Sex differences and brain development during puberty and adolescence

Handb Clin Neurol. 2020:175:25-54. doi: 10.1016/B978-0-444-64123-6.00003-5.


Sex differences in behavior, and whether these behavioral differences are related to sex differences in brain development, has been a longstanding topic of debate. Presumably, sex differences can provide critically important leads for explaining the etiology of various illnesses that show (i) large sex differences in prevalence and (ii) have an origin before or during adolescence. The general aim of this chapter is to provide an overview of scientific studies on sex differences in normative brain and behavioral development across puberty and adolescence, including the (sex) hormone-driven transition phase of puberty. Moreover, we describe the literature on brain and behavioral development in gender dysphoria, a severe and persistent incongruence between the self-identified gender and the assigned sex at birth. From the literature it becomes clear there is evidence for a specific link between pubertal maturation and developmental changes in arousal, motivation, and emotion. However, this link is rather similar between boys and girls. Moreover, although there is substantial evidence for sex differences in mean brain structure, these have not always been linked to sex differences in behavior, cognition, or psychopathology. Furthermore, there is little evidence for sex differences in brain development and thus, studies so far have been unable to explain sex differences in cognition. Suggestions for future research and methodologic considerations are provided.

Keywords: Adolescence; Affective processing; Brain structure; Cognition; Development; Gender; Hormones; Sex.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Brain
  • Cognition
  • Emotions
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Puberty*
  • Sex Characteristics*