A-11 The Neuropsychological Impact of Gender Affirming Treatments: A Systematic Review

Abstract

Objective Currently, there is strong evidence to demonstrate neuroanatomical changes in transgender and gender non-conforming (TGNC) adults following gender-affirming hormonal therapy (GHT). However, there has been no systematic review of the literature pertaining to GHTs’ neuronal effects. Such a review would help develop consensus within neuropsychology regarding standards of assessment with TGNC individuals. Data Selection Studies were only included if they assessed neuropsychological or neuroanatomical brain structure changes or functioning following GHT in the TGNC population. Search terms such as “neuropsychology” and “transgender” were entered in Medline, PsychINFO, and ProQuest. The 24 qualifying studies’ methodological and outcome data were critically reviewed by both researchers to reduce bias. Data Synthesis Neuroanatomical changes within the subcortical structures are found in TGNC individuals who received GHT over a longer duration. Current guidelines and recommendations do not consider the age of transition, dosage, and duration of GHT when interpreting neurocognitive data of TGNC patients; thus, it can lead to validity issues when selecting appropriate norms and interpreting neurocognitive domains with expected sex differences (i.e., visual, verbal, motor). Conclusion The literature review results indicate a paucity of guidelines and analysis related to the ethical practice of neuropsychological evaluation for TGNC individuals. Moving forward, guidelines need to be developed surrounding the age of transition, dosage, and duration of GHT when interpreting brain-behavior relationships on neuropsychological assessments.