2023 Sex and Gender in Alzheimer’s (SAGA) Grant (SAGA)
Cognitive Functioning and Gender-Affirming Hormones in Transgender Adults
How does gender-affirming hormone therapy in older transgender adults affects cognition?
Anthony Correro, Ph.D.
The Medical College of Wisconsin
Milwaukee, WI - United States
Background
A transgender person is someone whose gender identity does not correspond with the sex registered for them at birth—they may consider themselves masculine, feminine or nonbinary. Some studies suggest that cisgender—those who identify with the sex registered from them at birth—men and women have some differences in cognition. However, less is known about the cognition of transgender people. Moreover, studies have shown disproportionate rates of dementia among transgender relative to cisgender people.
Some transgender people receive gender-affirming hormone therapy (GAHT) to reach their goals of gender embodiment and/or to reduce gender dysphoria, which are negative feelings associated with a branching between gender identity and assigned sex. Typically, feminine embodiment GAHT includes estrogen and androgen-lowering medications, and masculine embodiment GAHT includes testosterone.
Studies of transgender people who are not on GAHT suggest the cognitive performances, brain structures, and functional neuroimaging of transgender people are more consistent with their gender identities than their sexes assigned at birth. However, there are few studies on long-term GAHT and cognition among older transgender adults and little work has focused on the reasons transgender adults may be at higher risk for dementia and Alzheimer’s.
Research Plan
Dr. Correro plans to examine how GAHT, minority stress (high levels of stress faced by members of stigmatized groups), and risk for Alzheimer’s impact the psychological functioning of transgender older adults. They will recruit 140 individuals (35 each of transgender women, transgender men, cisgender women, and cisgender men) over the age of 55 and assess cognition using clinical psychological instruments and minority stress via self-report as well as blood-based indicators of stress.
Impact
The results of this study may help understand the long-term effects of gender-affirming hormone therapy on cognition in older transgender adults. It may also help understand why transgender people have disproportionate rates of dementia.