Effects of testosterone treatment on hypothalamic neuroplasticity in female-to-male transgender individuals

Georg Kranz, A. Hahn, U. Kaufmann, M. Tik, S. Ganger, R. Seiger, A. Hummer, C. Windischberger, S. Kasper, R. Lanzenberger

Research output: Journal article publicationJournal articleAcademic researchpeer-review

16 Citations (Scopus)


Diffusion-weighted imaging (DWI) is used to measure gray matter tissue density and white matter fiber organization/directionality. Recent studies show that DWI also allows for assessing neuroplastic adaptations in the human hypothalamus. To this end, we investigated a potential influence of testosterone replacement therapy on hypothalamic microstructure in female-to-male (FtM) transgender individuals. 25 FtMs were measured at baseline, 4 weeks, and 4 months past treatment start and compared to 25 female and male controls. Our results show androgenization-related reductions in mean diffusivity in the lateral hypothalamus. Significant reductions were observed unilaterally after 1 month and bilaterally after 4 months of testosterone treatment. Moreover, treatment induced increases in free androgen index and bioavailable testosterone were significantly associated with the magnitude of reductions in mean diffusivity. These findings imply microstructural plasticity and potentially related changes in neural activity by testosterone in the adult human hypothalamus and suggest that testosterone replacement therapy in FtMs changes hypothalamic microstructure towards male proportions.

Original languageEnglish
Pages (from-to)321-328
Number of pages8
JournalBrain Structure and Function
Issue number1
Publication statusPublished - 1 Jan 2018
Externally publishedYes


  • Diffusion-weighted imaging
  • Female-to-male
  • Hypothalamus
  • Testosterone
  • Transgender

ASJC Scopus subject areas

  • Anatomy
  • Neuroscience(all)
  • Histology


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