title: Otoacoustic emissions, auditory evoked potentials and self-reported gender in people affected by disorders of sex development (DSD).
abstract: Both otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) are sexually dimorphic, and both are believed to be influenced by prenatal androgen exposure. OAEs and AEPs were collected from people affected by 1 of 3 categories of disorders of sex development (DSD) - (1) women with complete androgen insensitivity syndrome (CAIS); (2) women with congenital adrenal hyperplasia (CAH); and (3) individuals with 46,XY DSD including prenatal androgen exposure who developed a male gender despite initial rearing as females (men with DSD). Gender identity (GI) and role (GR) were measured both retrospectively and at the time of study participation, using standardized questionnaires. The main objective of this study was to determine if patterns of OAEs and AEPs correlate with gender in people affected by DSD and in controls. A second objective was to assess if OAE and AEP patterns differed according to degrees of prenatal androgen exposure across groups. Control males, men with DSD, and women with CAH produced fewer spontaneous OAEs (SOAEs) - the male-typical pattern - than control females and women with CAIS. Additionally, the number of SOAEs produced correlated with gender development across all groups tested. Although some sex differences in AEPs were observed between control males and females, AEP measures did not correlate with gender development, nor did they vary according to degrees of prenatal androgen exposure, among people with DSD. Thus, OAEs, but not AEPs, may prove useful as bioassays for assessing early brain exposure to androgens and predicting gender development in people with DSD.
authors.affiliation: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. Electronic address: amy-wisniewski@ouhsc.edu.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Wisniewski
authors.affiliation: Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126, USA. Electronic address: Blas-Espinoza-varas@ouhsc.edu.
authors.forename: Blas
authors.initials: B
authors.lastname: Espinoza-Varas
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. Electronic address: chris-aston@ouhsc.edu.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Aston
authors.affiliation: Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126, USA. Electronic address: sedmund608@aol.com.
authors.forename: Shelagh
authors.initials: S
authors.lastname: Edmundson
authors.affiliation: Department of Communication Sciences and Disorders, University of Texas at Austin, TX 78712, USA. Electronic address: champlin@austin.utexas.edu.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Champlin
authors.affiliation: Department of Psychology and Center for Perceptual Systems, University of Texas at Austin, TX 78712, USA. Electronic address: pasanen@psy.utexas.edu.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Pasanen
authors.affiliation: Department of Psychology and Center for Perceptual Systems, University of Texas at Austin, TX 78712, USA. Electronic address: mcfadden@psy.utexas.edu.
authors.forename: Dennis
authors.initials: D
authors.lastname: McFadden
mesh_terms: D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000503:physiopathology / Q000523:psychology; D000328:Adult; D013734:Androgen-Insensitivity Syndrome / Q000503:physiopathology / Q000523:psychology; D000728:Androgens / Q000502:physiology; D016022:Case-Control Studies; D058490:Disorder of Sex Development, 46,XY / Q000503:physiopathology* / Q000523:psychology; D005072:Evoked Potentials, Auditory / Q000502:physiology*; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D012189:Retrospective Studies; D012649:Self Concept; D057566:Self Report; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000728:Androgens
keywords: Auditory evoked potential (AEP); Complete androgen insensitivity syndrome (CAIS); Congenital adrenal hyperplasia (CAH); Disorders of sex development (DSD); Gender identity (GI); Gender role (GR); Otoacoustic emission (OAE); Sex difference