Sex and gender 5: The biopsychosocial approach Flashcards
(23 cards)
What is the biopsychosocial approach of sex/gender differences?
Sex/gender differences are best conceptualised as a product of several non-binary factors, including biological, psychological, and social/environmental influences
What are four reasons as to why sex/gender differences characterised by small effect sizes and are inconsistent?
1) Different methodological approaches and reference measures
2) Small and/or heterogeneous sample composition
3) The specific tasks/paradigm used
4) The limited consideration of sex/gender-related factors that can explain inter-and intra-individual differences in brain and behaviour better than sex/gender per se - only looked at sex or gender in a binary sense
- For example, sex/gender-related factors include biological factors such as levels of sex hormones and sex-linked genes, environmental factors such as gender roles and stereotypes, and psychological factors such as self-identified masculinity/femininity.
- These and related factors should be acknowledged routinely within a biopsychosocial approach when studying sex/gender differences in brain and behaviour.
Why do few studies adopt a biopsychosocial approach?
- Methodologically difficult to design – needs to include measures that cover all three strands - difficult to define sex and gender
- Dispute over how to account for ‘sex’ versus ‘gender’ as conceptually distinct things
Studies that do exist support the notion that gender roles and gender stereotypes can interact with biological factors in a way that contributes to the generation and maintenance of sex/gender differences in brain structure and function.
- Belfi et al. (2014) used MRI to investigate the relationship between gender roles and brain structure in 108 children (56 boys and 52 girls).
- All children completed the Children’s Sex Role Inventory (Boldizar, 1991)
- Very stereotypical and problematic masculine/feminine traits
- Each participant gets a ‘masculine’ score and a ‘feminine’ score
- Belfi et al. (2014) also created a masc-fem continuum score (masc – fem = continuum score)
- Higher score = more masc, lower score = more fem
What were the results?
- Male sex associated with higher continuum score (r = .54), but this isn’t strong enough to say sex and gender are the same - high but not high enough
- Psych and bio correlations:
- Masculinity positively correlated with white matter volumes in the frontal lobe
- Femininity positively correlated with grey matter volumes in the temporal lobe
- In both cases, effects remained even after biological sex was controlled for (just based on calculated masculinity or femininity
- But – the direction of causality in this relationship is not clear - does having more white matter make you more masc or vice versa?
- Still, the authors suggested that this effect may represent a sex/gender-related environmental influence on sex/gender differences in the brain, that goes beyond the effect of biological sex
What are consequences of negative stereotypes triggering a high stress response?
This can impair performance
Wraga et al. (2007) used fMRI to investigate the effects of gender stereotyping on the neural underpinnings of visuospatial performance in 54 women.
- Control, positive, negative stereotype groups
- Mental rotation task
What did behavioural and neural data show?
- Significantly poorer performance in negative group (increased error rates)
- Improved performance in the positive group
Negative stereotype group
- Poorer performance in the negative stereotype group was characterised by greater activation in brain regions associated with emotional processing, including the orbital and medial frontal gyri, and the anterior cingulate cortex - all involved in emotion regulation
- Suggests the negative stereotypes led to an increased emotional load (e.g., increased self-consciousness? Stress?) resulting in poorer performance
- Interestingly, women reported not being affected by the stereotype – suggests effects operate on an unconscious level
Positive stereotype group
- Increased activation of secondary visual processing areas, superior occipital gyrus, and anterior prefrontal gyrus.
- These regions are typically associated with good mental rotation performance, as well as higher-order cognitive functions (e.g., PFC and working memory)
- Women given positive information showed higher activation in areas that would help them complete this task
- Most importantly – no activation of areas associated with emotional processing/increased emotional load or stress response
Hausmann et al. (2009) did cognitive testing and endocrinological measures to investigate stereotype threat effects.
- Gender stereotype questionnaire vs gender neutral questionnaire
- Mental rotation tasks
- Verbal fluency tasks
Saliva samples to assess testosterone
- Why testosterone? Previous studies showed that high testosterone in women = more threat effects
- Testosterone is also associated with mental rotation performance in men
Hypothesis: gender stereotypes should result in relatively poor performance in women, and this effect will be related to stereotypes influencing testosterone levels.
Did results support the hypothesis?
Partly:
Stereotype improves male performance to the point that sex difference becomes much bigger
Male testosterone increased significantly when they heard the stereotype and performed better
No testosterone difference in women - stereotype had no effect on this
Pletzer et al. (2019):
- Men and women completed a mental rotation task
- Sex hormone levels assessed via saliva
- All women tested in the luteal phase
- Gender role identification also measured via questionnaire
Were able to examine the relationship between hormones, gender roles, and mental rotation ability - what did they find?
Estradiol positively related to mental rotation performance - faster reaction time
Only a relationship seen with testosterone and progesterone in male ppts
Testosterone strongest relationship
Only in female ppts - relationship between self-identified masculinity score and testosterone
Does an interactive relationship exists between sex/gender relevant biological, psychological, and social factors that is capable of influencing sex/gender differences in cognition?
Yes
However:
- Most studies look at EITHER sex OR gender (in isolation), or something in between (i.e., studies that conflate sex and gender)
- For a truly biopsychosocial approach, the distinction between “sex” and “gender” should be acknowledged, and the effects of both (in conjunction) should be accounted for in future studies
- Look at effect of sex and effect of biological gender and their interaction
- Issue because they are so closely intertwined
To truly account for both sex and gender as distinct concepts, what is it important to recognise?
That neither biological sex nor gender can accurately be conceptualised as binary
Studies of the brain to date have not appropriately acknowledged the impact of gender, and “binary sex may not be a precise enough independent variable for partitioning subjects when it is often gendered behaviour we seek to understand” (Rauch and Eliot, 2022)
- Zhang et al. (2021) combined connectivity data from four large, international databases (n = 9620) to create a “brain-gender continuum” of resting state networks
- Brain-gender continuum (score that says how male or female a brain is) was mapped onto measure internalising and externalising, which are known to differ according to masculinity/femininity
What did this mapping result in?
- This mapping resulted in a U-shaped curve according to internalising behaviour, with ‘androgynous’ (i.e., those in the middle of the continuum) brains being associated with the lowest levels of internalisation
This supports adopting non-binary sex/gender measures as independent variables, as opposed to separating participants by self-identified binary sex. Moreover, adopting such methods may allow for a truly biopsychosocial approach to the study of sex/gender.
Transgender and nonbinary individuals have largely been ignored in psychological research or have been separated out as disordered, dysphoric, or otherwise outside mainstream considerations of gender.
What are consequences of this for research?
Psychologists will consistently miss important aspects of how gender organizes and functions within people’s lives
- The integration of these groups into research should help researchers uncover new experiences and highlight existing ones that have been obscured when only cisgender experience is the focus.
Harrison et al. (2020) interviewed 8 trans people to gain an in-depth understanding of the lived experience of gender dysphoria - discomfort and stress when their sex does not match their gender (in trans adults seeking gender-affirming care)
- Using interpretative phenomenological analysis, what three themes emerged?
1) Accessing healthcare services
2) Searching for acceptance
3) Impact of gender dysphoria on psychological wellbeing
Moolchaem et al. (2015) synthesis of qualitative studies that explored the lived experiences of trans people
What five major themes were identified from this?
(a) crossing gender and physical problems in life
(b) experiencing psychological distress
(c) encountering discrimination and social exclusion
(d)having relationships does matter
(e) dealing with difficulties in life
Existing on the boundary of a social norm - alienating, should be integrating them instead
Kurth et al. (2022) is one of very few studies that has conducted neuroimaging with transgender participants
- Aim of the study was to investigate if brains of transgender people resemble their birth sex (i.e., biologically determined) or their gender identity (i.e., socio-/psychologically determined)
- Cisgender men, cisgender women, and transgender women (pre-GAHT) - had no gender affirming healthcare
- Subjected brain scans to a ‘brain sex classifier’ algorithm
What did results show?
- Transgender women’s brains fit in between two cisgender groups – suggests a shift away from male-typical brain structure
- Supports idea that brain is sexually dimorphic
- Suggests that gender identity shapes brain structure more so than biological sex
Mueller et al. (2021)
- Compared structural MRI data between cis (m/f) and trans (m/f) groups (pre-GAHT) across a range of measures (inc. grey matter volume, brain size metrics, cortical thickness)
How did transgender groups compare to cisgender groups?
- Both transgender groups differed from the cisgender groups with respect to subcortical brain volumes and surface area
Structural patterns differed between all 4 groups – specific pattern depended both on the brain region examined and the direction of gender identity (i.e., towards male or towards female)
Trans brains exist in their own unique category
Suggests that transgender participants have a unique brain phenotype, it is not simply a shift along the male-female spectrum
Giannantonio et al. (2024) aimed to investigate the experiences and milestones of non-binary identification (what gave them clues that this was their identity), and identify the challenges of living in a binary world as a non-binary person.
- Semi-structured interviews with 20 non-binary participants
- Results revealed what four domains?
Growing up in a binary world
Gender dysphoria
Non-binary awareness
Looking forward
Do cognitive neuroscience studies exist for non-binary people?
No
What is gender affirming therapy?
- Gender-affirming therapy (aka gender-affirming care) refers to any clinical/medical treatment given to a transgender person that helps bring their physical body in line with their gender identity (and in turn, reduce gender dysphoria)
E.g., cross-sex hormone therapy, puberty blockers, surgery
Harrison et al. (2020) investigated the impact of gender-affirming therapy on the psychological wellbeing, quality of life, and daily functioning of transgender people:
lived-experiences of accessing care as a trans person in the UK
However, what is still needed in this research area?
- There is a need for more translational research from biomedicine and neuroscience in this area to truly understand how such therapy can influence neurological processes and behaviour
- Very important since anti-trans legislators often use this lack of research as a reason to block access to gender-affirming care, despite the documented improvements to QoL and psychological wellbeing for trans people
Aghi et al. (2022) provide a comprehensive review of current translational research that could be applied to the study and practice of gender affirming therapy.
What do they argue that research fails to do?
- They argue that current research fails to address the needs of GAHT users, and further translational research is needed (e.g., via animal models)
- Better access and support is needed
- They conclude that “[…] if necessary and important steps are taken to address these issues, translational research on GAHTs will greatly benefit the health care outcomes of trans and gender non-comforming people.”
Need to consider effects of GAHT on many things, and factors that may influence effects of GAHT
What is gender essentialism?
Gender essentialism refers to beliefs that women and men have distinct, innate, and fixed biological essences that differentiate them from each other.
Şahin and Yalcinkaya (2020) investigated the impact of engaging with scientific research into sex and gender on underlying beliefs regarding gender essentialism, sexism, and gender inequality
- Two studies exposed participants to neuroscience research findings concerning sex/gender differences and similarities in the brain, and measured participants gender essentialist beliefs
What did results show?
- Across both studies, participants who were exposed to scientific evidence on brain similarities between men and women reported lower gender essentialism than those in the control and brain difference conditions.
- Findings suggest that exposure to information on brain similarities between men and women can challenge essentialist views on gender, and importantly, indirectly relate to sexism and justification of gender inequality – challenges the notion that sex/gender differences research will increase the likelihood of ‘neurosexism’
- Also has implications for improving gender equality in cultures where this remains an issue (as this is often underpinned by a belief in innate, hardwired biological differences between men and women)
- Importance of psychoeducation
