Brain connectivity dynamics in cisgender and transmen people with gender incongruence before gender affirmative hormone treatment

Abstract

Large-scale brain network interactions have been described between trans- and cis-gender binary identities. However, a temporal perspective of the brain's spontaneous fuctuations is missing. We investigated the functional connectivity dynamics in transmen with gender incongruence and its relationship with interoceptive awareness. We describe four states in native and meta-state spaces: (i) one state highly prevalent with sparse overall connections; (ii) a second with strong couplings mainly involving components of the salience, default, and executive control networks. Two states with global sparse connectivity but positive couplings (iii) within the sensorimotor network, and (iv) between salience network regions. Transmen had more dynamical fuidity than cismen, while cismen presented less meta-state fuidity and range dynamism than transmen and ciswomen. A positive association between attention regulation and fuidity and meta-state range dynamism was found in transmen. There exist gender diferences in the temporal brain dynamism, characterized by distinct interrelations of the salience network as catalyst interacting with other networks. We ofer a functional explanation from the neurodevelopmental cortical hypothesis of a gendered-self.