MCG reports some of the first biological evidence brain gender may differ from body gender in people who identify as transgender


Recently, popular beauty influencer and YouTube star known as NikkeTutorials came out publicly to her more than 13 million subscribers.

Video posted to YouTube by NikkiTutorials on January 13th

In the video that has been viewed more than 33 million times, Nikke de Jager say, “when I was younger, I was born in the wrong body, which means, that I am Transgender.”

Right now, researchers at the Medical College of Georgia at Augusta University are studying if there is biological evidence you can be “born in the wrong body.” They are investigating the biological process that could cause the gender of your body to be different from the gender of brain. They refer to this experience as “gender dysphoria.”

“I’ve seen a number of these patients for about 20 years,” says Dr. Lawerence C. Layman, Chief of the MCG Section of Reproductive Endocrinology, Infertility and Genetics in the Department of Obstetrics and Gynecology.

Dr. Lawerence explains why he studies the science of gender identity.

“I think there has to a biological basis for it,” Dr. Layman says. “It just seems that people wouldn’t chose to do that and many of these people know at a very young age they are the opposite sex of what their gender is.”

OB/GYN Dr. J. Graham Theisen is a co-author on the paper that outlines their the findings on gender dysphoria. Dr. Theisen says they based their study on research in animals that shows there is a critical period for brain development related to exposure to estrogen or testosterone that impacts gender expression.

“That’s the time where the brain is able to be masculinized or feminized and for most, if not all, of the mammals that we’ve seen this in, it happens right before birth and then a little bit afterwards,” Dr. Theisen explains. “Once that exposure occurs the behavior is lifelong.”

This previously studied process in animals, pointed them towards a targeted focus area in humans. They analyzed the DNA of 30 transgender people and specifically looked at genes involved in estrogen and testosterone metabolism in the brain.

“We were looking for variants in some of the genes in the pathways of estrogen and testosterone metabolism that might affect the way it’s metabolized and so therefore alter the exposure to the brain,” Dr. Layman says.

The results of their research indicated 21 variants in 19 genes in estrogen pathways of the brain critical to establishing whether the brain is masculine or feminine.

“Variants in genes cause everything about us that makes us unique people,” Dr. Theisen points out.”So something like blue eyes, versus brown eyes, how tall you are…We see gender identity in that way and we think that gender is as diverse as any other trait that we have.”

The results of this study show some of the first biological evidence of the mental verses physical struggle transgender people say they experience. Dr. Layman says there is still much to be uncovered.

“We found variants that could go along with that,” Dr. Layman says, “but you know it’s not totally confirmed whether that is a cause and effect…so you really have to have bigger numbers.”

Dr. Layman and Dr. Theisen will continue studying gender identity to understand more. They say there is a lack of understanding of the biologic basis of gender dysphoria.

“For the majority of people, who we are, the gender that we feel ourselves to be matches what we see on the outside, but that’s not obviously not always the case and we are trying to help people understand why that is including people who are our own patients who want to understand themselves better,” Dr. Theisen says.

Their initial study included 30 people and they now have data on more then 30 others.

The research was funded in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

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