Evidence for a Robust, Estradiol-Associated Sex Difference in Narrative-Writing Fluency

Schultheiss O, Köllner M, Busch H, Hofer J (2021)

Publication Type: Journal article

Publication year: 2021


Book Volume: 35

Pages Range: 323-333

Journal Issue: 3

DOI: 10.1037/neu0000706


Objective: Despite evidence for an estradiol-linked sex difference in verbal fluency favoring women, recent reviews question this difference. We therefore examined the issue based on a narrative task that we have administered to different populations for over 20 years. Method: We meta-analyzed 98 studies (N = 11,528) conducted by our laboratories and that featured measures of biological sex and storytelling. We ran primary-data analyses (N = 797) on an overlapping subset of these studies that also included salivary hormone and digit ratio measures. Results: Women told longer stories than men, d = 0.31, 95% CI [0.24, 0.38], an effect that did not vary by geographic region but was moderated by cue type (verbal: d = 0.57, [0.44, 0.71]; pictures: d = 0.29, [0.22, 0.36]), response modality (oral: d = -0.04, [-0.18, 0.09]; handwriting: d = 0.39, [0.31, 0.47]; typing: d = 0.31, [0.21, 0.42]), and age (prepubertal children: d = 0.13, [-0.04, 0.30]; pubescents: d = 0.48, [0.23, 0.74]; premenopausal adults: d = 0.36, [0.29, 0.42]; postmenopausal adults: d = -0.09, [-0.35, 0.16]). Consistent with the age effect, estradiol, a sex-dimorphic hormone during the reproductive life stage, was a specific mediator of the sex difference in narrative-writing fluency. This mediation effect was moderated by prenatal hormone exposure, estimated via digit ratio. Conclusions: When verbal fluency is assessed through narrative writing, a robust female advantage becomes evident. It is associated with the reproductive life stage and variations in current estradiol concentrations, particularly in individuals prenatally exposed to relatively more estradiol than testosterone.

Authors with CRIS profile

Involved external institutions

How to cite


Schultheiss, O., Köllner, M., Busch, H., & Hofer, J. (2021). Evidence for a Robust, Estradiol-Associated Sex Difference in Narrative-Writing Fluency. Neuropsychology, 35(3), 323-333. https://doi.org/10.1037/neu0000706


Schultheiss, Oliver, et al. "Evidence for a Robust, Estradiol-Associated Sex Difference in Narrative-Writing Fluency." Neuropsychology 35.3 (2021): 323-333.

BibTeX: Download