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Lerario MP, Rosendale N, Waugh JL, Turban J, Maschi T. Functional Neurological Disorder Among Sexual and Gender Minority People. Neurol Clin 2023; 41:759-781. [PMID: 37775203 DOI: 10.1016/j.ncl.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Sexual and gender minority (SGM) people can face unique stressors and structural discrimination that result in higher rates of neuropsychiatric symptoms, such as depression, anxiety, and suicidality. Although more rigorous studies are needed, emerging data suggest a possible higher prevalence of functional neurological disorder and other brain-mind-body conditions in SGM people. Representation and iterative feedback from affected community members is critical to the process of developing affirming environments. More research is needed to explore the relevance of functional neurologic disorder in SGM people within a biopsychosocial framework.
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Affiliation(s)
- Mackenzie P Lerario
- Fordham Graduate School of Social Service, New York, NY, USA; Greenburgh Pride, Greenburgh, NY, USA.
| | - Nicole Rosendale
- Department of Neurology, University of California San Francisco; Weill Institute for Neurosciences, University of California San Francisco
| | - Jeff L Waugh
- Department of Pediatrics, UT Southwestern Medical School, Dallas, TX, USA
| | - Jack Turban
- Division of Child & Adolescent Psychiatry, University of California San Francisco
| | - Tina Maschi
- Fordham Graduate School of Social Service, New York, NY, USA; Greenburgh Pride, Greenburgh, NY, USA
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Fisher AD, Ristori J, Morelli G, Maggi M. The molecular mechanisms of sexual orientation and gender identity. Mol Cell Endocrinol 2018; 467:3-13. [PMID: 28847741 DOI: 10.1016/j.mce.2017.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/02/2017] [Accepted: 08/15/2017] [Indexed: 12/21/2022]
Abstract
Differences between males and females are widely represented in nature. There are gender differences in phenotypes, personality traits, behaviors and interests, cognitive performance, and proneness to specific diseases. The most marked difference in humans is represented by sexual orientation and core gender identity, the origins of which are still controversial and far from being understood. Debates continue on whether sexual behavior and gender identity are a result of biological (nature) or cultural (nurture) factors, with biology possibly playing a major role. The main goal of this review is to summarize the studies available to date on the biological factors involved in the development of both sexual orientation and gender identity. A systematic search of published evidence was performed using Medline (from January 1948 to June 2017). Review of the relevant literature was based on authors' expertise. Indeed, different studies have documented the possible role and interaction of neuroanatomic, hormonal and genetic factors. The sexual dimorphic brain is considered the anatomical substrate of psychosexual development, on which genes and gonadal hormones may have a shaping effect. In particular, growing evidence shows that prenatal and pubertal sex hormones permanently affect human behavior. In addition, heritability studies have demonstrated a role of genetic components. However, a convincing candidate gene has not been identified. Future studies (e.i. genome wide studies) are needed to better clarify the complex interaction between genes, anatomy and hormonal influences on psychosexual development.
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Affiliation(s)
- Alessandra D Fisher
- Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, Florence, Italy
| | - Jiska Ristori
- Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, Florence, Italy
| | - Girolamo Morelli
- Department of Surgical, Medical, Molecular and of the Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Mario Maggi
- Department of Experimental, Clinical and Biomedical Sciences, Careggi University Hospital, Florence, Italy.
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Abstract
There is now compelling evidence that the ratio of the length of the second digit divided by the length of the fourth digit (2D:4D) is affected by prenatal androgens in humans. This ratio is greater in females than males from fetal life through adulthood, correlates with polymorphism in the androgen receptor gene in men, is feminine in XY androgen insensitivity syndrome, and masculinized in congenital adrenal hyperplasia. Using 2D:4D as a correlate, researchers have found evidence that prenatal androgens affect many sexually differentiated human behaviors, including sexual orientation in women (but not in men), attention deficit disorder, autism, eating disorders, aggression, and risk-taking. In each case, lower 2D:4D, indicative of greater prenatal androgen stimulation, is associated with behavior more commonly displayed by males than females. The correlation between 2D:4D and prenatal androgen stimulation is too imperfect to accurately predict the phenotype of a particular individual, even in terms of sex. However, digit ratio is the best available retrospective marker of average differences in prenatal androgen stimulation between groups of people, and/or correlations of prenatal androgen stimulation with particular behaviors and characteristics within a group. Thus digit ratios offer a valid test of the organizational hypothesis that androgens act early in life to masculinize various human behaviors.
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Affiliation(s)
- S Marc Breedlove
- Neuroscience Program and Department of Psychology, 108 Giltner Hall, Michigan State University, East Lansing, Michigan 48824-1101, USA.
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Abstract
While most men prefer women as their sexual partners, some are bisexual and others are homosexuals. It has been debated for a long time whether a person's sexual preference is innate, learned, or due to a combination of both causes. It was recently discovered that the human right-versus-left-hand use preference and the direction of scalp hair-whorl rotation develop from a common genetic mechanism. Such a mechanism controls functional specialization of brain hemispheres. Whether the same mechanism specifying mental makeup influences sexual preference was determined here by comparing hair-whorl rotation in groups enriched with homosexual men with that in males at large. Only a minority of 8.2% (n = 207) unselected 'control' group of males had counterclockwise rotation. In contrast, all three samples enriched with homosexual men exhibited highly significant (P < 0.0001), 3.6-fold excess (29.8%, n = 272) counterclockwise rotation. These results suggest that sexual preference may be influenced in a significant proportion of homosexual men by a biological/genetic factor that also controls direction of hair-whorl rotation.
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Abstract
A form concerning handedness, dyslexia, stuttering (self-report), and twinning was included in a study of sexual habits of homosexual men. Questions about interests in music, art, and creative writing were also included. A questionnaire was sent out to male homosexuals. Out of 391 returned forms, 363 were suitable for data processing. Analysis showed 13.9% reported writing with the left hand, 6.5% with stuttering, and 8.6% with dyslexia. The twin incidence was 1.2%. The creativity questions indicated a high music and painting activity. The results confirmed previous studies, showing a left shift in laterality and increased stuttering and dyslexia in the sample.
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Affiliation(s)
- K O Götestam
- Norwegian University of Science and Technology, Trondheim, Department of Psychiatry and Behavioural Medicine
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Lalumière ML, Blanchard R, Zucker KJ. Sexual orientation and handedness in men and women: a meta-analysis. Psychol Bull 2000; 126:575-92. [PMID: 10900997 DOI: 10.1037/0033-2909.126.4.575] [Citation(s) in RCA: 172] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent findings suggest that sexual orientation has an early neurodevelopmental basis. Handedness, a behavioral marker of early neurodevelopment, has been associated with sexual orientation in some studies but not in others. The authors conducted a meta-analysis of 20 studies that compared the rates of non-right-handedness in 6,987 homosexual (6,182 men and 805 women) and 16,423 heterosexual (14,808 men and 1,615 women) participants. Homosexual participants had 39% greater odds of being non-right-handed. The corresponding values for homosexual men (20 contrasts) and women (9 contrasts) were 34% and 91%, respectively. The results support the notion that sexual orientation in some men and women has an early neurodevelopmental basis, but the factors responsible for the handedness-sexual orientation association require elucidation. The authors discuss 3 possibilities: cerebral laterality and prenatal exposure to sex hormones, maternal immunological reactions to the fetus, and developmental instability.
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Affiliation(s)
- M L Lalumière
- Law and Mental Health Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Pattatucci AM, Patterson C, Benjamin J, Hamer DH. A Crossover Interaction Between Sex, Sexual Orientation, and Handedness. Laterality 1998; 3:331-42. [PMID: 15513096 DOI: 10.1080/713754312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The distribution of handedness scores was analysed in 1414 heterosexual, bisexual, and homosexual men and women. Hand preference was assessed by a questionnaire that distinguishes consistently right-handed from partially or completely left-handed individuals, and sexual orientation was measured by the Kinsey scales. As expected from population-based studies, heterosexual men were, on average, more left-handed than heterosexual women. By contrast, gay men were more right-handed than lesbians or heterosexual men, and lesbians were more left-handed than gay men or heterosexual women. This crossover interaction suggests that a common variable influences sex, sexual orientation, and hand preference.
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Affiliation(s)
- A M Pattatucci
- CRCI/PR-SSI, Recinto de Río Piedras, Universidad de Puerto Rico, San Juan.
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Cohen-Kettenis PT, van Goozen SH, Doorn CD, Gooren LJ. Cognitive ability and cerebral lateralisation in transsexuals. Psychoneuroendocrinology 1998; 23:631-41. [PMID: 9802133 DOI: 10.1016/s0306-4530(98)00033-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
It is still unclear to what extent cross-gender identity is due to pre- and perinatal organising effects of sex hormones on the brain. Empirical evidence for a relationship between prenatal hormonal influences and certain aspects of gender typical (cognitive) functioning comes from pre- and postpubertal clinical samples, such as women suffering from congenital adrenal hyperplasia and studies in normal children. In order to further investigate the hypothesis that cross-gender identity is influenced by prenatal exposure to (atypical) sex steroid levels we conducted a study with early onset, adult male-to-female and female-to-male transsexuals, who were not yet hormonally treated, and nontranssexual adult female and male controls. The aim of the study was to find out whether early onset transsexuals performed in congruence with their biological sex or their gender identity. The results on different tests show that gender differences were pronounced, and that the two transsexual groups occupied a position in between these two groups, thus showing a pattern of performance away from their biological sex. The findings provide evidence that organisational hormonal influences may have an effect on the development of cross-gender identity.
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Affiliation(s)
- P T Cohen-Kettenis
- Department of Child and Adolescent Psychiatry, Utrecht University Hospital, The Netherlands.
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Bogaert AF, Blanchard R. Handedness in homosexual and heterosexual men in the Kinsey interview data. ARCHIVES OF SEXUAL BEHAVIOR 1996; 25:373-378. [PMID: 8836470 DOI: 10.1007/bf02437580] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The relationship between sexual orientation and handedness in a large sample of men was examined. Subjects were 6544 nondelinquent men interviewed by the Kinsey Institute for Research in Sex, Gender, and Reproduction from 1938 to 1963. Subjects were classified as either homosexual (n = 1004) or heterosexual (n = 4579). Results failed to demonstrate a difference in handedness, with both groups having rates of non-right-handedness (i.e., 11-12%) approximately equal to establish norms. These findings do not replicate some recent studies indicating an increased level of non-right-handedness in homosexual men.
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Affiliation(s)
- A F Bogaert
- Social Sciences and Humanities Research Council of Canada
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Jariabková K, Hugdahl K, Glós J. Immune disorders and handedness in dyslexic boys and their relatives. Scand J Psychol 1995; 36:355-62. [PMID: 8533054 DOI: 10.1111/j.1467-9450.1995.tb00993.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Thirty dyslexic and 30 control boys aged 7-11 years were compared for frequency of immune disorders and handedness as well as for family history of immune disorders and learning disabilities (dyslexia and stuttering). They were also compared for neurological status and for history of speech and language difficulties. There were no significant differences between the two groups in the frequency of immune disorders and in handedness. The results showed significantly more dyslexic boys with soft neurological signs and signs of speech and language disorders. The frequency of dyslexia was significantly higher in the relatives of the dyslexic boys. Also significantly more mothers of the dyslexic boys reported difficulties during pregnancy and complications at delivery. The results are discussed in terms of Geschwind's hypothesis and neuromaturational delay as possible determinants of developmental dyslexia.
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Affiliation(s)
- K Jariabková
- Department of Social and Biological Communication, Slovak Academy of Sciences, Bratislava, Slovakia
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Abstract
We investigated the relations among mental rotations and spatial perception abilities, handedness, and sexual orientation in both men and women. The present study included a relatively large sample and attempted to control statistically for important covariates such as general intelligence. Significant sex differences were obtained for mental rotations and spatial perception, but not for handedness. None of these measures was significantly related to sexual orientation within either sex.
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Affiliation(s)
- B A Gladue
- Department of Psychology, North Dakota State University, Fargo 58105, USA
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Comings DE. Role of genetic factors in human sexual behavior based on studies of Tourette syndrome and ADHD probands and their relatives. AMERICAN JOURNAL OF MEDICAL GENETICS 1994; 54:227-41. [PMID: 7810580 DOI: 10.1002/ajmg.1320540309] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Most significant variations in the expression of human sexuality are considered to be the result of learned behavior or psychological problems. Tourette syndrome (TS) is a common, hereditary tic and disinhibition disorder sometimes associated with compulsive use of obscene words (coprolalia) and previously reported to be occasionally associated with exhibitionism. To further explore the relationship between the Gts genes and sexual behavior, questions concerning a wide range of such behaviors were administered to 1,040 subjects, 14 years of age or older, consisting of 358 TS probands, 101 non-proband relatives with TS, 359 non-TS first degree relatives, 79 attention deficit hyperactivity disorder (ADHD) probands, 70 unaffected relatives of the ADHD probands, and 73 controls. The behaviors included magnitude of sex drive, sex orientation, exhibitionism, transvestitism, transsexualism, sadism, masochism, pedophilia, fetishism, aversion to being touched, and aversion to sex. While most of these behaviors occurred in a distinct minority of TS subjects, there was a significant positive correlation between each behavior examined and the degree of genetic loading for the Gts gene(s). The nature of these behaviors and their association with TS suggests many are variants of obsessive-compulsive disorder. Studies in animals indicate that changes in serotonin and dopamine play a significant role in the sexual behavior and many lines of evidence are consistent with the hypothesis that TS is due to genetic changes in serotonin and dopamine metabolism. These studies suggest that genetic factors play a much greater role in a wide range of forms of sexual expression than previously thought.
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Affiliation(s)
- D E Comings
- Department of Medical Genetics, City of Hope Medical Center, Duarte, California 91010
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