Journal article
Changes to hypothalamic volume and associated subunits during gender-affirming hormone therapy
- Abstract:
-
Background:
Among its pleiotropic properties, gender-affirming hormone therapy (GHT) affects regional brain volumes. The hypothalamus, which regulates neuroendocrine function and associated emotional and cognitive processes, is an intuitive target for probing GHT effects. We sought to assess changes to hypothalamus and hypothalamic subunit volumes after GHT, thereby honouring the region’s anatomical and functional heterogeneity.
Methods:
Individuals with gender dysphoria and cisgender controls underwent 2 MRI measurements, with a median interval of 145 days (interquartile range [IQR] 128.25–169.75 d, mean 164.94 d) between the first and second MRI. Transgender women (TW) and transgender men (TM) underwent the first MRI before GHT and the second MRI after approximately 4.5 months of GHT, which comprised estrogen and anti-androgen therapy in TW or testosterone therapy in TM. Hypothalamic volumes were segmented using FreeSurfer, and effects of GHT were tested using repeated-measures analysis of covariance.
Results:
The final sample included 106 participants: 38 TM, 15 TW, 32 cisgender women (CW) and 21 cisgender men (CM). Our analyses revealed group × time interaction effects for total, left and right hypothalamus volume, and for several subunits (left and right inferior tubular, left superior tubular, right anterior inferior, right anterior superior, all pcorr < 0.01). In TW, volumes decreased between the first and second MRI in these regions (all pcorr ≤ 0.01), and the change from the first to second MRI in TW differed significantly from that in CM and CW in several subunits (pcorr < 0.05).Limitations:We did not address the influence of transition-related psychological and behavioural changes.
Conclusion:
Our results suggest a subunit-specific effect of GHT on hypothalamus volumes in TW. This finding is in accordance with previous reports of positive and negative effects of androgens and estrogens, respectively, on cerebral volumes.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, pdf, 141.7KB, Terms of use)
-
- Publisher copy:
- 10.1503/jpn.230017
Authors
+ FWF Austrian Science Fund
More from this funder
- Funder identifier:
- https://ror.org/013tf3c58
- Grant:
- KLI504
- P23021
- Publisher:
- Canadian Medical Association
- Journal:
- Journal of Psychiatry & Neuroscience More from this journal
- Volume:
- 48
- Issue:
- 5
- Pages:
- E369-E375
- Place of publication:
- Canada
- Publication date:
- 2023-09-26
- Acceptance date:
- 2023-08-01
- DOI:
- EISSN:
-
1488-2434
- ISSN:
-
1180-4882
- Pmid:
-
37751919
- Language:
-
English
- Pubs id:
-
2118970
- Local pid:
-
pubs:2118970
- Deposit date:
-
2025-04-18
- ARK identifier:
Terms of use
- Copyright holder:
- Konadu et al.
- Copyright date:
- 2023
- Rights statement:
- © 2023. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made.
If you are the owner of this record, you can report an update to it here: Report update to this record