Gender Dysphoria in Children with Autism Spectrum Disorder

Hisle-Gorman, Elizabeth; Landis, Corinne A.; Susi, Apryl; Schvey, Natasha A.; Gorman, Gregory; Nylund, Cade M.; Klein, David A.

doi:10.1089/lgbt.2018.0252

Cited by 68 publications

(46 citation statements)

References 41 publications

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“…In other words, a strength of this study is that none of the datasets were collected to specifically test the association between autism and gender identity. Furthermore, similar ORs have been observed in a large-scale study of autism in participants of GD clinics which are unlikely to be affected by this specific type of selection bias 17 , providing further corroboration to our findings.…”

Section: Discussionsupporting

confidence: 91%

“…Third, sensitivity analysis in the MU dataset did not identify differences in the rates of autism diagnosis between participants who indicated "Other" vs. "Transgender". Fourth, the ORs observed in this study are similar to those observed in participants from GD clinics 17 , suggesting that ORs observed using an internet-based convenience sampling framework is similar to ORs observed in GD clinic-based samples.…”

Section: Discussionsupporting

confidence: 78%

“…Supporting this, subsampling bootstrap analyses indicate that the ORs are similar across the different datasets. Additionally, the ORs are similar between the five internet-based datasets in this study and a study based on GD-clinic based samples 17 . This similarity suggests that regardless of recruitment (internet-based vs. clinic-based) or ascertainment criteria (self-report gender identity vs. clinically ascertained gender dysphoria) or age (adults vs. children), the results converge on similar ORs.…”

Section: Discussionsupporting

confidence: 63%

“…Most of these studies in children and adolescents have used a single item on the Child Behavior Checklist (CBCL), a caregiver-report measure for behavioral problems, to quantify gender variance, and these have identified that between 4% and 5.4% of autistic children may potentially be transgender or gender-diverse, compared to 0.7% of non-autistic children 14 – 16 . The largest of these, conducted in nearly 300,000 children, identified a fourfold likelihood of GD clinical diagnoses in autistic compared to non-autistic children (i.e., 0.07% of autistic children and 0.01% of non-autistic children) 17 . Despite the differences in percentages of transgender and gender-diverse identities in the studies using CBCL and clinical GD information, the relative rates are largely similar (between 5.7 and 7.7).…”

Section: Introductionmentioning

confidence: 99%

“…A few studies, mostly clinic-based, typically with small sample sizes, and in individuals with gender dysphoria (GD, defined as persistent distress arising from a mismatch between sex assigned at birth and gender identity), have investigated the link between autism/traits related to autism and gender diversity 12,13 . These studies have identified increased rates of gender diversity in autistic children and adolescents [14][15][16][17][18] , and adults 19,20 , compared to the general population. Most of these studies in children and adolescents have used a single item on the Child Behavior Checklist (CBCL), a caregiver-report measure for behavioral problems, to quantify gender variance, and these have identified that between 4% and 5.4% of autistic children may potentially be transgender or gender-diverse, compared to 0.7% of non-autistic children [14][15][16] .…”

mentioning

confidence: 99%

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Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals

et al. 2020

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It is unclear whether transgender and gender-diverse individuals have elevated rates of autism diagnosis or traits related to autism compared to cisgender individuals in large nonclinic-based cohorts. To investigate this, we use five independently recruited cross-sectional datasets consisting of 641,860 individuals who completed information on gender, neurodevelopmental and psychiatric diagnoses including autism, and measures of traits related to autism (self-report measures of autistic traits, empathy, systemizing, and sensory sensitivity). Compared to cisgender individuals, transgender and gender-diverse individuals have, on average, higher rates of autism, other neurodevelopmental and psychiatric diagnoses. For both autistic and non-autistic individuals, transgender and gender-diverse individuals score, on average, higher on self-report measures of autistic traits, systemizing, and sensory sensitivity, and, on average, lower on self-report measures of empathy. The results may have clinical implications for improving access to mental health care and tailoring adequate support for transgender and gender-diverse individuals.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals

et al. 2020

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Helping Autistic Children

Davis¹,

Houting²,

Fletcher‐Watson³

2022

The Wiley‐Blackwell Handbook of Childhood Social Development

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Gender diversity in autistic and neurotypical youth over adolescence and puberty: A longitudinal study

Corbett,

Muscatello,

Cyperski

et al. 2024

Autism Research

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Recent research in autism spectrum disorder (ASD) has suggested a higher prevalence of gender diversity in individuals diagnosed with ASD. Adolescence is a critical period for the consolidation of gender identity, yet the extent to which the experience of gender diversity is stable over adolescence and puberty in autistic youth is poorly understood. The aim of the study was to examine the consistency of gender diversity using the gender diversity screening questionnaire for self‐ and parent‐report of youth (GDSQ‐S, GDSQ‐P) over a four‐year longitudinal study of pubertal development in youth with ASD (N = 140, 36 assigned‐female‐at birth (AFAB)) and typical development (TD, N = 104, 58 assigned‐male‐at‐birth [AMAB]) and their parents. The extent to which diagnosis (ASD vs. TD), assigned sex (AFAB vs. AMAB) and developmental level (age, puberty) predict GDSQ trajectory over time was explored. There was a significant diagnosis by sex‐assigned‐at‐birth by age interaction for GDSQ‐S Gender Diversity, p = 0.002, showing higher scores in autistic AFAB youth over adolescence, and TD AFAB showing initially lower, then increasing levels over adolescence. For GDSQ‐P, Gender Incongruence was significantly different between the groups, p = 0.032, showing higher incongruence for autistic AFAB around age 10, decreasing between age 12–14 before increasing again, while TD AFAB evidence the inverse trend. AMAB trends were stable. The significant diagnostic, developmental and sex‐based differences indicate AFAB youth experience greater gender diversity that evolves over development. Findings suggest gender identity formation is nuanced and may be influenced by pubertal progression, hormonal patterns, and psychosocial factors. Results underscore the need for enhanced understanding of the unique, dynamic profiles of females‐assigned‐at‐birth.

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Gender Dysphoria in Children with Autism Spectrum Disorder

Cited by 68 publications

References 41 publications

Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals

Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals

Helping Autistic Children

Gender diversity in autistic and neurotypical youth over adolescence and puberty: A longitudinal study

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