Gender identity and own body perception implications for the neurobiology of gender dysphoria

性别认同和自己的身体感知对性别不安的神经生物学的影响

• 批准号: 10006729
• 负责人: Jamie Feusner
• 金额: $ 53.51万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-22 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10006729
• 关键词: Address; Affect; Aftercare; Anatomy; Anterior; Area; Awareness; Behavioral; Birth; Body Image; Brain; Cerebrum; Characteristics; Clinic; Clinical; Clinical Research; Costs and Benefits; Data; Decision Making; Development; Dose; Estrogens; Etiology; Evaluation; Exhibits; Female; Functional Magnetic Resonance Imaging; Gender; Gender Confirmation Surgery; Gender Identity; Gender Role; Gonadal Steroid Hormones; Hormonal; Hormones; Image; Individual; Institutes; Intervention; Investigation; Left; Life; Link; Magnetic Resonance Imaging; Measures; Mediating; Medical; Modeling; Neurobiology; Operative Surgical Procedures; Outcome; Participant; Pattern; Perception; Personal Satisfaction; Phenotype; Population; Procedures; Quality of life; Questionnaires; Reporting; Research; Rest; Role; Self Perception; Series; Site; Stigmatization; Stress; Structure; Sweden; Symptoms; Testing; Testosterone; Thick; Thinking; United States; Validity and Reliability; Visual; Waist-Hip Ratio; base; cingulate gyrus; cost; dysphoria; experience; experimental study; gender diversity; gender dysphoria; gender nonconforming; global health; improved; interest; male; neural circuit; neural patterning; neuroimaging; novel; outcome prediction; recruit; satisfaction; sex; sexual dimorphism; social culture; suicide rate; transgender; urban area; visual processing

Project Summary/Abstract Title: Gender identity and own body perception – implications for the neurobiology of gender dysphoria Individuals with gender dysphoria (GD) experience a stark contrast between their gender identity and their gender assigned at birth. These individuals discover, early in development or later in life, that their body is incongruent with their gender identity. Persistent desire for the physical characteristics and social roles of the other sex contributes to dysphoria. Public awareness of the diversity of gender experience is rising, and issues of those with GD related to self-identity, body image, and medical interventions are becoming more openly discussed across the globe. As this is occurring, more and more individuals are considering, or actually undergoing, treatments to alter their hormones and physical body in attempt to better conform to their gender identity. These interventions, termed medical gender (identity) confirming interventions include gender confirming or sex reassignment surgery and cross sex hormone treatment. Many individuals will obtain these costly, usually irreversible, invasive, and sometimes risky measures to address incongruence between their gender identity and their body. This is quickly becoming a critical global health issue; yet there is very little understanding of what developmental, neurobiological, and sociocultural factors contribute to GD, and who may or may not benefit from these procedures, including those who experience gender ambiguity rather than dysphoria. However, studies of brain structure have found abnormalities in cerebral midline structures, and recent studies found differences in functional connectivity within resting state networks associated with self- referential thinking, as well as differences in the functional neural circuitry related to body perception. The purpose of this study is to address core symptoms of GD–dissatisfaction and estrangement from the own body, and self-referential thinking–by using behavioral experiments and functional and structural neuroimaging to investigate the cerebral networks mediating own body perception in individuals with GD compared to cis- sexual controls, and how they relate to subjective body self-incongruence. We will also investigate the longitudinal effects of estrogen and testosterone treatment on brain functional connections and body phenotype, and how brain structure/function, body phenotype, and hormones pre-treatment may predict who will benefit in terms of improvement of dysphoria and quality of life. As an exploratory aim we will investigate a novel body-morph visual processing task in its reliability and validity for research and clinical use. Studying individuals in both Sweden and the United States will additionally allow us to investigate the effect of stress related to differential cultural stigmatization of non-conforming gender roles. This study will provide valuable information on the neurobiological underpinning of GD and the effects of sex hormones, and promises to uncover functional or structural neural patterns that could predict outcome in terms of body image and quality of life after cross-sex hormone treatment, which ultimately could be used to assist in medical decision-making.

项目概要/摘要 标题：性别认同和自己的身体感知——对性别不安的神经生物学的影响 患有性别焦虑症 (GD) 的人的性别认同和性别之间存在着鲜明的对比。 出生时指定的性别。这些人在发育早期或生命后期发现，他们的身体 与他们的性别认同不一致。对身体特征和社会角色的持续渴望 其他性别会导致烦躁不安。公众对性别经历多样性的认识正在不断提高，并且问题 与自我认同、身体形象和医疗干预相关的 GD 患者变得更加公开 在全球范围内进行讨论。随着这种情况的发生，越来越多的人正在考虑，或者实际上 接受改变荷尔蒙和身体的治疗，试图更好地符合自己的性别 身份。这些干预措施被称为医学性别（身份）确认干预措施，包括性别 确认或变性手术以及跨性激素治疗。许多人都会获得这些 为了解决两者之间的不一致问题，采取了代价高昂、通常是不可逆转的、侵入性的、有时甚至是危险的措施 性别认同和他们的身体。这正迅速成为一个关键的全球健康问题；但很少 了解哪些发育、神经生物学和社会文化因素会导致 GD，以及哪些人 可能会或可能不会从这些程序中受益，包括那些经历性别模糊而不是性别模糊的人 烦躁不安。然而，对大脑结构的研究发现大脑中线结构存在异常，并且 最近的研究发现，与自我相关的静息状态网络内功能连接的差异 参考思维，以及与身体感知相关的功能神经回路的差异。这 这项研究的目的是解决 GD 的核心症状——对自己身体的不满和疏远， 和自我参照思维——通过使用行为实验以及功能和结构神经影像学 研究 GD 患者与顺式患者相比调节自身身体知觉的大脑网络 性控制，以及它们与主观身体自我不一致的关系。我们还将调查 雌激素和睾酮治疗对大脑功能连接和身体的纵向影响 表型，以及大脑结构/功能、身体表型和激素预处理如何预测谁 将受益于改善烦躁情绪和生活质量。作为探索性目标，我们将调查 新颖的身体变形视觉处理任务在研究和临床应用中的可靠性和有效性。学习中 瑞典和美国的个人也将允许我们研究压力的影响 与不符合性别角色的不同文化污名化有关。这项研究将提供有价值的 有关 GD 的神经生物学基础和性激素影响的信息，并承诺 揭示可以预测身体形象和质量结果的功能或结构神经模式 跨性别激素治疗后的生活，最终可用于协助医疗决策。

项目成果

Cross-sex hormone treatment and own-body perception: behavioral and brain connectivity profiles.

• DOI: 10.1038/s41598-020-80687-2
• 发表时间: 2021-02-02
• 期刊: Scientific reports
• 影响因子: 4.6
• 作者: Khorashad BS;Manzouri A;Feusner JD;Savic I
• 通讯作者: Savic I

Predicting outcomes of cross-sex hormone therapy in transgender individuals with gender incongruence based on pre-therapy resting-state brain connectivity.

• DOI: 10.1016/j.nicl.2020.102517
• 发表时间: 2021
• 期刊: NeuroImage. Clinical
• 作者: Moody TD;Feusner JD;Reggente N;Vanhoecke J;Holmberg M;Manzouri A;Sorouri Khorashad B;Savic I
• 通讯作者: Savic I

Intrinsic network connectivity and own body perception in gender dysphoria.

• DOI: 10.1007/s11682-016-9578-6
• 发表时间: 2017-08
• 期刊: Brain imaging and behavior
• 影响因子: 3.2
• 作者: Feusner JD;Lidström A;Moody TD;Dhejne C;Bookheimer SY;Savic I
• 通讯作者: Savic I

Neurosurgery and neuromodulation for anorexia nervosa in the 21st century: a systematic review of treatment outcomes.

• DOI: 10.1080/10640266.2020.1790270
• 发表时间: 2022-01
• 期刊: Eating disorders
• 影响因子: 3.3
• 作者: Murray SB;Strober M;Tadayonnejad R;Bari AA;Feusner JD
• 通讯作者: Feusner JD

Interoception and Mental Health: A Roadmap.

• DOI: 10.1016/j.bpsc.2017.12.004
• 发表时间: 2018-06
• 期刊: Biological psychiatry. Cognitive neuroscience and neuroimaging
• 作者: Khalsa SS;Adolphs R;Cameron OG;Critchley HD;Davenport PW;Feinstein JS;Feusner JD;Garfinkel SN;Lane RD;Mehling WE;Meuret AE;Nemeroff CB;Oppenheimer S;Petzschner FH;Pollatos O;Rhudy JL;Schramm LP;Simmons WK;Stein MB;Stephan KE;Van den Bergh O;Van Diest I;von Leupoldt A;Paulus MP;Interoception Summit 2016 participants
• 通讯作者: Interoception Summit 2016 participants