The biological and social puzzle of gender identity

Health · Published 19 October 2026 Swipe more like this →

In short: Why does gender identity sometimes diverge from biological sex? Science suggests a complex tapestry of causes, ranging from prenatal hormones and genetic heritability to social dynamics. Because the etiology remains complex, researchers are moving toward a multi-factorial understanding of how these identities develop.

The study of gender incongruence—the discordance between biological sex and gender identity—dates back at least a century. In 1923, Magnus Hirschfeld first introduced the concept of 'transsexual' into professional literature, proposing that both homosexuality and transsexuality were results of natural sexual variability driven by a 'glandular orchestra' of hormonal factors.

Modern research explores several distinct etiological hypotheses. One prominent theory involves prenatal hormone exposure; some suggest that an excess of testosterone in females or a defect in males during fetal development could shape the brain in ways that incline individuals toward gender incongruence. Another area of study focuses on genetics. A 2013 twin study found that 33% of identical (monozygotic) twin pairs assigned male at birth were both transgender, compared to only 2.6% of non-identical (dizygotic) pairs. This suggests a significant genetic influence, though specific candidate genes remain unknown.

Psychological and social theories also play a role. Some theorists postulate that gender incongruence might be a response to unconscious parental conflicts within a family system. Others have explored links to clinical conditions, such as the possibility that the rigidity associated with Autism Spectrum Disorder (ASD) could lead to a fixation on gender issues. However, because many of these factors are difficult to test or show substantial overlap, current clinical guidelines, such as those from the WPATH, emphasize identifying and excluding other possible causes before initiating gender-affirming treatments.

Recent neuropsychological research seeks to move away from pathologizing these differences. A study in Türkiye involving 81 adults found that while some domain-specific differences in visuospatial and executive functions existed between transgender and cisgender groups, the distributions overlapped substantially. These findings suggest that cognitive performance does not correspond directly to gender identity or sex assigned at birth, highlighting the importance of sociocultural factors over inherent deficits.

General information, not professional advice. Spotted an error? Flag the card or see corrections and complaints.

Intellect Plus is a visual educational discovery platform for exploring fascinating facts and ideas. Brain Food, Not Brain Rot. What is Intellect Plus?

Related

• Five scientific challenges to the traditional gender binary in psychology
• Is gender an innate biological reality or a performance we repeat every single day?
• Is sexual orientation a social construct or a biological reality?
• Is gender defined by DNA alone, or can life experiences rewrite our biology?
• The science of gender: nature, nurture, and the limits of academic freedom
• Is a mental disorder an objective fact or a social value judgment?
• Why correlation is a misleading metric for measuring scientific agreement
• Can we ever truly measure a thought? The puzzle of construct validity.
• The second highest court in England and Wales
• The branding of a math formula: the truth about Cronbach's alpha
• The profound psychological cost of misgendering and systemic exclusion
• The Supreme Court rules on state bans for gender-affirming care

More in Psychiatry · More in Health · Latest · A–Z · All topics