Abstract
This study was performed to identify the sexual orientation in association with brain activation pattern in response to visual erotic stimuli in female-to-male (FtM) transsexuals by using functional magnetic resonance imaging (fMRI). Eleven FtM transsexuals who have had sex-reassignment surgery to alter their natal bodies with the gender-identity disorder were participated. Brain activation for sexual orientation was induced by visual stimuli with female and male erotic nude pictures compared with emotionally-neutral pictures. During viewing the erotic female pictures, the brain areas dominantly activated consist of the superior frontal gyrus, supplementary motor area, anterior/median cingulate gyri and hypothalamus, whereas during viewing male pictures, the brain areas with predominant activities were the middle frontal gyrus, precentral gyrus, middle temporal gyrus, fusiform gyrus, angular gyrus, precuneus, superior/middle occipital gyri, cerebellar cortex and vermis. These findings demonstrate that the brain activation patterns induced by viewing male or female erotic pictures show some correlation to the sexual orientation opposite to the genetic sex in FtM transsexuals. This study would be helpful to understand the neural mechanism associated with visual sexual arousal in patients with gender disorder.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Savic I, Arver S . Sex dimorphism of the brain in male-to-female transsexuals. Cereb Cortex 2011; 21: 2525–2533.
Sanchez FJ, Vilain E . Collective self-esteem as a coping resource for male-to-female transsexuals. J Couns Psychol 2009; 56: 202–209.
De Cuypere G, Van Hemelrijck M, Michel A, Carael B, Heylens G, Rubens R et al. Prevalence and demography of transsexualism in Belgium. Eur Psychiatry 2007; 22: 137–141.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-V), 5th (edn). American Psychiatric Association Publishing: Arlington, VA, 2013.
Cohen-Kettenis PT, Gooren LJ . Transsexualism: a review of etiology, diagnosis and treatment. J Psychosom Res 1999; 46: 315–333.
Swaab DF . Sexual differentiation of the brain and behavior. Best Pract Res Clin Endocrinol Metab 2007; 21: 431–444.
van Goozen SH, Slabbekoorn D, Gooren LJ, Sanders G, Cohen-Kettenis PT . Organizing and activating effects of sex hormones in homosexual transsexuals. Behav Neurosci 2002; 116: 982–988.
Bentz EK, Schneeberger C, Hefler LA, van Trotsenburg M, Kaufmann U, Huber JC et al. A common polymorphism of the SRD5A2 gene and transsexualism. Reprod Sci 2007; 14: 705–709.
Rametti G, Carrillo B, Gomez-Gil E, Junque C, Zubiaurre-Elorza L, Segovia S et al. Effects of androgenization on the white matter microstructure of female-to-male transsexuals. A diffusion tensor imaging study. Psychoneuroendocrinology 2012; 37: 1261–1269.
Zubiaurre-Elorza L, Junque C, Gomez-Gil E, Guillamon A . Effects of cross-sex hormone treatment on cortical thickness in transsexual individuals. J Sex Med 2014; 11: 1248–1261.
Kruijver FP, Zhou JN, Pool CW, Hofman MA, Gooren LJ, Swaab DF . Male-to-female transsexuals have female neuron numbers in a limbic nucleus. J Clin Endocrinol Metab 2000; 85: 2034–2041.
Zhou JN, Hofman MA, Gooren LJ, Swaab DF . A sex difference in the human brain and its relation to transsexuality. Nature 1995; 378: 68–70.
Garcia-Falgueras A, Swaab DF . A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity. Brain 2008; 131: 3132–3146.
Luders E, Sanchez FJ, Gaser C, Toga AW, Narr KL, Hamilton LS et al. Regional gray matter variation in male-to-female transsexualism. Neuroimage 2009; 46: 904–907.
Zubiaurre-Elorza L, Junque C, Gomez-Gil E, Segovia S, Carrillo B, Rametti G et al. Cortical thickness in untreated transsexuals. Cereb Cortex 2013; 23: 2855–2862.
Swaab DF, Hofman MA . An enlarged suprachiasmatic nucleus in homosexual men. Brain Res 1990; 537: 141–148.
Savic I, Berglund H, Lindstrom P . Brain response to putative pheromones in homosexual men. Proc Natl Acad Sci USA 2005; 102: 7356–7361.
Berglund H, Lindstrom P, Savic I . Brain response to putative pheromones in lesbian women. Proc Natl Acad Sci USA 2006; 103: 8269–8274.
Savic I, Lindstrom P . PET and MRI show differences in cerebral asymmetry and functional connectivity between homo- and heterosexual subjects. Proc Natl Acad Sci USA 2008; 105: 9403–9408.
Park K, Kang HK, Seo JJ, Kim HJ, Ryu SB, Jeong GW . Blood-oxygenation-level-dependent functional magnetic resonance imaging for evaluating cerebral regions of female sexual arousal response. Urology 2001; 57: 1189–1194.
Komisaruk BR, Whipple B . Functional MRI of the brain during orgasm in women. Annu Rev Sex Res 2005; 16: 62–86.
Ponseti J, Bosinski HA, Wolff S, Peller M, Jansen O, Mehdorn HM et al. A functional endophenotype for sexual orientation in humans. NeuroImage 2006; 33: 825–833.
Jeong GW, Park K, Youn G, Kang HK, Kim HJ, Seo JJ et al. Assessment of cerebrocortical regions associated with sexual arousal in premenopausal and menopausal women by using BOLD-based functional MRI. J Sex Med 2005; 2: 645–651.
Yang JC, Park K, Eun SJ, Lee MS, Yoon JS, Shin IS et al. Assessment of cerebrocortical areas associated with sexual arousal in depressive women using functional MR imaging. J Sex Med 2008; 5: 602–609.
Kim GW, Yang JC, Jeong GW . Brain activation patterns associated with sexual orientation in homosexual male and female: preliminary study with 3.0T fMRI. J Biomed Sci Eng 2011; 4: 196–199.
Maravilla KR, Yang CC . Magnetic resonance imaging and the female sexual response: overview of techniques, results, and future directions. J Sex Med 2008; 5: 1559–1571.
Miyagawa Y, Tsujimura A, Fujita K, Matsuoka Y, Takahashi T, Takao T et al. Differential brain processing of audiovisual sexual stimuli in men: comparative positron emission tomography study of the initiation and maintenance of penile erection during sexual arousal. NeuroImage 2007; 36: 830–842.
Kranz F, Ishai A . Face perception is modulated by sexual preference. Curr Biol 2006; 16: 63–68.
Gizewski ER, Krause E, Schlamann M, Happich F, Ladd ME, Forsting M et al. Specific cerebral activation due to visual erotic stimuli in male-to-female transsexuals compared with male and female controls: an fMRI study. J Sex Med 2009; 6: 440–448.
Oh SK, Kim GW, Yang JC, Kim SK, Kang HK, Jeong GW . Brain activation in response to visually evoked sexual arousal in male-to-female transsexuals: 3.0 Tesla functional magnetic resonance imaging. Korean J Radiol 2012; 13: 257–264.
Kim SK, Moon JB, Heo J, Kwon YS, Lee KC . A new method of urethroplasty for prevention of fistula in female-to-male gender reassignment surgery. Ann Plast Surg 2010; 64: 759–764.
Kinsey AC, Romeroy WB, Martin CE, Gebhard PH . Sexual behavior in the human female. Indiana University Press: Bloomington, IN, USA; Saunders: Philadelphia, PA, USA, 1953.
Coleman E . Assessment of sexual orientation. J Homosex 1987; 14: 9–24.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A . The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49: 822–830.
Chung TG, Lee TK, Chung S, Lee MS, Kim YS, Ahn TY . The Korean version of the international index of erectile function (IIEF): reliability and validation study. Korean J Urol 1999; 40: 1334–1343.
Dove GA, Morley F, Batchelor A, Lunn SF . Oestrogenic function in postmenopausal women. J Reprod Fertil 1971; 24: 1–8.
Komisaruk BR, Wise N, Frangos E, Liu WC, Allen K, Brody S . Women's clitoris, vagina, and cervix mapped on the sensory cortex: fMRI evidence. J Sex Med 2011; 8: 2822–2830.
Bradley MM, Lang PJ . In: Handbook of emotion elicitation and assessment (eds). Coan JA, Allen JJB; Oxford University Press: New York, NY, 2007; 29–46.
Bishara AJ, Hittner JB . Testing the significance of a correlation with nonnormal data: comparison of Pearson, Spearman, transformation, and resampling approaches. Psychol Methods 2012; 17: 399–417.
du Boisgueheneuc F, Levy R, Volle E, Seassau M, Duffau H, Kinkingnehun S et al. Functions of the left superior frontal gyrus in humans: a lesion study. Brain 2006; 129: 3315–3328.
Ulu MO, Tanriover N, Ozlen F, Sanus GZ, Tanriverdi T, Ozkara C et al. Surgical treatment of lesions involving the supplementary motor area: clinical results of 12 patients. Turk Neurosurg 2008; 18: 286–293.
Papez JW . A proposed mechanism of emotion. 1937. J Neuropsychiatry Clin Neurosci 1995; 7: 103–112.
Karama S, Lecours AR, Leroux J-M, Bourgouin P, Beaudoin G, Joubert S et al. Areas of brain activation in males and females during viewing of erotic film excerpts. Hum Brain Mapp 2002; 16: 1–13.
Sabatinelli DCA, Flaisch T, Bradley MM, Fitzsimmons JR, Lang PJ . Affective picture perception: gender differences in visual cortex? Neuroreport 2004; 15: 1109–1112.
Hamann S, Herman RA, Nolan CL, Wallen K . Men and women differ in amygdala response to visual sexual stimuli. Nat Neurosci 2004; 7: 411–416.
Stark R, Schienle A, Girod C, Walter B, Kirsch P, Blecker C et al. Erotic and disgust-inducing pictures—Differences in the hemodynamic responses of the brain. Biol Psychol 2005; 70: 19–29.
Gizewski E, Krause E, Karama S, Baars A, Senf W, Forsting M . There are differences in cerebral activation between females in distinct menstrual phases during viewing of erotic stimuli: a fMRI study. Exp Brain Res 2006; 174: 101–108.
Walter M, Bermpohl F, Mouras H, Schiltz K, Tempelmann C, Rotte M et al. Distinguishing specific sexual and general emotional effects in fMRI—Subcortical and cortical arousal during erotic picture viewing. NeuroImage 2008; 40: 1482–1494.
Devinsky O, Morrell MJ, Vogt BA . Contributions of anterior cingulate cortex to behaviour. Brain 1995; 118: 279–306.
Leknes S, Tracey I . A common neurobiology for pain and pleasure. Nat Rev Neurosci 2008; 9: 314–320.
Arnow BA, Desmond JE, Banner LL, Glover GH, Solomon A, Polan ML et al. Brain activation and sexual arousal in healthy, heterosexual males. Brain 2002; 125: 1014–1023.
Bartels A, Zeki S . The neural basis of romantic love. Neuroreport 2000; 11: 3829–3834.
Sewards TV, Sewards MA . Representations of motivational drives in mesial cortex, medial thalamus, hypothalamus and midbrain. Brain Res Bull 2003; 61: 25–49.
Snell RS . Clinical Neuroanatomy, 6th (edn). Lippincott Williams & Wilkins: Philadelphia, PA, USA, 2006.
Meisel RL, Sachs BD . in The Physiology of Reproduction (eds). Knobil E, Neill JD. Raven Press: New York, NY, 1994; 3–106.
Ferris CF, Snowdon CT, King JA, Duong TQ, Ziegler TE, Ugurbil K et al. Functional imaging of brain activity in conscious monkeys responding to sexually arousing cues. Neuroreport 2001; 12: 2231–2236.
Allen LS, Hines M, Shryne JE, Gorski RA . Two sexually dimorphic cell groups in the human brain. J Neurosci 1989; 9: 497–506.
Hofman MA, Swaab DF . Sexual dimorphism of the human brain: myth and reality. Exp Clin Endocrinol 1991; 98: 161–170.
Safron A, Barch B, Bailey JM, Gitelman DR, Parrish TB, Reber PJ . Neural correlates of sexual arousal in homosexual and heterosexual men. Behav Neurosci 2007; 121: 237–248.
Paul T, Schiffer B, Zwarg T, Kruger TH, Karama S, Schedlowski M et al. Brain response to visual sexual stimuli in heterosexual and homosexual males. Hum Brain Mapp 2008; 29: 726–735.
Swaab DF . Sexual orientation and its basis in brain structure and function. Proc Natl Acad Sci USA 2008; 105: 10273–10274.
Tsujimura A, Miyagawa Y, Fujita K, Matsuoka Y, Takahashi T, Takao T et al. Brain processing of audiovisual sexual stimuli inducing penile erection: a positron emission tomography study. J Urol 2006; 176: 679–683.
Apps R, Garwicz M . Anatomical and physiological foundations of cerebellar information processing. Nat Rev Neurosci 2005; 6: 297–311.
Acknowledgements
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) grants funded by the Ministry of Science, ICT & Future Planning (2015R1A2A2A01007827) and the Ministry of Education (2013R1A1A2013878).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Kim, TH., Kim, GW., Kim, SK. et al. Brain activation-based sexual orientation in female-to-male transsexuals. Int J Impot Res 28, 31–38 (2016). https://doi.org/10.1038/ijir.2015.29
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ijir.2015.29
This article is cited by
-
Gender Dysphoria and Sexual Euphoria: A Bayesian Perspective on the Influence of Gender-Affirming Hormone Therapy on Sexual Arousal
Archives of Sexual Behavior (2024)
-
A comparative study of white matter volume between postoperative female-to-male transsexuals and healthy female
International Journal of Impotence Research (2019)
-
Bisexuality among a cohort of university students: prevalence and psychological distress
International Journal of Impotence Research (2018)
-
Funktionelle Magnetresonanztomographie bei Trans*Menschen
Gynäkologische Endokrinologie (2017)