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Synopsis Females of some species are considered sex-role reversed, meaning that they face stronger competition for mates compared to males. While much attention has been paid to behavioral and morphological patterns associated with sex-role reversal, less is known about its physiological regulation. Here, we evaluate hypotheses relating to the neuroendocrine basis of sex-role reversal. We refute the most widely tested activational hypothesis for sex differences in androgen secretion; sex-role reversed females do not have higher levels of androgens in circulation than males. However, we find some evidence that the effects of androgens may be sex-specific; circulating androgen levels correlate with some competitive phenotypes in sex-role reversed females. We also review evidence that sex-role reversed females have higher tissue-specific sensitivity to androgens than males, at least in some species and tissues. Organizational effects may explain these relationships, considering that early exposure to sex steroids can shape later sensitivity to hormones, often in sex-specific ways. Moving forward, experimental and correlative studies on the ontogeny and expression of sex-role reversal will further clarify the mechanisms that generate sex-specific behaviors and sex roles.