Brain Changes and Cognitive Function in Adults Undergoing Gender-Affirming Hormone Therapy

What this Trial Is About

This research aims to understand how gender affirming hormone therapy GAHT affects the brains of transgender adults. The study will investigate changes in cerebral blood flow, brain structure, connectivity, and cognitive functions such as memory, attention, executive function, and processing speed. Researchers will compare these brain changes in transgender males and females over the first few months after starting GAHT. Participants will undergo two main sets of evaluations one before beginning GAHT and another 4 to 6 months after continuous hormone therapy. These evaluations include magnetic resonance imaging MRI scans to assess brain structure and function, cognitive and health tests to measure body composition and neurocognitive performance, and an optional graded exercise test to assess cardiorespiratory fitness. During the study, participants will have MRI scans involving structural brain imaging and scans during cognitive tasks and acute stress response. They will complete cognitive tasks using the NIH Toolbox and have body composition scans. Optional exercise testing may be performed. Researchers will monitor changes in brain blood flow, structure, connectivity, and various cognitive tests over the study period, with the entire observation lasting up to 6 months after starting GAHT.

Brain Health in Transgender Adults