Anatomical and Functional Findings in Female-to-Male Transsexuals: Testing a New Hypothesis

Cereb Cortex. 2017 Feb 1;27(2):998-1010. doi: 10.1093/cercor/bhv278.


Gender dysphoria (GD) is characterized by incongruence between onés gender assigned at birth and the gender that one identifies with. The biological mechanisms of GD are unclear, especially in female-to-male transsexuals (FtM-TR). Here, we investigate whether distinct structural and functional patterns along cerebral midline networks processing own-body perception may constitute a biological correlate.

Method: MRI of functional connectivity, cortical thickness, surface area, and gray matter volume was carried out in 28 female-to-male transsexuals (FtM-TR) and 68 cis-sexual controls (34 male). FtM-TR displayed thicker mid-frontal, precuneal-parietal, and lingual cortex than both male and female controls, whereas, in regions with reported anatomical sex differences among the controls, FtM-TR followed patterns of the gender assigned at their birth. FtM-TR also displayed weaker functional connections from the pregenual anterior cingulate to the insular cortex, and the temporo parietal junction compared with both control groups. Distinct structural and functional pattern in the own-body image network may represent biological markers for the dysphoric own-body perception in transgender individuals.

Keywords: MRI; cortical thickness; gender dysphoria; own-body perception; resting-state fMRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Body Image
  • Cerebral Cortex / diagnostic imaging*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Nerve Net / diagnostic imaging*
  • Neural Pathways / diagnostic imaging
  • Neuropsychological Tests
  • Transgender Persons
  • Transsexualism* / diagnostic imaging
  • Transsexualism* / psychology
  • Young Adult