Low perinatal androgens predict recalled childhood gender nonconformity in men

The contributions of gender socialization and direct hormonal action on the brain in the development of human behavioral sex differences are subjects of intense scientific and social interest. Prior research indicates masculinized behavioral patterns in individuals with high prenatal androgen exposure raised as girls, but complementary evidence regarding individuals with low prenatal androgens raised as boys is critically lacking. We investigated recalled childhood gender nonconformity (CGN) in men (n = 65) and women (n = 32) with isolated GnRH deficiency (IGD) and typically developing men (n = 463) and women (n = 1207). IGD is characterized by low or absent gonadal hormone production after the first trimester of gestation until hormone replacement therapy initiation around the time of puberty, but external appearance is concordant with chromosomal and gonadal sex. Compared to typically developing men, men with IGD reported higher CGN, particularly if they also reported cryptorchidism at birth, a marker of low perinatal androgens. Women with IGD did not differ from typically developing women. These results suggest that early androgen exposure after the first trimester contributes to male-typical gender role behaviors in childhood.