ArticleHormones and behavior2021
No evidence for a difference in 2D:4D ratio between youth with elevated prenatal androgen exposure due to congenital adrenal hyperplasia and controls.
Article in Hormones and behavior, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- In support of 2D:4D: More data exploring its conflicting results on handedness, sexual orientation and sex differences.PloS one · 2023Pooled it
- Investigating the effects of single-dose intranasal testosterone on economic preferences in a large randomized trial of men.Proceedings of the National Academy of Sciences of the United States of America · 2025Trial
- Are sex differences in blood cell count and hemoglobin moderated by the 2D:4D ratio? A cross-sectional study in a Ghanaian population.Health science reports · 2023Article
- Sex-moderated relationship between the 2D:4D ratio and circulating hormones in an adult Ghanaian population.Physiological reports · 2023Article
- Digit ratio (2D:4D) and maternal testosterone-to-estradiol ratio measured in early pregnancy.Scientific reports · 2022Article
- Evidence for Perinatal Steroid Influence on Human Sexual Orientation and Gendered Behavior.Cold Spring Harbor perspectives in biology · 2022Review
- 2D:4D and Self-Employment: A Preregistered Replication Study in a Large General Population Sample.Entrepreneurship theory and practice · 2022Article
- Sex, population origin, age and average digit length as predictors of digit ratio in three large world populations.Scientific reports · 2021Article
- Do sex hormones at birth predict later-life economic preferences? Evidence from a pregnancy birth cohort study.Proceedings. Biological sciences · 2020Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 3 countries.
Funding
Abstract
The second-to-fourth digit ratio (2D:4D) has been associated with sexual dimorphism, with a lower 2D:4D in males. A large body of research has relied on the 2D:4D as a proxy for prenatal androgen exposure, and includes reports of relationships between 2D:4D and a wide range of human traits. Here, we examine the validity of the 2D:4D proxy by studying the association between 2D:4D and classical Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency, a condition characterized by excessive prenatal exposure to androgens during most of the gestational period. To this end, we retrospectively examine 513 serial radiographs of the left hand obtained clinically in 90 youth with classical CAH (45 female) and 70 control youth (31 female). Replicating previous reports, we observe associations of the 2D:4D with sex (lower 2D:4D in males) and age (increase of 2D:4D through development). However, we find no evidence for differences in 2D:4D between CAH and controls (full sample: β = -0.001 (-0.008, 0.006); females: β = -0.004 [-0.015, 0.007]; males: β = 0.001, [-0.008, 0.011]). Although our findings do not rule out a small association between the 2D:4D and CAH, they cast doubt on the usefulness of the 2D:4D as a biomarker for prenatal androgen exposure in behavioral research.
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Registered trials
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