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Previous studies suggest that high levels of prenatal testosterone (T) in natal females and low levels in natal males might contribute to GD. Here, we investigated if the 2D:4D digit ratio, a biomarker of prenatal T effects, is related to GD. We first report results from a large Iranian sample, comparing 2D:4D in 104 transwomen and 89 transmen against controls of the same natal sex. We found significantly lower (less masculine) 2D:4D in transwomen compared to control men. We then conducted random-effects meta-analyses of relevant studies including our own (<jats:italic>k<\/jats:italic>\u2009=\u20096, <jats:italic>N<\/jats:italic>\u2009=\u2009925 for transwomen and <jats:italic>k<\/jats:italic>\u2009=\u20096, <jats:italic>N<\/jats:italic>\u2009=\u2009757 for transmen). In line with the hypothesized prenatal T effects, transwomen showed significantly feminized 2D:4D (<jats:italic>d<\/jats:italic>\u2009\u2248\u20090.24). Conversely, transmen showed masculinized 2D:4D (<jats:italic>d<\/jats:italic>\u2009\u2248\u2009\u2212\u20090.28); however, large unaccounted heterogeneity across studies emerged, which makes this effect less meaningful. These findings support the idea that high levels of prenatal T in natal females and low levels in natal males play a part in the etiology of GD. As we discuss, this adds to the evidence demonstrating the convergent validity of 2D:4D as a marker of prenatal T effects.\n<\/jats:p>","DOI":"10.1007\/s10508-020-01630-0","type":"journal-article","created":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T17:04:16Z","timestamp":1579799056000},"page":"421-432","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["2D:4D Suggests a Role of Prenatal Testosterone in Gender Dysphoria"],"prefix":"10.1007","volume":"49","author":[{"given":"Mostafa","family":"Sadr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behzad S.","family":"Khorashad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Talaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Fazeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"H\u00f6nekopp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,23]]},"reference":[{"issue":"7","key":"1630_CR1","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.earlhumdev.2015.04.007","volume":"91","author":"FS Al-Zaid","year":"2015","unstructured":"Al-Zaid, F. 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