Evidence Supporting the Biologic Nature of Gender Identity

Aruna Saraswat, MD; Jamie D. Weinand, BA, BS; Joshua D. Safer, MD


Endocr Pract. 2015;21(2):199-204. 

In This Article

Abstract and Introduction


Objective To review current literature that supports a biologic basis of gender identity.

Methods A traditional literature review.

Results Evidence that there is a biologic basis for gender identity primarily involves (1) data on gender identity in patients with disorders of sex development (DSDs, also known as differences of sex development) along with (2) neuroanatomical differences associated with gender identity.

Conclusions Although the mechanisms remain to be determined, there is strong support in the literature for a biologic basis of gender identity.


Gender identity is a fundamental human attribute that has a profound impact on personal well-being. Transgender individuals are those whose lived and identified gender identity differs from their natal sex. Various etiologies for transgender identity have been proposed, but misconceptions that gender identity can be altered persist. However, clinical experience with treatment of transgender persons has clearly demonstrated that the best outcomes for these individuals are achieved with their requested hormone therapy and surgical sexual transition as opposed to psychiatric intervention alone.[1] In this review, we will discuss the data in support of a fixed, biologic basis for gender identity.