title: Cross-sex hormone treatment does not change sex-sensitive cognitive performance in gender identity disorder patients.
abstract: Cognitive performance in untreated early onset gender identity disorder (GID) patients might correspond to their born sex and not to their perceived gender. As a current mode of intervention, cross-sex hormone treatment causes considerable physical changes in GID patients. We asked, as has been suggested, whether this treatment skews cognitive performance towards that of the acquired sex. Somatically healthy male and female early onset GID patients were neuropsychologically tested before, 3 and 12 months after initiating cross-sex hormone treatment, whereas untreated healthy subjects without GID served as controls (C). Performance was assessed by testing six cognitive abilities (perception, arithmetic, rotation, visualization, logic, and verbalization), and controlled for age, education, born sex, endocrine differences and treatment by means of repeated measures analysis of variance. GID patients and controls showed an identical time-dependent improvement in cognitive performance. The slopes were essentially parallel for males and females. There was no significant three-way interaction of born sex by group by time for the six investigated cognitive abilities. Only education and age significantly influenced this improvement. Despite the substantial somatic cross-sex changes in GID patients, no differential effect on cognition over time was found between C and GID participants. The cognitive performance of cross-sex hormone-treated GID patients was virtually identical to that of the control group. The documented test-retest effect should be taken into consideration when evaluating treatment effects generally in psychiatry.
authors.affiliation: Department of Psychiatry, Ullevål University Hospital, University of Oslo, 0407 Oslo, Norway. i.h.haraldsen@psykiatri.uio.no
authors.forename: Ira R
authors.initials: IR
authors.lastname: Haraldsen
authors.forename: Thore
authors.initials: T
authors.lastname: Egeland
authors.forename: Egil
authors.initials: E
authors.lastname: Haug
authors.forename: Arnstein
authors.initials: A
authors.lastname: Finset
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
mesh_terms: D000328:Adult; D003071:Cognition / Q000187:drug effects*; D004967:Estrogens / Q000494:pharmacology* / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D013739:Testosterone / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D014189:Transsexualism / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D004967:Estrogens; D013739:Testosterone; D004997:Ethinyl Estradiol; C004648:testosterone enanthate