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Prenatal Exposure to Anticonvulsants and Psychosexual Development

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Abstract

Animal studies have shown that prenatal exposureto the anticonvulsant drugs phenobarbital and phenytoinalters steroid hormone levels which consequently leadsto disturbed sexual differentiation. In this study, possible sequelae of prenatal exposureto these anticonvulsants on gender development in humanswere investigated. A follow-up study was carried out inphenobarbital- and phenytoin-exposed subjects and control subjects matched for age, sex, andthe mothers' ages. Subjects were born in the AcademicMedical Center between 1957 and 1972. Out of 243 exposedand 222 control subjects who were asked to volunteer, 147 exposed subjects (72 male, 75 female) andequal numbers of their matched control subjectsparticipated in the follow-up study. They wereinterviewed and were asked to fill out questionnaires ongender role behavior, gender development, and sexualorientation. As a group, exposed and control subjectsdid not differ with respect to gender role behavior,although higher numbers of prenatallyanticonvulsant-exposed subjects reported current or past cross-genderbehavior and/or gender dysphoria. Three prenatallyanticonvulsant-exposed subjects were transsexuals andhad undergone sex reassignment surgery, a remarkably high rate given the rarity of transsexualism.In addition, two exposed males had exclusivelyhomosexual experiences, whereas none of the controlmales reported exclusive homosexual behavior. The groups did not differ in attainment of pubertalpsychosexual milestones.

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Dessens, A.B., Cohen-Kettenis, P.T., Mellenbergh, G.J. et al. Prenatal Exposure to Anticonvulsants and Psychosexual Development. Arch Sex Behav 28, 31–44 (1999). https://doi.org/10.1023/A:1018789521375

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