Research Article

Neuropsychobiology
Neuropsychobiology Received: December 11, 2022
Accepted: April 21, 2023
DOI: 10.1159/000530931 Published online: June 27, 2023

Deep Learning in the Identification of

Electroencephalogram Sources
Associated with Sexual Orientation

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Anastasios Ziogas a Andreas Mokros b Wolfram Kawohl c, d
Mateo de Bardeci c Ilyas Olbrich e Benedikt Habermeyer d
Elmar Habermeyer a Sebastian Olbrich c
a
Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland;
b
FernUniversität in Hagen, Hagen, Germany; cDepartment of Psychiatry, Psychotherapy and Psychosomatics,
Psychiatric Hospital, University of Zurich, Zurich, Switzerland; dClienia Schlössli AG, Oetwil am See, Switzerland;
e
RG Gymnasium, Zurich, Switzerland

Keywords homosexual and heterosexual males. The newly trained net-

Electroencephalogram · Deep learning · Homosexual males ·
Sexual orientation
Abstract
Introduction: It is unclear if sexual orientation is a biological
trait that has neurofunctional footprints. With deep learning,
the power to classify biological datasets without an a priori
selection of features has increased by magnitudes. The aim of
this study was to correctly classify resting-state electroence-
work was able, however, to correctly classify the cohorts with a
total accuracy of 83%. The retrograde activation using Grad-
CAM technology yielded distinctive functional EEG patterns in
the Brodmann area 40 and 1 when combined with Fourier
analysis and a source localization. Discussion: This study shows
that electrophysiological trait markers of male sexual orienta-
tion can be identified using deep learning. These patterns are
different from the differentiating signatures of males and
females in a resting-state EEG. © 2023 The Author(s).
Published by S. Karger AG, Basel

phalogram (EEG) data from males with different sexual ori-

entation using deep learning and to explore techniques to
identify the learned distinguishing features. Methods: Three
cohorts (homosexual men, heterosexual men, and a mixed sex
cohort), one pretrained network on sex classification, and one
newly trained network for sexual orientation classification were
used to classify sex. Further, Grad-CAM methodology and
source localization were used to identify the spatiotemporal
patterns that were used for differentiation by the networks.
Results: Using a pretrained network for classification of males
and females, no differences existed between classification of
Introduction
Sexual orientation is an important personal character-
istic of every person. The individual orientation can be
placed on a continuum between homo- and heterosexual
alignment rather than applying a strict dichotomous
division [1]. Throughout history, persons with sexual
preferences for the same sex and thus a differing

karger@karger.com © 2023 The Author(s). Correspondence to:

www.karger.com/nps Published by S. Karger AG, Basel Sebastian Olbrich, sebastian.olbrich @ pukzh.ch
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International License (CC BY) (http://www.karger.com/Services/
OpenAccessLicense). Usage, derivative works and distribution are
permitted provided that proper credit is given to the author and the
original publisher.
orientation from the majority have been facing persecu-
tion and violence, also in the Christian-coined western
world [2–4]. The American Psychiatric Association only
removed homosexuality from the category of psychiatric
diseases in 1973 [5]. However, people always tried to
understand the reason for these differences in sexual
orientation. One of the main questions thereby has
been if either homosexuality is a hereditary trait or
environmental factors influence the development of these
preferences [1]. A main motivation for research in this
area has been the search for notorious preventive meas-
ures for a long time [6]. Nowadays, in the western world,
the freedom of choice including the sexual preferences
has evolved as the widely accepted social agreement,
although it is still a long way from providing safety
and participation for every person, regardless of their
sexual orientation.
Having reached this cultural developmental stage, it
still is of high scientific interest, whether there exist
biological patterns that differ between persons with dif-
ferent sexual orientations. The authors are aware of the
ethical questions arising from this research, as outlined
above. The approvement of biological traits in alignment
with sexual orientation still could help further withdraw
the basis of involuntary behavioral measures against
persons with nonheterosexual orientation [7]. The fra-
ternity hypothesis stated that the existence of older male
brothers increased the probability of being gay in men,
thereby attributing a significant impact to environmental
factors on sexual orientation [8]. Others found genetic [9,
10], epigenetic [11], brain structure [12–14], or immu-
nological [15] differences in subjects with same sex sexual
orientation, supplying evidence for a biological trait.
Especially findings from large-scale studies using data
from over 400.000 subjects from the UK Biobank and the
23andMe database revealed that there are genetic pre-
dispositions for same-sex sexual behavior [10]. However,
the main outcome was that no genetic variant allowed for a
prediction of the individual sexual orientation. The authors
underline that their findings shed light on the complexity of
sexual behavior because of still largely unknown interac-
tions between genetics and environment.
In the light of structural differences between individ-
uals with different variants of sexual orientation, it seems
paramount to also search for possible functional differ-
ences. Electrophysiology, and electroencephalogram
(EEG) in particular, provides a highly suitable framework
for a noninvasive analysis of brain function for a large
variety of conditions. In combination with advanced
technologies such as deep learning, EEG data recently
have been used to differentiate between males and
2 Neuropsychobiology
DOI: 10.1159/000530931
females based on their brain function patterns during
rest [16]. Although EEG research has been misused to
identify pathological EEG patterns in males with homo-
sexual orientation [17, 18], more recent research was
more focused on mainly functional, non-pathological
differences in groups of homosexual and heterosexual
males (HeMs) [19]. When EEG data were used in these
studies to differentiate between males and females [20] or
groups of homosexual and HeMs [21], the data were
always recorded during cognitive task performance (e.g.,
mental rotation). Results could therefore be related to
sex-dimorphic cognitive task properties and less to func-
tional differences by means of basic central nervous
system activity during rest.
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Within recent years, new techniques derived from the
field of artificial intelligence research emerged that allow
for powerful analysis of medical and electrophysiological
data [22]. Especially so-called deep learning algorithms
proved their superiority in the classification of time series
data in comparison to conventional statistical analysis,
given that enough labeled data are available [23]. These
deep learning techniques stem from the functional prin-
ciple of natural neuronal networks as can be found in the
human brain [24]. By changing the connection strength
between different nodes, i.e., neurons during the training
of the network, the labeled input data will be processed to
result in the desired output, i.e., the classification label.
The network then can be tested with previously unseen
testing data. Since it is appealing to classify brain-derived
functional time series using a technique that follows the
function of neuronal networks, in this study, we aimed to
test whether there are differences in the electrophysio-
logical patterns during rest between homosexual and
heterosexual men using these deep learning. Assuming
that cues of biological sex are detected and processed in
similar ways within individuals who are interested in the
same sex of potential partners [25], we assumed a re-
semblance in the resting state activity between
homosexual men (HoM) and heterosexual women.
Some research of the past showed similar functional
activations in homosexual males and heterosexual fe-
males [12]. Consequently, we at first tested if (1) HoM
might exhibit similar EEG patterns like heterosexual
females in comparison to heterosexual men. That means
HoM could be classified via a network that was trained on
sex and not sexual orientation, receiving the label “fe-
male.” If this quite mechanistical hypothesis would not
hold true, i.e., homosexual males would not exhibit
similar EEG patterns as heterosexual females, it was
further hypothesized that (2) HoM could be classified
by applying a new network trained on HoM and
Ziogas/Mokros/Kawohl/de Bardeci/
Olbrich/Habermeyer/Habermeyer/Olbrich
heterosexual men, i.e., being classified via a network
trained on sexual orientation and not sex. For testing
(1), a previously trained male/female classification deep
learning network (“SexNet”) [16] was applied to datasets
of HoM, heterosexual men, and a third group of mixed
males and females. For testing (2), a new network was
trained to differentiate sexual orientation by using data
from HoM or heterosexual men. To further elucidate the
functional properties and anatomical distribution of po-
tential EEG patterns for differentiation between homo-
sexual and heterosexual men at the individual level, a
gradient CAM (Grad-CAM) approach in combination
with a source localization technique and Fourier trans-
formation was used.
Materials and Methods
The study was approved by the Ethical Committee Zurich (EC-
No 2014-0623). All participants gave written informed consent.
The study was conducted following the rules established by the
Declaration of Helsinki.
Subjects Sample 1 and Sample 2: EEG Recording
Sample 1 consisted of 39 HeMs and 38 HeMs recruited from
2017 to 2019 in Zurich and was reported in another study [26]. Ten
additional subjects had been recruited but needed to be excluded,
four due to regular intake of medication. Two more subjects
showed a sexual orientation that showed no clear preference for
on sex (bisexuality), based on a Klein Sexual Orientation Grid
(KSOG) Score between 3and 4.9. Four subjects had to be excluded
due to missing or bad EEG data.
Sample 2 consisted of 37 healthy controls with mixed sex
(female = 16) and unknown sexual orientation, recorded with
the same equipment under the same conditions as sample 1.
Sample 2 was recorded in year 2010 as control subgroup for
the ZINEP study [27].
Subjects Sample 3: EEG Recording and SexNet Training
In total, 1,300 EEG datasets were used for the SexNet training
and validation. They were recorded and preprocessed using a
standardized methodology and platform (Brain Resource Ltd.,
Australia) for which full details have been published elsewhere
[28] and which is in large parts identical for sample 1 and 2. The
used SexNet has previously been reported to differentiate men and
women based on 80 s resting-state EEG recordings with an
accuracy of 84% [16], which is a highly significant finding, given
a random guess distribution of 50%. To avoid overestimation for
transfer learning, we did not apply the top performance net from
[16] but relied on an average model with a performance accuracy
of 73%. Therefore, SexNet was trained on 24 channel EEG seg-
ments with a 128 Hz resolution from 1000 adults and tested on
unseen 300 EEG datasets. The architecture of SexNet consisted of 9
layers with 256 × 24 as input matrix, convolutional layers with
decreasing number of filters (300–50) and pooling function after
each of the first four convolutional layers, and a dropout function
of 25% after each convolutional layer. A rectifier linear unit served
Deep Learning and EEG Patterns for Sexual
Orientation
for activation. A final dense layer with softmax activation was used
for classification probabilities. The rest of the training procedure
was done as described in [16].
EEG Processing and SexOrientationNet
The EEGs were recorded at 2.5 kHz (BrainAmp, BrainProducts,
Germany) during a 5-min resting state with eyes closed using a 32-
electrode BrainCap (MR 32 standard, Easycap) referenced to FCz
following the international 10 to 20 system. Impedances were kept
below 20 kOhm. Eye movements were recorded using bipolar
diagonal electrooculogram channels. Software analysis was done
using Brain Vision Analyzer 2.0, Gilching, Germany: raw data
were downsampled to 128 Hz and band pass filtered between 0.5
and 25 Hz plus notch filter. To compare the results with the
outcome of the SexNet, 24 channels were kept for further analysis
as follows: Fp1, Fp2, F7, F3, Fz, F4, F8, FC3, FCz, FC4, T3, C3, Cz,
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C4, T4, CP3, CPz, CP4, T5, P3, Pz, P4, T6, O1. EEG data were
eye – artefact corrected using a regression-based approach Grat-
ton, Coles, and Donchin [29]. Artefact rejection was done using an
automated pipeline following different voltage and power criteria,
detailed in [28]. Finally, the EEG was inspected visually by an
experienced EEG-rater, and artefacts were marked and rejected for
consecutive 2 s segments (example Fig. 1). Raw data of 4-min
recordings were imported to Matlab software (R2019b), where a
three-dimensional matrix of channels (24) × segment-length (2 sec
with 2 × 128 = 256 timepoints) × epochs (120 with 2 sec duration)
were stacked for each subject. Labeling of the subjects (homosexual
man or heterosexual man in sample 1 and additionally hetero-
sexual woman in sample 2 and sample 3) was done using one-hot
coding. The matrix then was exported to the python environment.
The SexOrientationNet was deployed in a python (3.8) Tensor-
Flow (version 1.2 GPU version) environment with a Keras backend
(Version 2.2). The structure of the used network was identical to
the structure of the SexNet, only the number of filters was between
100 and 300. However, training was not performed on sample 3
but on sample 1 (homosexual and heterosexual men) with a Leave
One Out validation process (see below Sex Orientation network
validation)
Assessment of Sexual Orientation
The KSOG [30] was used to check for self-reported sexual
preference. This scale uses seven items on sexual orientation (sexual
attraction, sexual behavior, sexual fantasies, emotional preference,
social preference, self-identification, and heterosexual/gay lifestyle
outcomes) that are addressed with responses on three dimensions
(past, present, and future). Responses are given on a 7-point Likert
scale ranging from 1 (other sex only/heterosexual only) to 7 (same sex
only/gay only). Cronbach’s alpha of 0.96 and significant correlation
with self-reported sexual orientation (r = 0.71) have been reported for
the KSOG [31]. Average scores across the present time dimension were
calculated. Values of 2.9 or less refer to heterosexual orientation; values
of 5.0 or above refer to a homosexual orientation [32].
Deep Learning SexNet and SexOrientationNet Validation and
Feature Extraction
Validation for the usage of the SexNet was done using separate
training and test sets. Accuracy measures were used for assessing
the quality of the classification in the test set.
Validation for the usage of the newly trained SexOrientation-
Net on homosexual and heterosexual men was done using the
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DOI: 10.1159/000530931

Fig. 1. Example of cleaned 2 s segment of
EEG data used for classification of sexual
orientation.
“Leave One Out Cross Validation.” This common practice splits
data into k independent folds and subsequently trains in k−1 folds
and tests in the complementary fold until the model has been
trained and tested in every fold (i.e., in the complete dataset). This
cross-validation is seen as the method of choice when it comes to
deep learning with a limited amount of data and a separate training
and test sets are not feasible [33].
Grad-CAM Feature Extraction
For feature extraction, the class activation maps allow to seek for
distinctive features in the input data for deep learning based networks.
The class activation maps show weighted heatmaps of the input data
that allow for the identification of the most important data points for
classification tasks, e.g., in medical imaging [34]. Their successor,
Grad-CAM allows for the same approach without the necessity of
global average pooling before the softmax layer by using gradient
information that flows into the last convolutional layer of the network.
Grad-CAM also outperforms other heatmap algorithms in medical
imaging [35]. To apply Grad-CAM method, a rectified linear unit is
used to focus on the decisive features for a certain class. This method
has been used to detect EEG channels with highest information load
in brain-computer-interface scenarios [36]. Following this procedure,
data from the subject to classify were fed into the network, and from
each layer of the network, the decisive weights were exported and
averaged over all layers. This weight map then was projected on the
input data, i.e., the EEG segments. Then, these 2-D maps were
averaged over the time axis, yielding the 1-D activation array in
space, i.e., electrode positions. This process was repeated for all
subjects. The output Grad-CAM maps were then averaged for all
homosexual and all heterosexual subjects. Feeding these arrays into a
source localization algorithm such as the low-resolution electromag-
netic tomography (eLORETA), it was possible to map the intracortical
sources of electrophysiological activity that allowed the correct clas-
sification of a group.
4 Neuropsychobiology
DOI: 10.1159/000530931
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EEG-Source Localization
Source localization analysis was done using eLORETA software
package, version 20221229 (Roberto Pascual-Marqui/The KEY
Institute for Brain-Mind Research, Zurich). The eLORETA algo-
rithm is an inverse solution for EEG signals that has no localization
error. In contrast to other source localization techniques, this is
also applicable in the presence of measurement and structured
biological noise [37]. The family of LORETA algorithms allows
imaging of current density distributions inside the human cortex
via constraining the solution to only gray matter-dense regions
within 6,239 predefined 3D-voxels [38]. EEG assessment in con-
junction with simultaneous recordings in other neuroimaging
modalities cross-validated the family of LORETA algorithm and
showed overlapping results of intracortical EEG-source estimates
and the BOLD signal [39, 40] or glucose metabolic rate [41, 42]. To
generate the input for the source localization, the projections of the
network were trained on k−1 datasets and tested on the remaining
dataset repeatedly, until all subjects of one group (hetero- or
homosexual) were extracted from all layers for all EEG channels
and averaged over all subjects of the group. The electrode activa-
tion matrix for the LORETA analysis was thus fed with the weights
of the network, which allowed a correct classification. The LOR-
ETA transformation matrix was computed from the EEG channel
positions used in the EEG recordings and the electrode activation
matrix was projected into the intracortical solution space of the
eLORETA software.
Frequency Analysis of the LORETA Regions
To determine which frequencies of the EEG input data were
used for classification by the SexualOrientationNet, the output of
all filters (ranging from 100–300 per layer) from all convolutional
layers (n = 6) of the network were computed while using a loss
function that maximized the activation of the filters. For each layer,
the filter with the largest activation was projected into a 24 × 256
Ziogas/Mokros/Kawohl/de Bardeci/
Olbrich/Habermeyer/Habermeyer/Olbrich
array, representing the EEG input with the highest potential of
layer activation. A Fourier transformation was applied for the
x-axis (i.e., EEG channel time series) to analyze the prevailing
frequencies in the corresponding layers.
Estimating Statistical Threshold
For assessment of statistical significance of the SexualOrienta-
tionNet, we randomly assigned sexual orientation to each subject
in a test set (n = 20), using the prior sexual orientation distribution
(50% homosexual males). To set the p value for statistical sig-
nificance at p ≤ 0.01, we performed 100 simulations in Matlab,
following the principles of Monte Carlo simulation. The best
classification accuracy reached was 70%, which was subsequently
considered the significance threshold for p ≤ 0.01.
Comparison with fMRI Findings
To compare the sources of differentiating EEG activity with
findings from neuroimaging studies using fMRI, the “Neurosynth”
website (“neurosynth.org”) was used [43]. In total, 81 studies using
fMRI and the context “sexual” were included into the sample.
Works with the highest load in the analysis included studies on
functional endophenotypes for sexual orientation [44], neural
substrates of sexual desire [45], and correlates of gender differences
[46]. The results of the uniformity analysis (z-scores from a one-
way ANOVA testing) were corrected for multiple comparisons
using the false discovery rate with a 0.01 criterion.
Results
Sociodemography
For sample 1 (n = 77), mean age of homosexual males (n =
38) was 24.7 years with SD 5.0, HeMs (n = 38) with 24.6 years
and SD 4.9. Mean KSOG score for homosexual males was 1.9
with SD 0.40, for HeMs 5.7 SD 0.39. For sample 2 (n = 37
with 16 females), mean age was 28.6 years (28.4 years for
females only) with SD 5.9. For sample 3 (n = 1,300), the mean
age was 43.4 with 18.4 SD with 47% males [16]. Different
personal variables and performances, including handedness,
sexual desire, sexual excitation, and the attentional network
task [47], were tested for differences between groups (homo-
sexual males vs. HeMs) with no significant alterations
between the groups (see [26] for details).
Classification of Homo- or Heterosexual Orientation
Using a Pretrained SexNet
The SexNet trained on 1,000 and tested on 300 EEGs
from women and men to differentiate sex (accuracy of
73%) was applied to three different groups (two groups
from sample 1 with HoM and HeM controls) and data
from sample 2 (mixed male female [MixMF]). In all
datasets, HoM, HeM, and MixMF, males irrespective
of their sexual orientation were classified (binary classi-
fication with a probability of being male >50% for the
majority of all 120 segments per subject) as male with an
Deep Learning and EEG Patterns for Sexual
Orientation
accuracy of 89.2–97.5% with no significant differences
between the three datasets (p > 0.05). Only when numeric
probabilities of subject classification were tested for dif-
ferences, the HoM dataset showed a significant higher
probability for correctly classified sex in comparison to
the correct classification of the MixMF group (p = 0.00,
see Table 1).
Classification of Sexual Orientation Using a New
Trained Deep Net
To further test whether male subjects with different
sexual orientation (homosexual or heterosexual) could be
correctly classified using deep learning, a new network
(SexOrientationNet) was trained on data from sample 1.
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The used Leave One Out training and testing procedure
of the network for classification of homosexual or het-
erosexual men showed a performance of a 75.95% accu-
racy for the correct classification of HoM or heterosexual
men for all segments of the dataset (Fig. 1). Following the
majority vote on the 120 epochs of each subject when
trained on the rest of the subjects, 26 out of 39 hetero-
sexual men were classified correctly and 38 out of 38
HoM. A four-fold table of the results can be found in
Figure 2 (bottom). The sensitivity to correctly classify a
homosexual man as homosexual was 100%; the specificity
was 67% with a positive predictive value of 76% and a
negative predictive value of 100%, yielding a total accu-
racy of 83%. Taking into account that an accuracy of 70%
is equivalent to a statistical threshold of p < 0.01 accord-
ing to the Monte Carlo simulation, this result can be seen
as highly significant. The number of epochs of learning
for each trial (with one subject left out and an early
stopping rule after four consecutive failed decreases of
validation loss) ranged from 6 to 51. The averaged train-
ing and test accuracies and training and test losses for all
segments (not only subjects) can be found in Figure 2.
Visualization and Localization of Differentiating
Features at the Single EEG Segment Level
To analyze whether it is possible to extract the EEG
patterns that showed discriminative features for sexual
orientation classification in single subjects, a Grad-CAM
approach was used. Therefore, the trained filters from all
layers (ranging from 100–300 filters per layer) from a
single leave-one-out run were averaged layer-wise, and
the gradients of a single EEG epoch from the test subject
were computed for each averaged layer filter (single layer
averages can be found in Fig. 3, panel a). It is obvious that
early layers focus on activity at 10 Hz at posterior sites
(Fig. 3, panel a), while later layers have less differentiation
due to the max-pooling steps in the algorithm. The
Neuropsychobiology 5
DOI: 10.1159/000530931
Table 1. Correct classification of sex of three different groups from sample 1 and 2. Men were classified as men irrespective of their
sexual orientation

HoM Heterosexual Mixed sex Ho Ho He

men versus He versus mix versus mix

Correct classification (binary) 97.5% (39/40) 92.3% (36/39) 89.2% (33/37) p = 0.30 p = 0.13 p = 0.64
Probability of correct 88.8% 83.5% (SD 18.5%) 75.8% p = 0.16 p = 0.00* p = 0.10
classification (SD 14.2%) (SD 21.6%)

Significant differences were only found when considering the general probability of a subject being classified correctly:
homosexual males were classified correctly with higher probabilities than a mixed male/female cohort.

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Fig. 2. Top: illustration of the accuracies and losses of the training set and the test set by means of classification of
total segment count of each set. Results are averaged over 77 runs of the network with one subject left out every
time for training. Bottom: a four-fold table for the correct classification of homosexual and heterosexual men
using the SexOrientationNetwork, trained on data from homosexual and heterosexual men with a total accuracy
of 83%.

6 Neuropsychobiology Ziogas/Mokros/Kawohl/de Bardeci/

DOI: 10.1159/000530931 Olbrich/Habermeyer/Habermeyer/Olbrich
 a d
b
Fig. 3. Panel (a) shows averaged filter weights from layer 1–6,
superimposed on a single epoch input EEG time series. High
gradients are red; low gradients are blue. Since the network
convolutes and max-pooling is applied, the resolution of the layer
gets coarse toward the deeper layers. Panel (b) illustrates the grand
average of all filters, again superimposed on a single EEG segment
gradient projections from all layer averages were summed
up to give a visualization of the gradients on the raw EEG
(Fig. 3, panel b). The averaged layer weights then were
convoluted toward the EEG channel axis and the weights
were used for the LORETA source reconstruction. The
main focus of the differentiating features was found in the
Brodmann area 7, parietal lobe at x = −3, y = −53, z = 57)
for the shown activity (Fig. 3, panel c and d).
Visualization of Differentiating Features at the
Group Level
As a next step, we trained 77 networks following the
LOO approach and calculated an averaged Grad-CAM map
for the remaining subject. Then, the maps were averaged for
the two groups (homo- and heterosexual men, Fig. 3, panel
a). Following the eLORETA source localization approach,
the region with the activity that allowed for best labeling
HeMs was located at the postcentral gyrus at the parietal
Deep Learning and EEG Patterns for Sexual
Orientation
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c
of 2 s. Red color codes for the areas with highest “attention” of the
network; blue color codes for the least “attention” for differ-
entiation into labels “heterosexual” or “homosexual” male EEG
segments. A clear focus on the parietal and occipital alpha waves
can be seen. Panel (c) and (d) show the reconstruction of the
associated sources of the weights in LORETA space.
lobe at Brodmann area 1 (X = −45, Y = −30, Z = 65, MNI
cords, Fig. 4, panel b top). The region with the largest
discriminative activity for HoM was found at the inferior
parietal lobule at Brodmann area 40 (X = 40, Y = −55, Z =
60, MNI cords, Fig. 4, panel b, bottom).
Identification of Frequency Properties for Classification
at Group Level
For assessment of the frequencies that are associated with
the identification of male sexual orientation, the filters of all
layers of the SexOrientationNet were fed backward with
patterns that activated each filter the most, thus generating
archetypical inputs for the decisions of the networks. These
patterns (Fig. 4, panel c) can be seen as EEG traces that evoke
the classifications “heterosexual” or “homosexual.” Since
these patterns have the same dimension as the input EEG
segments (24 channels × 256 points in time), these time
series were forwarded to Fourier transformation to reveal the
Neuropsychobiology 7
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a b
Fig. 4. Panel (a) visualizes the averaged Grad-CAM results for
the channels of highest activation for HeMs (top) and homo-
sexual males (bottom). These matrices were averaged over time
and used for the transformation matrices to identify the cortical
sources of these activities (panel c). While HeMs showed high-
est weights in the inferior parietal gyrus (panel b, top), homo-
sexual males showed highest weights in the superior temporal
involved frequencies. Analysis was restricted to the closest
electrodes of the intracortical clusters (Fig. 4, panel b). This
process was done separately for heterosexual and homo-
sexual classification patterns and for all layers. While there
were clear peak frequencies around 17 Hz and 48 Hz in early
layers (Fig. 4, panel d, picture 1 and 3 for layer 2), later layers
resampled more complex patterns that did seem to comprise
multiple frequencies (Fig. 4, panel d, picture 2 and 4).
Comparison with fMRI Research
Comparing the sources of the discriminating EEG fea-
tures identified by the SexOrientationNet with meta-
analytical findings from 81 fMRI studies that used a
sexuality context in their paradigms revealed an overlap
mainly in the parietal cortices, i.e., at the superior parietal
lobe (Brodmann x = −26, y = −60, z = 48). As can be seen in
Figure 5, both groups, HoM and HeM, show source clusters
with high filter weights in this area.
8 Neuropsychobiology
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c d
gyrus (panel b, bottom). From the backward activated filters of
the SexOrientationNet (panel c, ×3x3 filters with largest weights
of 1–6), the time series of nearby electrodes was Fourier trans-
formed to obtain information about the associated frequencies.
While early layers show peaks at 17 and 48 Hz (panel d, pictures
1 and 3), no clear peaks were found for later layers (panel
d, picture 2 and 4).
Discussion
This study aimed at the differentiation of homosexual
and heterosexual orientation in men using neurophysio-
logical resting state data. Further goal was to test feature
extraction from the used networks to gain new insights
into electrophysiological patterns that differ between ho-
mosexual and heterosexual men. While the sexual
orientation in men could not be classified by a network
previously trained on sex (SexNet), a newly trained net-
work on sexual orientation (SexOrientationNet) was able
to distinguish between males with homo- or heterosexual
orientation with a very high accuracy of 83%. Further, the
Grad-CAM method was able to extract electrode-wise
gradients that allowed for an identification of distinguish-
ing patterns at the temporal dimension, i.e., in the EEG
traces and in the spatial dimension, i.e., the anatomical
source space. Additionally, these sources could be linked to
Ziogas/Mokros/Kawohl/de Bardeci/
Olbrich/Habermeyer/Habermeyer/Olbrich
 Downloaded from http://karger.com/nps/article-pdf/doi/10.1159/000530931/3931240/000530931.pdf by guest on 07 July 2023
Fig. 5. Comparison of results from a Neurosynth meta-analysis of fMRI findings of studies related to sexual
content and the weighted sources of the SexOrientationNet on EEG data differentiating HeMs and homosexual
males. XYZ coordinates are all the same for top to bottom panels.

frequency analysis to reveal associated oscillations at the
group level. These findings provide evidence that deep
learning in combination with EEG data can successfully
classify sexual orientation at the group level and extract
non-a priori-defined features on the single subject/
segment and group level that might help to understand
underlying electrophysiological and anatomical circuits.
The further extraction of source-bound frequencies that
contributed to the network to learn revealed the impor-
tance of specific EEG oscillations for differentiation.
Using the pretrained SexNet, all different groups from
sample 1 and sample 2 showed very high classification
accuracy for sex. However, contrary to the hypothesized
classification of homosexual males as more akin to females,
following potential similarities of sexual stimulus processing
between homosexual males and females in contrast to
HeMs, there was no difference for classification of homo-
sexual males and HeMs. Strikingly, both variants of sexual
orientations were classified as males when using a network
trained on gender in another cohort. This counteracts
assumptions that homosexual males are “femalized” wom-
an. Interestingly, when not looking at the binary classifi-
cation (yes/no) but into the probabilities for correct clas-
sification, the homosexual group even had a significant
higher probability to be rated correctly in comparison to a
mixed sex group. It is further interesting that the overall
accuracy of this trial was higher than the results that this
pretrained network achieved when being tested on 300
subjects from sample 3. The reason for a higher accuracy
of 89–97.5% in comparison to 73% could be found in the
fact that longer EEG epochs with a subsequently increased
segment number per subject were used. The sample 1 and
sample 2 datasets consisted of a three-fold number of
segments per subject (240 s vs. 80 s) in comparison to
the SexNet training (sample 3). A simulation on the
association between numbers of segments for each subject
(when classifying each subject into a specific group
with >50% of classified segments in a binary labeling

Deep Learning and EEG Patterns for Sexual Neuropsychobiology 9

Orientation DOI: 10.1159/000530931

Fig. 6. Increase of probability for a correct classification of a single
subject (for >50% of segments of one subject classified correctly)
with different numbers of EEG segments (x-axis) from one record-
ing and increasing overall probability for a correct classification of
a single segment (colored graphs). Olbrich et al. [40].
approach) and the overall probability of one segment being
classified correctly shows a sharp increase of correct clas-
sification of subjects (Fig. 6) with increasing segment
numbers. Hence, future studies on subject classification
using deep learning and multiple EEG segments per subject
should consider restricting the size of each segment to just
contain the essential information for increasing the overall
number of segments. This also strongly implies that deep
learning approaches benefit from longer EEG recordings
since this allows for more data on each subject to be
classified. The increase of training samples has been found
to go in line with a logarithmical performance increase in
vison tasks [48].
When a new trained net was used for classification
instead (SexOrientationNet), the network was able to
accurately differentiate between homosexual males and
HeMs. It is noteworthy that all homosexual subjects were
classified correctly but only 2/3rd (26 out of 39) from the
HeMs. Although this result must be taken with caution,
since no replication has yet been done, it might imply that
most homosexual males show distinct features (or miss
some features), while HeMs sometimes share these fea-
tures (or miss them, too) without being homosexual.
However, only the heterosexual group reveals (or misses)
a feature in some of them (the correctly classified) that is
not there (or present) in the homosexual group. Thus, the
SexOrientationNet revealed a very high specificity for
classifying subjects as HeMs and a very high sensitivity
for homosexual orientation.
10 Neuropsychobiology
DOI: 10.1159/000530931
The second aim of this work was the identification
features that allowed discrimination between homosexual
and HeMs without a definition of an a priori feature space.
The extraction of features from the network by using the
Grad-CAM approach and backward filter activation from
discriminative tasks using deep learning allows the identi-
fication of nonlinear features from the raw data [49].
Following this path, the presented work was able to show
that the shape of the parietal and occipital alpha waves was
focused by the SexOrientationNet to label single subjects
according to their sexual orientation. This is in line with
previous EEG findings. One study found that heterosexual
men rated the erotic video with higher general and sexual
arousal than the homosexual participants. During observa-
Downloaded from http://karger.com/nps/article-pdf/doi/10.1159/000530931/3931240/000530931.pdf by guest on 07 July 2023
tion of the neutral and erotic videos, both groups showed
decreased amplitude of the alpha band in prefrontal and
parietal cortices, indicating increased attention [50]. Another
study revealed less suppression of the mu-rhythm, a specific
central rhythm in the frequency range of alpha, in HoM as
reaction to painful actions in comparison to heterosexual
men [51]. Interestingly, Alexander and Sufka found in-
creased alpha activity in homosexual males over right parietal
cortices during cognitive tasks [19]. Ziogas et al. [52] related
hemispheric alpha activity further to sexual arousal.
However, at the group level, the extracted frequencies
showed peaks in the beta and gamma range, not within
the alpha band. Again, EEG beta activity has been asso-
ciated with processing of erotic content in homosexual
males [50]. Further, at both, the single subject level and at
the group level, the areas with the most important weights
for differentiation by the network were in the parietal
cortex. It is of special interest that the right Brodmann
area 40 was source of EEG activity that yielded highest
discriminative power for homosexual males and Brod-
mann area 1 had the highest load for HeMs. Parietal
regions have been described in the context of sexual
arousal in fMRI studies [53], while Brodmann area 1 is
part of the somatosensory cortex and thus highly related
to social perception [54] and sexual arousal [55]. The
meta-analysis of 81 fMRI studies using paradigms with
sexual content revealed a more likely activation of parietal
regions in studies with sexual in comparison when no
sexual content was present. Here, it must be mentioned
that fMRI activation maps have to be regarded with
caution since they cannot be interpreted as simple
maps of areas with higher or lower neuronal activity,
given the nature of the underlying blood oxygenation
dependent signal [56, 57]. However, the involvement of
the parietal and temporal cortex in activity generation in
both homosexual and HeMs during sexual exposure [58]
has been linked to arousal and attention networks [59].
Ziogas/Mokros/Kawohl/de Bardeci/
Olbrich/Habermeyer/Habermeyer/Olbrich
The findings of this study underline the presence of Acknowledgments
specific functional patterns at defined cortical areas
that are different for homosexual and HeMs. Sincere thanks go to Christine Wyss, Tania Villar de Araujo,
Xenia Binner, Laura Nanz, and Helena Pejic for their assistance.
Although this study clearly shows the potentials of
deep learning-guided EEG analysis for discriminative
tasks, it still bears some limitations. The first limitation Statement of Ethics
can be found in the relatively small number of homo-
sexual subjects and heterosexual controls in sample 1 for The study was approved by the Ethical Committee Zurich (EC-
No 2014-0623). All participants gave written informed consent.
the training of the SexOrientationNet. Although the The study was conducted following the rules established by the
analysis was enriched with data from other samples Declaration of Helsinki.
with heterosexual subjects, it was not possible to separate
a complete unseen test dataset; a Leave One Out approach
had to be used instead. Although this can be seen as the Conflict of Interest Statement
method of choice in an environment with limited data, a

Downloaded from http://karger.com/nps/article-pdf/doi/10.1159/000530931/3931240/000530931.pdf by guest on 07 July 2023

No conflicts of interest are reported by the authors.
larger dataset would have allowed for a more rigid testing
procedure. Moreover, following this limitation, all con-
clusions drawn from this study have to be considered with
Funding Sources
caution until proved in an independent sample.
Another limitation was the low sampling frequency of No external funding was provided for this study.
the finally used EEG datasets. Although higher sampling
rate was available for most datasets, at the point in time
where the analysis was carried out, the authors did not Author Contributions
have access to the computational power to calculate the
networks for higher frequencies. Anastasios Ziogas designed the study, performed data acquis-
ition, and helped in analyzing, drafting, revising, and approving
the manuscript. Andreas Mokros, Wolfram Kawohl, Benedikt
Habermeyer, and Elmar Habermeyer helped in the study design,
Conclusion result interpretation, and drafting and revising the manuscript.
Mateo de Bardeci and Ilyas Olbrich helped in analyzing the data,
Homosexual males did not show female-like patterns interpreting the results, and drafting and revising the manuscript.
in a pretrained network on sex but could be differentiated Sebastian Olbrich helped in the design of the study, performed
data analysis, and drafted and revised the manuscript.
from HeMs in a newly trained network. It was possible to
extract neurophysiological features and identify anatom-
ical regions of interest for further research. Thus, deep
Data Availability Statement
learning in the EEG domain has the potential to open new
avenues for research in the field by decoupling discrim- Data are not publicly available due to ethical reasons. Further
inative tasks from a priori-defined features. inquiries can be directed to the corresponding author.

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