Cited by 41LGBTQ Health, Identity, and PolicyHormonal and reproductive studiesSexual Differentiation and Disorders

Gender-affirming hormone treatment and cognitive function in transgender young adults: a systematic review and meta-analysis

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Karalexi, Maria A., Georgakis, Marios K., Dimitriou, Nikolaos G., Vichos, Theodoros, Katsimpris, Andreas, Petridou, Eleni Th., Papadopoulos, Fotios C.·2020·Psychoneuroendocrinology

Abstract

BACKGROUND: Previous studies have examined whether steroid hormone treatment in transgender individuals may affect cognitive function; yet, their limited power does not allow firm conclusions to be drawn. We leveraged data from to-date literature aiming to explore the effect of gender-affirming hormone administration on cognitive function in transgender individuals. METHODS: A search strategy of MEDLINE was developed (through June 1, 2019) using the key terms transgender, hormone therapy and cognitive function. Eligible were (i) cohort studies examining the longitudinal effect of hormone therapy on cognition, and (ii) cross-sectional studies comparing the cognitive function between treated and non-treated individuals. Standardized mean differences (Hedges' g) were pooled using random-effects models. Study quality was evaluated using the Newcastle-Ottawa Scale. OUTCOMES: Ten studies (seven cohort and three cross-sectional) were eligible representing 234 birth-assigned males (aM) and 150 birth-assigned females (aF). The synthesis of cohort studies (n = 5) for visuospatial ability following hormone treatment showed a statistically significant enhancement among aF (g = 0.55, 95% confidence intervals [CI]: 0.29, 0.82) and an improvement with a trend towards statistical significance among aM (g = 0.28, 95%CI: -0.01, 0.58). By contrast, no adverse effects of hormone administration were shown. No heterogeneity was evident in most meta-analyses. INTERPRETATION: Current evidence does not support an adverse impact of hormone therapy on cognitive function, whereas a statistically significant enhancing effect on visuospatial ability was shown in aF. New longitudinal studies with longer follow-up should explore the long-term effects of hormone therapy, especially the effects on younger individuals, where there is greater scarcity of data.

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  • In a recent meta-analysis, HRT was found not to affect the motor coordination or visuospatial abilities of transwomen.

    “in a recent meta-analysis, HRT was found not to affect the motor coordination or visuospatial abilities of transwomen [47].”

    From Integrating Transwomen and Female Athletes with Differences of Sex Development (DSD) into Elite Competition: The FIMS 2021 Consensus Statement (2021) · cites this paper as [47]

    Section 3.4 (page unavailable) reports a non-significant trend toward improved visuospatial ability in assigned-male transgender participants, not evidence that HRT had no effect. Its explicit finding of no significant change in motor coordination concerns assigned-female participants, not transwomen. The claim therefore overstates the visuospatial result and applies the motor-coordination finding to a different group. (LLM, conf=0.86)

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Authors
Karalexi, M. A., Georgakis, M. K., Dimitriou, N. G., Vichos, T., Katsimpris, A., Petridou, E. T., & Papadopoulos, F. C.
Affiliations
  • Uppsala University (SE)
  • National and Kapodistrian University of Athens (GR)
Corresponding author
Papadopoulos, Fotios C.
Venue
Psychoneuroendocrinology
Publisher
Elsevier BV
Published
2020-09
Volume
119
Pages
104721
ISSN
0306-4530 (ISSN-L)
OpenAlex
W3029883418
Cited by
41
References
83
Citations by year
2026: 4 · 2025: 8 · 2024: 8 · 2023: 6 · 2022: 8 · 2021: 5 · 2020: 2
FWCI
0.84
Type
journal article
Language
en
Open access
Locations
  • Psychoneuroendocrinology (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
Keywords
gender-affirming hormone therapy, cognitive function, transgender young adults, visuospatial ability, sex differences
MeSH terms
Gender Dysphoria, Cognition, Cross-Sectional Studies, Female, Humans, Male, Spatial Behavior, Transsexualism, Cohort Studies, Hormone Replacement Therapy, Young Adult, Gender-Affirming Procedures, Transgender Persons

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