Resting-state functional connectivity patterns are altered in adolescents diagnosed with gender dysphoria

While several studies showed altered functional connectivity (FC) patterns in brain resting-state networks in transgender adults, it is unclear whether such patterns also exist in children and adolescents diagnosed with gender... [ view full abstract ]

While several studies showed altered functional connectivity (FC) patterns in brain resting-state networks in transgender adults, it is unclear whether such patterns also exist in children and adolescents diagnosed with gender dysphoria (GD). Besides, it is not elucidated yet whether FC alterations are induced by an atypical sexual brain differentiation or by subjective experiences associated with GD.

We aimed to address both above-described research questions by determining how FC patterns in boys diagnosed with GD, girls diagnosed with GD, cisgender boys (CBs) and cisgender girls (CGs) are related to each other. [ view full abstract ]

We aimed to address both above-described research questions by determining how FC patterns in boys diagnosed with GD, girls diagnosed with GD, cisgender boys (CBs) and cisgender girls (CGs) are related to each other.

We included 31 pre-pubertal children (18 boys) and 40 adolescents (19 boys) diagnosed with GD and 39 prepubertal (21 boys) and 41 adolescent (20 boys) cisgender controls. Using independent component analysis we identified the... [ view full abstract ]

We included 31 pre-pubertal children (18 boys) and 40 adolescents (19 boys) diagnosed with GD and 39 prepubertal (21 boys) and 41 adolescent (20 boys) cisgender controls. Using independent component analysis we identified the following well-known resting-state networks: sensorimotor network (SMN) I and II, auditory network, visual network I and II, dorsal attention network (DAN), left and right working memory networks (WMNs), default mode network (DMN) and salience network (SN). These spatial maps were used for group comparisons.

FC connectivity within the SMNs, auditory network, visual networks, DAN, left and right WMNs, DMN and SN. [ view full abstract ]

FC connectivity within the SMNs, auditory network, visual networks, DAN, left and right WMNs, DMN and SN.

In cisgender children, no group differences in FC in any of the networks were observed. In cisgender adolescents, we found a sex difference in FC within the SMN-II and DMN. In the same networks we found a difference between... [ view full abstract ]

In cisgender children, no group differences in FC in any of the networks were observed. In cisgender adolescents, we found a sex difference in FC within the SMN-II and DMN. In the same networks we found a difference between boys diagnosed with GD and CBs. However, girls diagnosed with GD only showed a difference with CGs in the SMN-II. While in visual network-II no sex differences were observed, boys diagnosed with GD showed higher FC than all other groups.

In adolescents diagnosed with GD we found evidence for sex-atypical FC patterns within the SMN-II and DMN. In visual network-II, no sex differences were found but boys diagnosed with GD differed from all other groups. Hence,... [ view full abstract ]

In adolescents diagnosed with GD we found evidence for sex-atypical FC patterns within the SMN-II and DMN. In visual network-II, no sex differences were found but boys diagnosed with GD differed from all other groups. Hence, these findings suggest that FC alterations are induced by subjective GD experiences rather than atypical sexual differentiation of the brain.