Minor Physical Anomalies as a Gateway to Understanding the Neurodevelopmental Roots of Gender Dysphoria

The etiology of gender dysphoria (GD) involves both biological and psychosocial factors and may have a neurodevelopmental aspect. We aimed to compare individuals with GD with each other and with cisgender individuals based on minor physical anomalies (MPAs). The case group comprised 108 individuals with GD (60 GD assigned female at birth [AFAB]; 48 GD assigned male at birth [AMAB]), most with same-biological-sex attraction. The control group consisted of 117 cisgender individuals with opposite-biological-sex attraction. Participants completed a sociodemographic-clinical-data form. Waldrop MPA Scale was used to assess MPAs. The total, craniofacial, and peripheral MPA scores of the AFAB-GD group were significantly higher than those of the cisgender controls. In the AMAB-GD group, the total and craniofacial MPA scores were significantly higher than those of the cisgender controls. Peripheral MPA scores were similar between AMAB and AFAB-GD groups, and both were higher than cisgender controls. Our findings reveal elevated MPA scores in individuals with GD, enhancing our understanding of the biological mechanisms, including early genetic and environmental factors, that may contribute to GD, at least in one group of individuals, although these findings may not be entirely attributable to gender identity and the potential influence of sexual orientation should be considered.