title: Intrinsic network connectivity and own body perception in gender dysphoria.
abstract: Gender dysphoria (GD) is characterized by incongruence between one's identity and gender assigned at birth. The biological mechanisms of GD are unclear. We investigated brain network connectivity patterns involved in own body perception in the context of self in GD. Twenty-seven female-to-male (FtM) individuals with GD, 27 male controls, and 27 female controls underwent resting state fMRI. We compared functional connections within intrinsic connectivity networks involved in self-referential processes and own body perception -default mode network (DMN) and salience network - and visual networks, using independent components analyses. Behavioral correlates of network connectivity were also tested using self-perception ratings while viewing own body images morphed to their sex assigned at birth, and to the sex of their gender identity. FtM exhibited decreased connectivity of anterior and posterior cingulate and precuneus within the DMN compared with controls. In FtM, higher "self" ratings for bodies morphed towards the sex of their gender identity were associated with greater connectivity of the anterior cingulate within the DMN, during long viewing times. In controls, higher ratings for bodies morphed towards their gender assigned at birth were associated with right insula connectivity within the salience network, during short viewing times. Within visual networks FtM showed weaker connectivity in occipital and temporal regions. Results suggest disconnectivity within networks involved in own body perception in the context of self in GD. Moreover, perception of bodies in relation to self may be reflective rather than reflexive, as a function of mesial prefrontal processes. These may represent neurobiological correlates to the subjective disconnection between perception of body and self-identification.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, suite 2200, Los Angeles, CA, 90095, USA. jfeusner@mednet.ucla.edu.
authors.forename: Jamie D
authors.initials: JD
authors.lastname: Feusner
authors.affiliation: Department of Womens and Childrens Health and Neurology Clinic, Karolinska Institute and University Hospital, Q2:07 SE, 171 76, Stockholm, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Lidström
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, suite 2200, Los Angeles, CA, 90095, USA.
authors.forename: Teena D
authors.initials: TD
authors.lastname: Moody
authors.affiliation: ANOVA, Center of Expertise in Andrology, Sexual Medicine, and Transgender Medicine, Karolinska University Hospital & Center for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institute, C2:84 Karolinska University Hospital, Huddinge, 14186, Stockholm, Sweden.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Dhejne
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, suite 2200, Los Angeles, CA, 90095, USA.
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Bookheimer
authors.affiliation: Department of Womens and Childrens Health and Neurology Clinic, Karolinska Institute and University Hospital, Q2:07 SE, 171 76, Stockholm, Sweden.
authors.forename: Ivanka
authors.initials: I
authors.lastname: Savic
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001931:Brain Mapping; D003430:Cross-Sectional Studies; D005260:Female; D000068116:Gender Dysphoria / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D005783:Gender Identity; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology; D012146:Rest; D063106:Transgender Persons / Q000523:psychology; D014189:Transsexualism / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
keywords: Body identification; Body image; Gender identity disorder; Resting state fMRI; Transgender; Transsexual