenderism 12(1):1–14

    Google Scholar 

  35. Wallen K, Hassett JM (2009) Sexual differentiation of behaviour in monkeys: role of prenatal hormones. J Neuroendocrinol 21(4):421–426

    Article  PubMed  CAS  Google Scholar 

  36. Yang X, Schadt EE, Wang S et al (2006) Tissue-specific expression and regulation of sexually dimorphic genes in mice. Genome Res 16(8):995–1004

    Article  PubMed  CAS  Google Scholar 

  37. Zhou J-N, Hofman MA, Gooren LJG et al (1995) A sex difference in the human brain and its relation to transsexuality. Nature 378:68–70

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported, in part, by NIMH grant P30-MH-43530 (P.I.: Anke A. Ehrhardt, Ph.D.).

Author information

Authors and Affiliations

  1. NYS Psychiatric Institute/Department of Psychiatry, Columbia University, New York, NY, 10032, USA

    Heino F.L. Meyer-Bahlburg

Authors
  1. Heino F.L. Meyer-Bahlburg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Heino F.L. Meyer-Bahlburg .

Editor information

Editors and Affiliations

  1. Mount Sinai School of Medicine, One Gustave L. Levy place box, New York, 10029, USA

    Maria I. New

  2. Florida International University, 11200 S.W. 8th Street, Miami, 33199, Florida, USA

    Joe Leigh Simpson

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this paper

Cite this paper

Meyer-Bahlburg, H.F. (2011). Transsexualism (“Gender Identity Disorder”) – A CNS-Limited Form of Intersexuality?. In: New, M., Simpson, J. (eds) Hormonal and Genetic Basis of Sexual Differentiation Disorders and Hot Topics in Endocrinology: Proceedings of the 2nd World Conference. Advances in Experimental Medicine and Biology, vol 707. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-8002-1_17

Download citation

Publish with us

Policies and ethics

Search

Navigation