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Gaspari L, Soyer-Gobillard MO, Kerlin S, Paris F, Sultan C. Early Female Transgender Identity after Prenatal Exposure to Diethylstilbestrol: Report from a French National Diethylstilbestrol (DES) Cohort. J Xenobiot 2024; 14:166-175. [PMID: 38249107 PMCID: PMC10801508 DOI: 10.3390/jox14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Diagnostic of transsexualism and gender incongruence are terms to describe individuals whose self-identity does not match their sex assignment at birth. A transgender woman is an individual assigned male at birth (AMAB) on the basis of the external or internal genitalia who identifies and lives as a woman. In recent decades, a significant increase in the number of transgender people has been reported. Although, its etiology is unknown, biological, anatomical, genetic, environmental and cultural factors have been suggested to contribute to gender variation. In XY animals, it has been shown that environmental endocrine disruptors, through their anti-androgenic activity, induce a female identity. In this work, we described four XY individuals who were exposed in utero to the xenoestrogen diethylstilbesterol (DES) and were part of the French HHORAGES cohort. They all reported a female transgender identity starting from childhood and adolescence. This high prevalence of male to female transgenderism (1.58%) in our cohort of 253 DES sons suggests that exposure to chemicals with xenoestrogen activity during fetal life may affect the male sex identity and behavior.
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Affiliation(s)
- Laura Gaspari
- Unité d’Endocrinologie-Gynécologie Pédiatrique, CHU Montpellier, University Montpellier, 34090 Montpellier, France; (L.G.); (F.P.)
- INSERM 1203, Développement Embryonnaire Fertilité Environnement, University of Montpellier, 34295 Montpellier, France
- CHU Montpellier, University Montpellier, Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, 34295 Montpellier, France
| | - Marie-Odile Soyer-Gobillard
- Laboratoire Arago, Observatoire Océanologique, Sorbonne University, CNRS, 75016 Paris, France;
- Association HHORAGES-France, 66100 Perpignan, France
| | - Scott Kerlin
- DES International Information and Research Network, Livermore, CA 94551, USA;
| | - Françoise Paris
- Unité d’Endocrinologie-Gynécologie Pédiatrique, CHU Montpellier, University Montpellier, 34090 Montpellier, France; (L.G.); (F.P.)
- INSERM 1203, Développement Embryonnaire Fertilité Environnement, University of Montpellier, 34295 Montpellier, France
- CHU Montpellier, University Montpellier, Centre de Référence Maladies Rares du Développement Génital, Constitutif Sud, Hôpital Lapeyronie, 34295 Montpellier, France
| | - Charles Sultan
- Unité d’Endocrinologie-Gynécologie Pédiatrique, CHU Montpellier, University Montpellier, 34090 Montpellier, France; (L.G.); (F.P.)
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Lavender R, Shaw S, Maninger JK, Butler G, Carruthers P, Carmichael P, Masic U. Impact of Hormone Treatment on Psychosocial Functioning in Gender-Diverse Young People. LGBT Health 2023. [PMID: 36989498 DOI: 10.1089/lgbt.2022.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Purpose: Few studies have assessed the effects of hormonal treatments such as gonadotropin-releasing hormone agonists (GnRHa) and gender-affirming hormones (GAH) on mental health outcomes in clinically referred gender-diverse young people from a younger age. Where this research has been conducted, findings have been mixed. This study investigated a cohort of young people before treatment, 1 year into GnRHa, and 1 year into GAH treatment to understand psychological and behavioral impacts over time. Methods: Thirty-eight young people (28 assigned female and 10 assigned male) referred to endocrinology, younger than 15 years at/beyond Tanner stage two, who received GnRHa followed by GAH treatment, were assessed in a retrospective analysis study. Young people completed the Youth Self Report (YSR), the Body Image Scale, and the Utrecht Gender Dysphoria Scale, while caregivers completed the Child Behavior Checklist (CBCL) and the Social Responsiveness Scale-2 at all time points. Results: Dissatisfaction with primary sexual characteristics (p = 0.02), gender dysphoria (p = 0.01), and social motivation (p = 0.04) improved significantly over time. Self-harm and suicidality also showed a general decrease. Caregivers reported a significant reduction in internalizing (p = 0.03) behaviors on the CBCL after GnRHa. Other subcategories of the YSR and CBCL were within normal ranges with no significant difference (p > 0.05). Conclusion: These findings demonstrate some improvements in psychological and behavioral outcomes in young people concurrently receiving psychosocial support and hormone treatment. Future research with larger and more diverse samples is warranted to further understand generalizability.
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Affiliation(s)
- Rosemary Lavender
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, United Kingdom
| | - Selina Shaw
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, United Kingdom
| | | | - Gary Butler
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, United Kingdom
- Department of Paediatric and Adolescent Endocrinology, University College London Hospital, London, United Kingdom
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Paul Carruthers
- Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Polly Carmichael
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, United Kingdom
| | - Una Masic
- Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, United Kingdom
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