How transgender research is changing science

Sometimes, you do have to reinvent the wheel.

That’s happening now in the field of transgender research. According to a 2019 article in the scientific journal Nature, increased attention to gender identity and expression has resulted in new interest in the scientific and medical communities. And researchers have had to change their approach to get results.

Clinical research relies on categories, otherwise known as variables. We need them to form hypotheses and generate results. Age would be considered a category, as would gender. Without these categories, we get results with no context.

Transgender identities challenge the historic definition of gender and, as a result, many of the preexisting notions about categorization.

So, scientists studying gender transitions have had to come up with their own framework, studying the full spectrum of gender rather a simple designation of male or female. That effort is starting to make headway in transgender research. Leading the charge is the European Network for the Investigation of Gender Incongruence (ENIGI) study at the Ghent University Hospital in Belgium (Reardon, 2019).

With 2,600 participants at four clinics, ENIGI is the largest study of transgender subjects in the world, as of April 2019. It monitors people both during and after their transition in immense detail. Nature journalist Sara Reardon (2019) writes:

“The hospital sees participants every three months at first and eventually once per year, collecting data each time. After a consultation, participants typically have their blood taken. Researchers track biological indicators, such as stress hormones and immune markers. Later, they collate these with other data, such as psychological examinations, brain scans and DNA sequences.” (para. 10)

That process has brought much-needed clarity to subjects such as hormone therapy. For instance, doctors have been known to prescribe hormones and dosages independently from one another, and that can lead to an overall lack of cohesion. Reardon (2019) writes:

“The numbers mean that the ENIGI researchers can finally draw some significant conclusions about the effects of standard care. So far, hormone treatments seem to be safe, with few side effects. The most common complaints from people are lowered sexual desire and voice changes. But the most significant change the researchers have measured is something positive — a decrease in anxiety and depression after treatment” (para. 17).

That insight is significant in part because it has long been virtually impossible to study transgender subjects effectively. A stigma in everyday life made it difficult for people to come forward. Often when they did, results were undermined by poor controls and a lack of standardization. That makes older publications not as reliable because scientists frequently used gender terms interchangeably, as noted by endocrinologist Dr. Joshua Safer of Mount Sinai Hospital.

“They look at a transgender woman and call her a transgender man because they say, ‘Oh, that’s a man who thinks he’s a woman’,” says [Joshua] Safer. “It’s not only insulting; it’s mixing us all up” (para. 24).

Studies such as ENIGI will go a long way toward correcting those assumptions as a new era of research begins. In 2017, for instance, the National Institutes of Health began studying the effects of puberty blockers on transgender teenagers.

“The interest level in the research community in transgender health has really, really grown at an incredible rate”(Reardon, 2019, para. 50), says Karen Parker, director of the National Institutes of Health’s Sexual and Gender Minority Research Office.


Watch this seven-minute video produced by Nature to hear directly from Dr. Guy T’Sjoen, an endocrinologist and leader of the ENIGI study, and learn what participants are saying about the program.

Check out the full article in Nature to learn more about the research on gender identity and where it’s headed.


Burke, S., Kreukels, B., Cohen-Kettenis, P., Veltman, D., Klink, D., & Bakker, J. (2016). Male-typical visuospatial functioning in gynephilic girls with gender dysphoria - organizational and activational effects of testosterone. Journal of Psychiatry & Neuroscience, 41(6), 395–404.

Getahun, D., Nash R., Flanders W.D., Baird, T.C., Becerra-Culqui, T.A., Cromwell, L., Hunkeler, E., Lash, T.L., Millman, A., Quinn, V.P., Robinson, B., Roblin, D., Silverberg, M.J., Safer, J., Slovis, J., Tangpricha, V., & Goodman, M. (2018). Cross-sex hormones and acute cardiovascular events in transgender persons: A cohort study. Annals of Internal Medicine, 169(4), 205–213.

Heylens, G., Verroken, C., De Cock, S., T’Sjoen, G., & De Cuypere, G. (2014). Effects of different steps in gender reassignment therapy on psychopathology: A Prospective study of persons with a gender identity disorder. The Journal of Sexual Medicine., 11(1), 119–126.

Nature Video. (2019, April 2). Understanding transition [Video]. Youtube.

Reardon, S. (2019, April 24). The largest study involving transgender people is providing long-sought insights about their health. Nature.

Gender Identity Gender identity icon Our core sense of who we are as a man, a woman, a mixture of both, or neither.

Gender Expression Gender expression icon How we show up in the world through choices like clothing, hair style, mannerisms or tone of voice.

Attraction attraction icon How we feel toward others sexually, romantically and/or emotionally.

Biological Sex Biological sex icon Physical attributes such as reproductive organs and genitalia, chromosomes, genes and hormone levels.

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