Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents

Abstract

Only case reports have described the co-occurrence of gender identity disorder (GID) and autism spectrum disorders (ASD). This study examined this co-occurrence using a systematic approach. Children and adolescents (115 boys and 89 girls, mean age 10.8, SD = 3.58) referred to a gender identity clinic received a standardized assessment during which a GID diagnosis was made and ASD suspected cases were identified. The Dutch version of the Diagnostic Interview for Social and Communication Disorders (10th rev., DISCO-10) was administered to ascertain ASD classifications. The incidence of ASD in this sample of children and adolescents was 7.8% (n = 16). Clinicians should be aware of co-occurring ASD and GID and the challenges it generates in clinical management.

Gender Dysphoria and Autism Spectrum Disorder: A Systematic Review of the Literature

“…Authors investigating rates of ASD in trans people attending services have found that up to 7.8% of them report a lifetime prevalence of ASD [12]. However, these findings are contradictory to more recent studies which have shown no differences between trans people and the general population in relation to ASD [16].…”

“…Out of the 19 articles, eight were case reports [13,21,22,23,24,25,26,27] and four were cohort studies. The first cohort study explored the development of gender identity in children with Autism [28], the second established the co-occurrence of ASD and Gender Dysphoria [12], the third attempting to establish predictive factors for autism spectrum traits [29], and the fourth reviewed the overrepresentation of adolescent developmental problems in minors with Gender Dysphoria [30]. Six studies considered within this systematic review were case control studies, two of which employed the AQ to compare autism spectrum traits within a sample of patients with Gender Dysphoria and a control group [16,31].…”

“…In 2010, De Vries et al [12] undertook a cohort trial to determine the co-occurrence of GID, as defined in the ICD-10 [5] and ASD, as per DSM-IV-TR [7]. The sample comprised of children (n=108) and adolescents (n=96) who were referred to a national gender identity clinic in the Netherlands and were clinically diagnosed with GID by a senior clinician.…”

“…De Vries et al [12] employed a well-validated diagnostic tool for ASD, the Diagnostic Interview for Social and Communication Disorder (DISCO 10) [44]. However, patients were only selected for further examination with the DISCO-10 if the clinician suspected a diagnosis, and therefore possible cases could have been missed by the researcher.…”

“…Within clinical services, there have been an increasing number of trans people also presenting with Autism Spectrum Disorder (ASD), which has been of great clinical interest as it has implications for diagnosis and treatment [12,13]. ASD is defined in the DSM-5 as persistent deficits in social communication and social interaction across multiple contexts.…”