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Human Genetics (2005) Online:

DOI: 10.1007/s00439-004-1241-4

The original publication is available at:

http://springerlink.metapress.com/openurl.asp?genre=article&id=doi:10.1007/s00439-

004-1241-4

Original Investigation

A genomewide scan of male sexual orientation

Brian S. Mustanski1, 2, Michael G. DuPree1, 3, Caroline M. Nievergelt4,

Sven Bocklandt1, 5, Nicholas J. Schork4 and Dean H. Hamer1

(1) Laboratory of Biochemistry, National Cancer Institute, National Institutes of Health,

Bethesda, Md., USA

(2) Institute for Juvenile Research Department of Psychiatry, University of Illinois at

Chicago (M/C 747), 1747 W. Roosevelt Road, Chicago, IL 60608, USA

(3) Department of Anthropology, Pennsylvania State University, University Park, Pa.,

USA

(4) Department of Psychiatry, University of California, San Diego, Calif., USA

(5) Department of Human Genetics, David Geffen School of Medicine at UCLA, Los

Angeles, Calif., USA

Brian S. Mustanski

Email: bmustanski@psych.uic.edu

Phone: +1-312-9969505

Received: 16 September 2004 Accepted: 30 November 2004 Published online:

12 January 2005

Abstract This is the first report of a full genome scan of sexual orientation in men. A

sample of 456 individuals from 146 families with two or more gay brothers was

genotyped with 403 microsatellite markers at 10-cM intervals. Given that previously

reported evidence of maternal loading of transmission of sexual orientation could indicate

epigenetic factors acting on autosomal genes, maximum likelihood estimations (mlod)

scores were calculated separated for maternal, paternal, and combined transmission. The

highest mlod score was 3.45 at a position near D7S798 in 7q36 with approximately

equivalent maternal and paternal contributions. The second highest mlod score of 1.96

was located near D8S505 in 8p12, again with equal maternal and paternal contributions.

A maternal origin effect was found near marker D10S217 in 10q26, with a mlod score of

1.81 for maternal meioses and no paternal contribution. We did not find linkage to Xq28

in the full sample, but given the previously reported evidence of linkage in this region,

we conducted supplemental analyses to clarify these findings. First, we re-analyzed our

previously reported data and found a mlod of 6.47. We then re-analyzed our current data,

after limiting the sample to those families previously reported, and found a mlod of 1.99.

These Xq28 findings are discussed in detail. The results of this first genome screen for

normal variation in the behavioral trait of sexual orientation in males should encourage

efforts to replicate these findings in new samples with denser linkage maps in the

suggested regions.

Brian S. Mustanski and Michael G. DuPree contributed equally to this work.

Introduction

Although most males report primarily heterosexual attractions, a significant minority

(approximately 2%–6%) of males report predominantly homosexual attractions

(Diamond 1993; Laumann et al. 1994; Wellings et al. 1994). Multiple lines of evidence

suggest that biological factors play a role in explaining individual differences in male

sexual orientation (MIM 306995). For example, the third interstitial nuclei of the human

anterior hypothalamus (INAH3), which is significantly smaller in females, is also

reported to be smaller in homosexual males (LeVay 1991). Byne and colleagues (2001)

followed up on this finding by reporting a trend for INAH3 to occupy a smaller volume

in homosexual men than in heterosexual men, with no significant difference in the

number of neurons within the nucleus. Neuropsychological studies have reported

differences in performance with respect to tasks that show sex differences, such as spatial

processing (e.g., Rahman and Wilson 2003), which may indicate differences in relevant

neural correlates (e.g., parietal cortex). The strong link between adult sexual orientation

and childhood gender-related traits expressed at an early age (Bailey and Zucker 1995)

suggests that such biological influences act early in development, possibly prenatally.

Similarly, the correlation between sexual orientation and a variety of prenatally canalized

anthropometric traits suggests that sexual orientation differentiation probably occurs

before birth (for a review, see Mustanski et al. 2002). Despite this evidence, specific

neurodevelopmental pathways have yet to be elucidated.

Family and twin studies have provided evidence for a genetic component to male sexual

orientation. Family studies, using a variety of ascertainment strategies, document an

elevation in the rate of homosexuality among relatives of homosexual probands (for a

review, see Bailey and Pillard 1995). Several family studies report evidence of increased

maternal transmission of male homosexuality (Hamer et al. 1993; Rice et al. 1999a),

whereas others find no increase relative to paternal transmission (Bailey et al. 1999;

McKnight and Malcolm 2000). Twin studies consistently show that male sexual

orientation is moderately heritable (for a review, see Mustanski et al. 2002). For example,

two recent twin studies in population-based samples both report moderate heritability

estimates, with the remaining variance being explained by nonshared environmental

influences (Kendler et al. 2000; Kirk et al. 2000). The results from family and twin

studies demonstrate that sexual orientation is a complex (i.e., does not show simple

Medelian inheritance) and multifactorial phenotype.

A more limited number of studies have attempted to map specific genes contributing to

variation in sexual orientation. Given the evidence for increased maternal transmission,

initial efforts focused on the X chromosome. One study produced evidence of significant

linkage, based on Lander and Kruglyak (1995) criteria, to markers on Xq28 (Hamer et al.

1993). Another study, from the same laboratory but with a new sample, reported a

significant replication of these findings (Hu et al. 1995). An independent group produced

inconclusive results regarding linkage to Xq28 (discussed in Sanders and Dawood 2003)

but did not publish the findings in a peer-reviewed journal. All three of these studies

excluded families showing evidence for non-maternal transmission. A fourth study from

another independent group found no support for linkage, even when excluding cases with

suggestive father-to-son transmission (Rice et al. 1999b). An analysis of the results across

all four studies produced a statistically suggestive multiple scan probability (MSP) value

of 0.00003 (Sanders and Dawood 2003). Two candidate gene studies have been

conducted, both producing null results: one for the androgen receptor (AR; Macke et al.

1993) and another for aromatase (CYP19A1; Dupree et al. 2004), on Xq12 and 15q21.2,

respectively.

Given the complexity of sexual orientation, numerous genes are likely to be involved,

many of which are expected to be autosomal rather than sex-linked. Indeed, the modest

levels of linkage that have been reported for the X chromosome can account for, at most,

only a fraction of the overall heritability of male sexual orientation as deduced from twin

studies. Therefore, we have undertaken a genomewide linkage scan to aid in the

identification of genes contributing to variation in sexual orientation. As in previous

studies, we diminished the probability of false positives (i.e., gay men who identify as

heterosexual) by only studying self-identified gay men. Unlike previous studies that have

focused solely on the X-chromosome and thus excluded families showing evidence of

non-maternal transmission, this study did not use transmission pattern as an exclusion

criteria. To consider the possibility that previously reported evidence of maternal loading

of transmission of sexual orientation was attributable to epigenetic factors acting on

autosomal genes, we calculated maximum likelihood estimations (mlod) scores separated

by maternal or paternal transmission and the combined statistic. Based on Lander and

Kruglyak s (1995) criteria, we found one region of near significance and two regions

close to the criteria for suggestive linkage.

Materials and methods

Family ascertainment and assessment

The sample consisted of a total of 456 individuals from 146 unrelated families, of which

137 families had two gay brothers and 9 families had three gay brothers. Thirty of the

families included one parent, and 30 of the families included both parents. Additionally,

46 of the families included at least one heterosexual male or female full sibling (up to 6

additional siblings per family). The sample included 40 families previously reported by

Hamer et al. (1993), 33 families previously reported by Hu et al. (1995), and 73

previously unreported families. The 73 previously described families were selected for

the presence of two gay brothers with no indication of non-maternal transmission by the

criteria described previously (Hamer et al. 1993; Hu et al. 1995). For the 73 new families,

the sole inclusion criterion was the presence of at least two self-acknowledged gay male

siblings.

Subjects were recruited through advertisements in local and national homophile

publications as described elsewhere (Hamer et al. 1993; Hu et al. 1995). The participants

were predominantly white (94.5%), college educated (87.4%), and of middle to upper

socioeconomic status. The mean (SD) age for the gay siblings was 36.98 (8.64). The

protocol was approved by the NCI Institutional Review Board, and each participant

signed an informed consent form prior to interview, questionnaire completion, and the

donation of blood for DNA extraction.

Sexual orientation was assessed through a structured interview or a questionnaire that

included a sexual history and the Kinsey scales of sexual attraction, fantasy, behavior,

and self-identification (Kinsey et al. 1948). Each scale ranges from 0 (exclusively

heterosexual) to 6 (exclusively homosexual). The mean (SD) of these four scales for the

gay males in this study was 5.65 (0.46)

Genotyping

DNA was extracted from peripheral blood by a commercial service (Genetic Design,

Greensboro, N.C., USA). A multiplex polymerase chain reaction (PCR) was conducted as

described (Dupree et al. 2004), with 403 microsatellite markers from the ABI PRISM

Linkage Mapping Set Version 2.5 with an average resolution of 10 cM. Following the

manufacturer s guidelines, products were analyzed on an ABI Prism 310 or 3100 and

sized with the GeneScan version 3.1.2 program (PE Biosystems, Foster City, Calif.,

USA), and genotypes were assigned with the Genotyper version 3.6 program (PE

Biosystems). A PCR product from a DNA reference sample (CEPH 1347-02) was used to

monitor sizing conformity (PE Biosystems). Across the 403 markers, genotypes were

ascertained on average for 95% of the 456 individuals. Mendelian incompatibilities

(<0.05% of genotypes) were removed from the data prior to analyses by using the
sib_clean routine from ASPEX version 2.4 (Hinds and Risch 1996). The computer

program CERVUS 2.0 (Marshall et al. 1998) was employed to test for deviation from the

Hardy-Weinberg equilibrium (HW) and to calculate polymorphism information contents

(PICs) at all loci. We found that the markers had a mean (SD) PIC of 0.76 (0.08), and

1.31% of the markers deviated significantly from HW.

Statistical analyses

Nonparametric exclusion mapping of affected sib-pair data (ASP) was performed by

using ASPEX version 2.4 (Hinds and Risch 1996). ASPEX calculates the percentage of

identical by descent (%IBD) sharing and reports the proportion of shared alleles of

paternal, maternal, and combined origin. The results for alleles of combined origin also

include alleles where the parental origin is unknown. We calculated mlod with a linear

model and assuming a multiplicative model. The ASPEX SIB_PHASE algorithm was

applied; this uses allele frequency information to reconstruct and to phase missing

parental information. Sex-specific recombination maps were used for the calculation of

multipoint mlod scores. Marker order and map positions were determined by using an

integrated map (Nievergelt et al. 2004) based on the deCODE genetic map and updated

physical map information.

Results

Results from the multipoint analyses on chromosomes 1 through 22 are shown in Fig. 1

for paternal, maternal, and combined meioses. Our complete genome scan for male

sexual orientation yielded three interesting peaks with mlod scores greater than 1.8,

located on chromosomes 7, 8, and 10. Table 1 contains additional information concerning

these peaks, including the nearest marker, the location, MLOD, and allele sharing.

Additionally, Table 1 contains the approximate boundary of the linkage peak, by

reporting the approximate cM position at which the mlod score declines below 1.0. For

chromosomes 7 and 8, the peak is a result of approximately equal contributions from

maternal and paternal transmission, whereas a maternal-origin effect was found for the

peak on chromosome 10.

Fig. 1 Genome scan results. The x-axis is the chromosome location (cM), and the y-axis

is the mlod score. Graphics included for combined (a), maternal (b), and paternal (c)

meioses

Table 1 Chromosomal locations with nominally significant linkage peaks. The cM

positions in parentheses indicate the boundary at which the mlod score declines below

1.0. For chromosomes 7 and 8, the position is based on the combined map, but for

chromosome 10, the position is based on the female map.

Location mlod Nearby

marker cM Cyto Paternal Maternal Combined

Percentage of

sharing

D7S798 169.9 (155.1–

end) 7q36 2.05 2.26 3.45 62.59

D8S505 54.2 (45.1–

64.8) 8p12 1.38 0.93 1.96 60.10

D10S217 208.1 (201.8–

217.4) 10q26 –0.13 1.89 1.43 58.51

Figure 2 shows the multipoint mlod plots for the X chromosome. Analyses of the full

sample (dashed line) did not produce any chromosomal regions with mlod scores greater

than 1.0. Given the previous evidence of linkage to Xq28 with a portion of the sample

reported here (Hamer et al. 1993; Hu et al. 1995), we performed supplemental analyses to

determine why we did not find linkage in the full sample. We began by re-analyzing the

data from the previously reported 73 families, which had been selected for showing no

evidence of paternal transmission, by using updated marker positions (dotted line). This

produced a maximum mlod score of 6.47 for markers in the Xq28 region. We then

performed a linkage analysis, with only the markers from the ABI linkage mapping set,

on these same 73 families. This produced a maximum mlod score of 1.99 for markers in

the Xq28 region. Although the mlod score is higher when using the current markers in the

limited sample compared with the full sample (1.99 vs. 0.35), it is still significantly lower

than the previously reported markers in the limited sample. We provide Table 2 in order

to help clarify these results. Table 2 provides singlepoint and multipoint results for the 73

previously reported families on all markers ever reported from our group, starting with

the most telemeric new Xq28 marker. Table 2 makes it clear that, although the multipoint

results suggest a dramatic change in mlod score between the current markers and the

previously reported markers (6.47 vs. 1.99 for markers 0.62 cM apart), the singlepoint

results are not dramatically different (2.23 vs. 1.47). This difference is likely to be

attributable to two factors. First, the previous reports focused on the X chromosome and

contained many more markers in the Xq28 region; the previously reported markers had

an average resolution of 1 marker every 1.12 cM, whereas the current markers had an

average resolution 6.97 cM in the Xq28 region. The higher concentration of previously

reported markers surely allowed for the extraction of more multipoint linkage

information. Second, there were more telomeric markers in the previously reported

mapping sets than in the current one. The singlepoint results showed a trend for higher

mlod scores closer to the telomere, with the exception of JXYQ28, which had a low PIC

(0.28).

Fig. 2 Multipoint linkage analysis for the X chromosome. The x-axis is the chromosome

location (cM), and the y-axis is the mlod score. —— Current markers with sample

restricted to previously reported families. – – – – Current markers with full sample. ……

Previously reported markers with previously reported families

Table 2 Supplemental analyses comparing Xq28 results across markers reported on in

1995, 1997, and the current report. All analyses reported here are based on the sample

restricted to those families previously reported. Current markers and previously reported

markers were analyzed separately for the purpose of calculating multipoint mlod scores.

Marker Study

year

Location

(cM)

Marker

distance

(cM)

Multipoint

mlod

(previous

markers)

Multipoint

mlod (current

markers)

Singlepoint

mlod

DXS1073 Current 188.22 1.99 1.47

F8C 1993 188.84 0.62 6.47 2.23

DXS1108 1993 190.32 1.47 6.27 4.22

JXYQ28 1995 190.47 0.15 6.28 0.48

DXYS154 1993 190.79 0.32 5.71 3.53

Discussion

This study reports results from the first full genome scan for male sexual orientation.

Using 73 previously reported families and 73 new families with two or more gay male

siblings, we found three new regions of genetic interest. Our strongest finding was on

7q36 with a combined mlod score of 3.45 and equal contribution from maternal and

paternal allele transmission. This score falls just short of Lander and Kruglyak s (1995)

criteria for genomewide significance. Several interesting candidate genes map to this

region of chromosome 7. Vasoactive intestinal peptide (VIP) receptor type 2 (VIPR2;

MIM 601970) is a G protein-coupled receptor that activates adenylate cyclase in response

to VIP (Metwali et al. 1996), which functions as a neurotransmitter and as a

neuroendocrine hormone. VIPR2 is essential for the development of the hypothalamic

suprachiasmatic nucleus in mice (Harmar et al. 2002), which makes it an interesting

candidate gene for sexual orientation in view of earlier reports of an enlarged

suprachiasmatic nucleus in homosexual men (Swaab and Hofman 1990). Sonic hedgehog

(SHH; MIM 600725) plays an essential role in patterning the early embryo, including

hemisphere separation (Roessler et al. 1996) and left to right asymmetry (Tsukui et al.

1999). Homosexual men and women show a significant increase in non-righthandedness,

which is related to brain asymmetry (Lalumiere et al. 2000).

Two additional regions approached the criteria for suggestive linkage. The region near

8p12 contains several interesting candidate genes, given the hypothesized relationship

between prenatal hormones and sexual orientation (Mustanski et al. 2002). Gonadotropinreleasing

hormone 1 (GNRH1; MIM 152760) stimulates both the synthesis and release of

luteinizing hormone and follicle-stimulating hormone, which are important regulators of

steroidogenesis in the gonads, and inhibits the release of prolactin (Adelman et al. 1986).

GnRH is synthesized in the arcuate nucleus and other nuclei of the hypothalamus

(Kawakami et al. 1975). Steroidogenic acute regulatory protein (STAR; MIM 600617)

mediates pregnenolone synthesis and is involved in the hypothalamic-pituitary regulation

of adrenal steroid production (Sugawara et al. 1995), which in turn plays an important

role in sexual development. Neuregulin1 (NRG1; MIM 142445) produces a variety of

isoforms that regulate the growth and differentiation of neuronal and glial cells through

interaction with ERBB receptors (Burden and Yarden 1997; Wen et al. 1994).

The 10q26 region is of special interest because it results from excess sharing of maternal

but not paternal alleles. Previous studies have suggested that there is an excess of

homosexual family members related to the proband through the mother, and we have

proposed previously that this might result in part from genomic imprinting (Bocklandt

and Hamer 2003). In support of a connection between 10q26 and imprinting, a germline

differentially methylated region has been identified at this location by Strichman-

Almashanu et al. (2002) who performed a genomewide screen for normally methylated

CpG islands and found 12 regions to be differentially methylated in uniparental tissues of

germline origin, i.e., hydatidiform moles (paternal origin) and complete ovarian

teratomas (maternal origin). Such CpG islands can regulate the expression of imprinted

genes over distances of several hundred kilobases. The region around the 10q26 CpG

islands includes the brain-expressed gene Shadow of Prion Protein (SPRN), several

transcription regulators (ZNF511, VENTX2; MIM 607158), neurotransmitter interacting

proteins (DRD1IP; MIM 604647), and cell signaling pathway proteins (INPP5A; MIM

600106, GPR123).

Four previous linkage studies have been conducted on the X chromosome and together

produce a statistically suggestive MSP in the Xq28 region (Sanders and Dawood 2003).

Because the focus of this study was a full genome scan with the ABI linkage mapping set

on a partially new set of families, we began by reporting results for these markers on the

full sample. This analysis did not produce evidence of linkage in the Xq28 region;

therefore, we conducted supplemental analyses to clarify this result given previous

findings. Our first supplemental analysis combined results from the two previous reports

from our group (Hamer et al. 1993; Hu et al. 1995) in order to determine the magnitude

of the linkage signal in the 73 previously reported families that currently comprised half

of the current sample. This produced a mlod of 6.47. To determine whether the lack of

linkage evidence in the full sample was attributable to the new markers or the additional

families (who were not selected based on family transmission patterns), we then

conducted analyses on the previously reported families by using the markers from the

ABI linkage mapping set. This produced an mlod score of 1.99. Table 2, which provides

a summary of the single point and multipoint results for this comparison, suggests that

that the difference in mlod score between the restricted sample with the old and new

markers is attributable to the non-optimal position and density of the new markers. The

difference in mlod scores between the full sample and the sample restricted to families

without evidence of paternal transmission (with the goal of enriching the sample for

families showing maternal transmission) denotes the possibility of etiologic heterogeneity

for the proposed Xq28 locus.

Several limitations of the current study should be noted. First, we were unable to

calculate empirically derived significance levels for this project because none of the

simulation programs that currently exist allow for the use of sex-specific maps with ASP

data. Future development of simulation programs that allow for the incorporation of this

important information will prevent this limitation in the future. Second, our marker set

had an average resolution of 10 cM, which may have led to underestimated mlod scores.

We discuss in detail above the likely negative effects that this had on our X chromosome

results. Optimally, genome scans are followed up with dense markers placed in promising

regions, but because of financial limitations, we were unable to do this. Future studies

will undoubtedly employ more sophisticated and dense marker sets. Third, we analyzed

only 146 independent families, which is a small sample for a complex trait such as sexual

orientation. Approximately half of these families have previously been included in

reports on the X chromosome (Hamer et al. 1993; Hu et al. 1995). Future research should

be conducted on a new and larger sample of participants. Our linkage results should be

interpreted with consideration of the fact that we only included families with two selfidentified

gay brothers. Our results may not extrapolate to individuals who do not meet

our exclusion criteria, such as individuals who engage in same-sex behavior but do not

identify as gay or individuals who identify as bisexual. The definition of homosexuality is

complicated, and future genetic research would benefit from additional phenotype

development or the identification of endophenotypes for sexual orientation (Mustanski et

al. 2002). The identification of basic processes that underlie sexual orientation could

increase the power of future genetic studies. A related limitation is that we did not

include females in our study because it is not yet clear if female sexual orientation is

determined by the same factors as male sexual orientation (for a discussion, see

Mustanski et al. 2002). Future research with mix-sexed samples should help to answer

this question. Finally, we did not collect data on the number of older brothers, which

shows a robust association with male sexual orientation (Blanchard 2004). Future studies

should collect this data to allow for explorations of gene by environment interactions; this

could increase the ability to identify genetic loci and also help to elucidate the process

linking number of older brothers to sexual orientation.

In summary, we report the first genome scan for loci involved in the complex phenotype

of male sexual orientation. We have also identified several chromosomal regions and

candidate genes for future exploration. The molecular analysis of genes involved in

sexual orientation could greatly advance our understanding of human variation,

evolution, and brain development. In the absence of obvious animal models, genetic

linkage and association studies provide the best opportunity for discovering these loci.

Acknowledgements We thank all the individuals who participated in the project for

their time and openness and Lynn Goldin and Danielle Dick for comments on the

manuscript. B.S.M. was supported by a NSF Graduate Research Fellowship and an NIH

Summer Research Fellowship. N.J.S. and C.M.N. were supported in part by the NHLBI

Family Blood Pressure Program (FBPP; HL64777-01).

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