Elsevier

Hormones and Behavior

Volume 50, Issue 5, December 2006, Pages 708-717
Hormones and Behavior

Estrogen treatment effects on cognition, memory and mood in male-to-female transsexuals

https://doi.org/10.1016/j.yhbeh.2006.06.008Get rights and content

Abstract

Gonadal hormones, particularly estrogens, have been suggested to influence memory and cognitive tasks that show sex differences. Previously, we reported that male-to-female (M–F) transsexuals undergoing estrogen treatment for sex re-assignment scored higher on verbal Paired Associate Learning (PAL) than a transsexual control group awaiting estrogen treatment. The present study used a more robust design to examine further associations between estrogen and cognition. We assessed additional aspects of memory, including visual, spatial, object and location memory, other cognitive abilities that show reliable sex differences, including verbal and visual–spatial abilities, and mood variables that could mediate associations between estrogen and cognition. In addition to comparing groups of individuals on and off estrogen, we used two repeated measures designs (AB and BA). The AB group was tested prior to hormone treatment and then again after treatment had begun; the BA group was tested while on estrogen treatment and then again when hormones had been withdrawn prior to surgery. Few changes in memory or cognition were observed, and changes that were observed were not consistent across study designs. The lack of significant effects did not relate to mood changes or to the sexual orientation of participants. These findings suggest that estrogen treatment associated with sex change for M–F transsexuals has little or no influence on sex-typed aspects of cognition or memory.

Section snippets

Participants

Genetic males (n = 103) desiring sex re-assignment as females and diagnosed as having Gender Identity Disorder (American Psychiatric Association, 1994) were recruited through the Gender Identity Clinic, Charing Cross Hospital, London, UK, and were paid £10 for participation. For the repeated measures analyses, participants formed 2 conditions, depending on their stage in the treatment process. (1) Off then on (AB) condition: patients were tested first shortly before estrogen treatment began (n = 

Results

Prior to analyses, data were examined for skew. Data for variables showing significant skew were transformed to produce normal distributions, and analyses were carried out on transformed values, as well as on untransformed values. In all cases, both analyses produced the same results in terms of significance and insignificance. Results reported are for untransformed values.

There were three primary analyses. Two were repeated measures MANOVAs. One (off then on (AB)) compared participants before

Discussion

We found no support for the hypothesis that treatment of M–F transsexuals with estrogen influences memory or cognitive abilities that show sex differences. For participants tested before and then after estrogen treatment, performance changed on only one task, DS backwards, a control task for which no estrogen treatment effects had been predicted. In addition, the improvement on DS backwards was no longer significant when changes in the mood scale Composed were controlled statistically. For

Acknowledgments

We thank all the patients who participated in this study. We also thank Dr. David Dalrymple, Dr. James Barrett (for referring patients to the study), Jane Eyre (Clinic Manager) and other staff from the Gender Identity Clinic, and Mr. Graham Carter, Charing Cross Hospital, London (for advice on Endocrinology).

This work formed part of the Ph.D. thesis submitted by Clare Miles to the Department of Psychology, City University, London, UK, and financial support for the project was provided by the

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    Present address: Marie Curie Palliative Care Research Unit, Department of Mental Health Sciences, Royal Free and University College Medical School, London, UK.

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