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Wiersch L, Hamdan S, Hoffstaedter F, Votinov M, Habel U, Clemens B, Derntl B, Eickhoff SB, Patil KR, Weis S. Accurate sex prediction of cisgender and transgender individuals without brain size bias. Sci Rep 2023; 13:13868. [PMID: 37620339 PMCID: PMC10449927 DOI: 10.1038/s41598-023-37508-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/22/2023] [Indexed: 08/26/2023] Open
Abstract
The increasing use of machine learning approaches on neuroimaging data comes with the important concern of confounding variables which might lead to biased predictions and in turn spurious conclusions about the relationship between the features and the target. A prominent example is the brain size difference between women and men. This difference in total intracranial volume (TIV) can cause bias when employing machine learning approaches for the investigation of sex differences in brain morphology. A TIV-biased model will not capture qualitative sex differences in brain organization but rather learn to classify an individual's sex based on brain size differences, thus leading to spurious and misleading conclusions, for example when comparing brain morphology between cisgender- and transgender individuals. In this study, TIV bias in sex classification models applied to cis- and transgender individuals was systematically investigated by controlling for TIV either through featurewise confound removal or by matching the training samples for TIV. Our results provide strong evidence that models not biased by TIV can classify the sex of both cis- and transgender individuals with high accuracy, highlighting the importance of appropriate modeling to avoid bias in automated decision making.
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Affiliation(s)
- Lisa Wiersch
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Sami Hamdan
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Felix Hoffstaedter
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-10: Brain Structure-Function Relationships), Research Centre Jülich, Jülich, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-10: Brain Structure-Function Relationships), Research Centre Jülich, Jülich, Germany
| | - Benjamin Clemens
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-10: Brain Structure-Function Relationships), Research Centre Jülich, Jülich, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
- LEAD Graduate School and Research Network, University of Tübingen, Tübingen, Germany
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Kaustubh R Patil
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.
| | - Susanne Weis
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.
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Reed MB, Handschuh PA, Klöbl M, Konadu ME, Kaufmann U, Hahn A, Kranz GS, Spies M, Lanzenberger R. The influence of sex steroid treatment on insular connectivity in gender dysphoria. Psychoneuroendocrinology 2023; 155:106336. [PMID: 37499299 DOI: 10.1016/j.psyneuen.2023.106336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Sex-specific differences in brain connectivity were found in various neuroimaging studies, though little is known about sex steroid effects on insular functioning. Based on well-characterized sex differences in emotion regulation, interoception and higher-level cognition, gender-dysphoric individuals receiving gender-affirming hormone therapy represent an interesting cohort to investigate how sex hormones might influence insular connectivity and related brain functions. METHODS To analyze the potential effect of sex steroids on insular connectivity at rest, 11 transgender women, 14 transgender men, 20 cisgender women, and 11 cisgender men were recruited. All participants underwent two magnetic resonance imaging sessions involving resting-state acquisitions separated by a median time period of 4.5 months and also completed the Bermond-Vorst alexithymia questionnaire at the initial and final examination. Between scans, transgender subjects received gender-affirming hormone therapy. RESULTS A seed based functional connectivity analysis revealed a significant 2-way interaction effect of group-by-time between right insula, cingulum, left middle frontal gyrus and left angular gyrus. Post-hoc tests demonstrated an increase in connectivity for transgender women when compared to cisgender men. Furthermore, spectral dynamic causal modelling showed reduced effective connectivity from the posterior cingulum and left angular gyrus to the left middle frontal gyrus as well as from the right insula to the left middle frontal gyrus. Alexithymia changes were found after gender-affirming hormone therapy for transgender women in both fantasizing and identifying. CONCLUSION These findings suggest a considerable influence of estrogen administration and androgen suppression on brain networks implicated in interoception, own-body perception and higher-level cognition.
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Affiliation(s)
- Murray B Reed
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Patricia A Handschuh
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Manfred Klöbl
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Melisande E Konadu
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Ulrike Kaufmann
- Department of Obstetrics and Gynecology, Medical University of Vienna, Austria
| | - Andreas Hahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Georg S Kranz
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Marie Spies
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria.
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Clemens B, Lefort-Besnard J, Ritter C, Smith E, Votinov M, Derntl B, Habel U, Bzdok D. Accurate machine learning prediction of sexual orientation based on brain morphology and intrinsic functional connectivity. Cereb Cortex 2023; 33:4013-4025. [PMID: 36104854 PMCID: PMC10068286 DOI: 10.1093/cercor/bhac323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sexual orientation in humans represents a multilevel construct that is grounded in both neurobiological and environmental factors. OBJECTIVE Here, we bring to bear a machine learning approach to predict sexual orientation from gray matter volumes (GMVs) or resting-state functional connectivity (RSFC) in a cohort of 45 heterosexual and 41 homosexual participants. METHODS In both brain assessments, we used penalized logistic regression models and nonparametric permutation. RESULTS We found an average accuracy of 62% (±6.72) for predicting sexual orientation based on GMV and an average predictive accuracy of 92% (±9.89) using RSFC. Regions in the precentral gyrus, precuneus and the prefrontal cortex were significantly informative for distinguishing heterosexual from homosexual participants in both the GMV and RSFC settings. CONCLUSIONS These results indicate that, aside from self-reports, RSFC offers neurobiological information valuable for highly accurate prediction of sexual orientation. We demonstrate for the first time that sexual orientation is reflected in specific patterns of RSFC, which enable personalized, brain-based predictions of this highly complex human trait. While these results are preliminary, our neurobiologically based prediction framework illustrates the great value and potential of RSFC for revealing biologically meaningful and generalizable predictive patterns in the human brain.
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Affiliation(s)
- Benjamin Clemens
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
- Research Center Jülich, Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Wilhelm-Johnen-Strase, 52428 Jülich, Germany
| | | | - Christoph Ritter
- Interdisciplinary Center for Clinical Research (IZKF), RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Elke Smith
- Biological Psychology, Department of Psychology, University of Cologne, Bernhard-Feilchenfeld-Str. 11, 50969 Cologne, Germany
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
- Research Center Jülich, Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Wilhelm-Johnen-Strase, 52428 Jülich, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerst. 14, 72076 Tübingen, Germany
- Werner Reichardt Center for Integrative Neuroscience (CIN), University of Tübingen, Otfried-Müller-Str. 25, 72076 Tübingen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany
- Research Center Jülich, Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Wilhelm-Johnen-Strase, 52428 Jülich, Germany
| | - Danilo Bzdok
- McConnell Brain Imaging Centre, McGill University, 3801 University Rue, Montreal Quebec H3A 2B4, Canada
- Department of Biomedical Engineering, McGill University, 3775 University Rue, Montreal Quebec H3A 2B4, Canada
- Faculty of Medicine, Montreal Neurological Institute (MNI) and Hospital, McGill University, 3801 University Rue, Montreal Quebec H3A 2B4, Canada
- Mila–Quebec Artificial Intelligence Institute, 6666 Rue St-Urbain #200, Montreal Quebec H2S 3H1, Canada
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Levin RN, Erickson-Schroth L, Mak K, Edmiston EK. Biological studies of transgender identity: A critical review. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2022. [DOI: 10.1080/19359705.2022.2127042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Rachel N. Levin
- Departments of Biology and Neuroscience, Pomona College, Claremont, CA, USA
| | | | - Kristie Mak
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - E. Kale Edmiston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Hope M, Lilley J. Gender expansive listeners utilize a non-binary, multidimensional conception of gender to inform voice gender perception. BRAIN AND LANGUAGE 2022; 224:105049. [PMID: 34826679 DOI: 10.1016/j.bandl.2021.105049] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 06/13/2023]
Abstract
Few studies on voice perception have attempted to address the complexity of gender perception of ambiguous voices. The current study investigated how perception of gender varies with the complexity of the listener's own gender conception and identity. We explicitly recruited participants of all genders, including those who are gender expansive (i.e. transgender and/or non-binary), and directed them to rate ambiguous synthetic voices on three independent scales of masculine, feminine, and "other" (and to select one or multiple categorical labels for them). Gender expansive listeners were more likely to use the entire expanse of the rating scales and showed systematic categorization of gender-neutral voices as non-binary. We propose this is due to repeated use of reflective processes that challenge pre-existing gender categories and the incorporation of this decision-making process into their reflexive system. Because voice gender influences speech perception, the perceptual experience of gender expansive listeners may influence perceptual flexibility in speech.
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Affiliation(s)
- Maxwell Hope
- University of Delaware, Department of Linguistics & Cognitive Science, 125 E Main St, Newark, DE 19716, United States.
| | - Jason Lilley
- Nemours Biomedical Research, Center for Pediatric Auditory and Speech Sciences, 1701 Rockland Road, Room 136B, Wilmington, DE 19803, United States.
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Clemens B, Votinov M, Puiu AA, Schüppen A, Hüpen P, Neulen J, Derntl B, Habel U. Replication of Previous Findings? Comparing Gray Matter Volumes in Transgender Individuals with Gender Incongruence and Cisgender Individuals. J Clin Med 2021; 10:1454. [PMID: 33916288 PMCID: PMC8037365 DOI: 10.3390/jcm10071454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 01/30/2023] Open
Abstract
The brain structural changes related to gender incongruence (GI) are still poorly understood. Previous studies comparing gray matter volumes (GMV) between cisgender and transgender individuals with GI revealed conflicting results. Leveraging a comprehensive sample of transmen (n = 33), transwomen (n = 33), cismen (n = 24), and ciswomen (n = 25), we employ a region-of-interest (ROI) approach to examine the most frequently reported brain regions showing GMV differences between trans- and cisgender individuals. The primary aim is to replicate previous findings and identify anatomical regions which differ between transgender individuals with GI and cisgender individuals. On the basis of a comprehensive literature search, we selected a set of ROIs (thalamus, putamen, cerebellum, angular gyrus, precentral gyrus) for which differences between cis- and transgender groups have been previously observed. The putamen was the only region showing significant GMV differences between cis- and transgender, across previous studies and the present study. We observed increased GMV in the putamen for transwomen compared to both transmen and ciswomen and for all transgender participants compared to all cisgender participants. Such a pattern of neuroanatomical differences corroborates the large majority of previous studies. This potential replication of previous findings and the known involvement of the putamen in cognitive processes related to body representations and the creation of the own body image indicate the relevance of this region for GI and its potential as a structural biomarker for GI.
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Affiliation(s)
- Benjamin Clemens
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Andrei Alexandru Puiu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Andre Schüppen
- Interdisciplinary Center for Clinical Research (IZKF), Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany;
- Division for Clinical and Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany
| | - Philippa Hüpen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Josef Neulen
- Department of Gynecological Endocrinology and Reproductive Medicine, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany;
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72074 Tübingen, Germany;
- LEAD Graduate School and Research Network, University of Tübingen, 72072 Tübingen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
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Merritt B, Bent T. Perceptual Evaluation of Speech Naturalness in Speakers of Varying Gender Identities. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2054-2069. [PMID: 32598195 DOI: 10.1044/2020_jslhr-19-00337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The purpose of this study was to investigate how speech naturalness relates to masculinity-femininity and gender identification (accuracy and reaction time) for cisgender male and female speakers as well as transmasculine and transfeminine speakers. Method Stimuli included spontaneous speech samples from 20 speakers who are transgender (10 transmasculine and 10 transfeminine) and 20 speakers who are cisgender (10 male and 10 female). Fifty-two listeners completed three tasks: a two-alternative forced-choice gender identification task, a speech naturalness rating task, and a masculinity/femininity rating task. Results Transfeminine and transmasculine speakers were rated as significantly less natural sounding than cisgender speakers. Speakers rated as less natural took longer to identify and were identified less accurately in the gender identification task; furthermore, they were rated as less prototypically masculine/feminine. Conclusions Perceptual speech naturalness for both transfeminine and transmasculine speakers is strongly associated with gender cues in spontaneous speech. Training to align a speaker's voice with their gender identity may concurrently improve perceptual speech naturalness. Supplemental Material https://doi.org/10.23641/asha.12543158.
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Affiliation(s)
- Brandon Merritt
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Tessa Bent
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
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Agana MG, Greydanus DE, Indyk JA, Calles JL, Kushner J, Leibowitz S, Chelvakumar G, Cabral MD. Caring for the transgender adolescent and young adult: Current concepts of an evolving process in the 21st century. Dis Mon 2019; 65:303-356. [DOI: 10.1016/j.disamonth.2019.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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