Effect of prenatal androgens on gender development

Purpose of review: A recent resurgence of interest in the role of early androgen exposure and subsequent development of gender identity has resulted from the complex and controversial issues involved in gender assignment of children born with intersex conditions. This review discusses research findings from animal and human studies as they may relate to the effects of androgen on the development of the central nervous system and human gender identity. Recent findings: Animal studies indicate a role of fetal and postnatal androgen exposure in gender-specific central nervous system anatomic changes and sexual behavior. Early excessive androgen exposure of human females, as evidenced by, for example, genital virilization, inconsistently results in male sex role behavior and is associated with a slightly increased risk of atypical gender identity. Summary: Based on available data, human gender development is incompletely determined by early sex steroid hormone action. Other factors, such as genetic inheritance and social and environmental factors, likely interact with hormonal factors in the determination gender identity.