Juvenile autoimmune hypothyroidism and gender dysphoria: A causal relationship or a casual coincidence?

Beatrice, Anne M; Sumana, K.; Mengade, Manoj Gopinath

doi:10.4103/ijem.ijem_656_18

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…This hypothesis is based on: 1) a presence of TPO deleterious (pathological) variant that control the T3 and T4 production and the absence of the variants that regulate the androgen hormone axis ( Table 1); 2) the observed testicular malformation at both the anatomical and histological levels ( Figure 2); and 3) the T-score values derived for the lumbar spine (−3.1) and femoral neck (−3.4) being comparable to those of patients with PAIS [18] while being much worse than those of older male subjects with low testosterone levels, respectively −0.48 and −1.56 [19]. Importantly, the T3 and T4 thyroid deficiency has been recently reported in a patient with GD and normal, 46, XX, female karyotype [20]. With this regard, the data presented in the current report raise a very important question is to whether the thyroid hormone deficiency could be viewed as one of the important biological underlinings of TGism and GD.…”

Section: Discussionmentioning

confidence: 81%

A Rare Case of 83-Year-Old Transgender Female: Can Thyroid Hormone Deficiency Be Involved in Transgenderism and Gender Dysphoria?

Frolov¹,

Polcaro²,

Lawson³

et al. 2020

ASM

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In the current report, we describe an 83-year-old biological male who selfidentified as a female by legally changing his first and middle names to female ones and whose death certificate states his sex as a female. The medical history of this individual indicated complete penectomy without further specification. Postmortem physical examination revealed an absence of penis with a large scrotum, transposed urethral orifice, and small testes. The histological analysis of the testes identified abnormal epithelium in the seminiferous tubules that lacked germ and Sertoli cells as well as the interstitium without Leydig cells present. The exome sequencing of the individual's DNA using the Next Generation Sequencing (NGS) Illumina platform revealed no genetic variants associated with either penile or urethral cancer that could have explained the complete penectomy, but pointed toward a potentially impaired production of T3 and T4 thyroid hormones which could account for the observed testicular malformation. Overall, the data obtained raise an important question as to whether the thyroid hormone axis could be an important part of the hormonal architecture supporting male sexual behavior.An 83-year-old TF cadaver was received through Saint Louis University (SLU) School of Medicine Gift of Body Program from an individual who had given his written informed consent. The body was embalmed through the right femoral artery with a mixture of water and a solution (2:1) containing 33.3% glycerin, 28.8% phenol, 4.6% formaldehyde, and 33.3% methanol. Anatomical DissectionThe cadaveric body was dissected according to [11].A. Frolov et al. Histological AnalysisTesticular tissue was procured from the embalmed body. Tissue fixation, paraffin embedding, sectioning, and staining with hematoxylin & eosin were performed by Research Microscopy and Histology Core, Department of Pathology, Saint Louis University (SLU) School of Medicine according to the standardized procedures. Images were captured on Olympus 41BX-EPI microscope equipped with the 10× UPlan FL N, 20× LUCPlan FL, and 40× UPlan FL N objectives. The data acquisition and image analysis were performed by using CellSens Standard software. Bone DensitometryBone density of the lumbar spine and left femoral neck of the embalmed body was measured in triplicates using certified Hologic QDR-4500 X-ray Bone Densitometer in the dual energy X-ray absorptiometry (DEXA) mode following the manufacturer's protocol. The respective average T-score values were used throughout the text. LimitationsThe deleterious (pathologic) genetic variants were identified by the exome sequencing of a single proband. The high scientific value of a single proband approach to unique human cases has been recently demonstrated [27].

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Section: Discussionmentioning

confidence: 81%

A Rare Case of 83-Year-Old Transgender Female: Can Thyroid Hormone Deficiency Be Involved in Transgenderism and Gender Dysphoria?

Frolov¹,

Polcaro²,

Lawson³

et al. 2020

ASM

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Cinsel Kimlik Gelişiminin Nörobiyolojik Yapıtaşları ve Çevresel Stresörlerin Epigenetik Etkileri

SARİ,

SAVCI,

BALTA

et al. 2024

Psikiyatride Güncel Yaklaşımlar

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In this review, we explore the intricate development of sexual identity, drawing insights from genetic, endocrinological, neuroanatomical, and neurophysiological studies. Gender identity, encapsulating an individual's internal perception as male or female, undergoes a nuanced and gradual formation, commencing early in life and progressing through distinct stages. Gender nonconformity delineates behaviors that diverge from culturally prescribed norms, while gender dysphoria encompasses the emotional distress experienced by some individuals due to a mismatch between their gender identity and assigned sex at birth. The genesis of sexual identity involves multifaceted processes spanning numerous years. Human sex differentiation involves the suppression or inactivation of specific genes, a phenomenon illuminated by genetic investigations into gender dysphoria, which have shown comparable rates of genetic variations to the general population. Nevertheless, twin studies suggest an augmented likelihood of transsexuality among family members, hinting at potential environmental influences. Brain sexual differentiation occurs during mid-to-late pregnancy due to the impact of gonadal hormones. The mechanisms underpinning the loss of feminine brain characteristics and subsequent masculinization likely involve a combination of factors, indicating a complex interplay rather than a singular cause. Studies propose that human sexual behavior is not governed by a solitary gene but rather by a network of genes dispersed across the genome. Notably, disparities in brain structures, functionalities between genders, as well as variations in endocrine and serotonin-dopamine levels, are implicated in the etiology of gender dysphoria, contributing to the understanding of this complex phenomenon situated between genders.

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Juvenile autoimmune hypothyroidism and gender dysphoria: A causal relationship or a casual coincidence?

Cited by 2 publications

References 3 publications

A Rare Case of 83-Year-Old Transgender Female: Can Thyroid Hormone Deficiency Be Involved in Transgenderism and Gender Dysphoria?

A Rare Case of 83-Year-Old Transgender Female: Can Thyroid Hormone Deficiency Be Involved in Transgenderism and Gender Dysphoria?

Cinsel Kimlik Gelişiminin Nörobiyolojik Yapıtaşları ve Çevresel Stresörlerin Epigenetik Etkileri

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