Psychosocial Stress and the Transsexual Brain

Stress of gender identity disorder may modify connections in the brain

On August 22, one day after receiving a sentence of 35 years in prison for leaking classified government documents, former US Army Private Bradley Manning announced his intention to undergo hormone treatment in view of a sex change. While not all transsexuals opt to live as the opposite gender, with which they identify more strongly, psychosocial stress in some form is commonly experienced by those in their situation. The results of a recent study show that this stress can lead to alterations in the brain and may have implications for the way we view individual choices regarding gender.

On August 22, one day after receiving a sentence of 35 years in prison for leaking classified government documents, former US Army Private Bradley Manning announced his intention to undergo hormone treatment in view of a sex change. While not all transsexuals opt to live as the opposite gender, with which they identify more strongly, psychosocial stress in some form is commonly experienced by those in their situation. The results of a recent study show that this stress can lead to alterations in the brain and may have implications for the way we view individual choices regarding gender.

 

Transsexuals are people who have a very strong and lasting sense of belonging to the opposite sex. They identify intensely with the gender opposite their biological sex, and may feel uncomfortable with their original sex or the roles assigned to it. This is known as gender identity disorder (GID).

It is difficult to estimate how many are affected by this, but it is clear that, with greater recognition and understanding of the condition, more and more people are seeking consultations for GID. Although it may show itself in different ways, a common denominator is the psychosocial stress experienced by many transsexuals. Choosing to dress like the opposite sex, displaying behaviors typical of the other gender, or even wishing to undergo sex reassignment surgery—these are all, to some extent, socially taboo in many cultures. A recent study published in PLOS One and available on MyScienceWork found that this stress can leave its mark in changes to the transsexual brain.

Jen-Chuen Hsieh of the Institute of Brain Science at National Yang-Ming University, in Taiwan, led a team that investigated whether a trace of the stress associated with GID could be seen in the functioning of the brain. They worked with both male and female transsexuals and a group of heterosexual control subjects, although it is important to note that gender identity disorder is different from homosexuality.

 

Pervasive cross-gender feelings

In one set of tests, carried out to reveal feelings of gender mismatch, participants watched silent clips of films, some erotic in nature, others neutral, then rated the degree to which they identified with the male or female character. In both contexts, transsexual subjects gave significantly higher scores to the person of their desired gender than did members of the reference group. Even during neutral films, the strength of this gender preference (desired versus non-desired) was much greater for transsexuals.

The authors acknowledge that reports by transsexuals of the strength of their cross-gender identification could be susceptible to bias, but the researchers took great care to express that the study results would only serve the interest of scientific research. Jen-Chuen Hsieh explains that the results of this test show the pervasiveness of transsexuals’ identification with their desired sex—in erotic situations, but also in neutral circumstances of daily life. This is considered a psychological trait that is a marker for gender identity disorder, he says.


(Source: Hsiao-Lun Ku, et al.)

Altered connections in the brain

To examine connections in the working brain, functional MRI scans were performed on transsexual participants (who were not undergoing hormone therapy, to avoid any influence of this treatment), in order to observe the level of connectivity among relevant brain regions. These were areas known to be involved in consciousness of self, conflict monitoring, and social processing, for example. The team’s analyses showed significant connectivity in brains of subjects with GID—something not seen in non-transsexual individuals. Dr. Hsieh considers this a consequence of a lifetime of psychosocial distress. Through associations made over time, the brain “learns” new connections and their neural imprint can be seen in the functioning of the brain. “This implies a neural plasticity emanating from psychosocial learning and coping in the face of social exclusion, conflict monitoring and punishment adjustment,” he says.

In this study, all of the participants exhibiting GID were from Taiwan,  “an Oriental country relatively more conservative as compared to western societies,” Jen-Chuen Hsieh points out. “Yet, we consider this the very essence of the psychosocial experience for the gender-sex incongruity of transsexuals in general, regardless of ethnicity.”

The results of the study point to the idea that a suffering brain “mirrors a mind in pain," explains Dr. Hsieh. “Neurophilosophically, we view this…work on transsexuals as neuroscientific evidence that may have relevance to the ‘free will’ of human kind for the selection of their own psychological gender and the associated transformation acts, either through hormone or sex-reassignment intervention.” The findings could also support new approaches to gender issue policies, he adds. Already, in France, sex change procedures can be reimbursed by social security, after significant medical and psychological evaluations. Because, as Dr. Hsieh concludes, deliverance from suffering “is the core value in pursuit of human rights.”