Evidence suggests over-representation of autism spectrum disorders (ASDs) and behavioral difficulties among people referred for gender issues, but rates of the wish to be the other gender (gender variance) among different neurodevelopmental disorders are unknown. This chart review study explored rates of gender variance as reported by parents on the Child Behavior Checklist (CBCL) in children with different neurodevelopmental disorders: ASD (N = 147, 24 females and 123 males), attention deficit hyperactivity disorder (ADHD; N = 126, 38 females and 88 males), or a medical neurodevelopmental disorder (N = 116, 57 females and 59 males), were compared with two non-referred groups [control sample (N = 165, 61 females and 104 males) and non-referred participants in the CBCL standardization sample (N = 1,605, 754 females and 851 males)]. Significantly greater proportions of participants with ASD (5.4%) or ADHD (4.8%) had parent reported gender variance than in the combined medical group (1.7%) or non-referred comparison groups (0-0.7%). As compared to non-referred comparisons, participants with ASD were 7.59 times more likely to express gender variance; participants with ADHD were 6.64 times more likely to express gender variance. The medical neurodevelopmental disorder group did not differ from non-referred samples in likelihood to express gender variance. Gender variance was related to elevated emotional symptoms in ADHD, but not in ASD. After accounting for sex ratio differences between the neurodevelopmental disorder and non-referred comparison groups, gender variance occurred equally in females and males.

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My academic interests used to focus on creating inclusive environments for students with disabilities. But my personal experiences parenting gender nonconforming children gradually expanded my interests to include creating welcoming schools for gender and sexually diverse students, families, and educators. When my 12-year-old son was three, he displayed a strong interest in toys, clothes, and activities typically associated with girls. He used a blankie pretending to have long hair and enjoyed playing with the many princess costumes his sister had, though rarely played with. His sister was interested in building things and playing sports, and not so much in princess dress-up and Barbie dolls. She was what we call a tomboy. Since I was a tomboy as a child, my daughter's interests and behaviors felt very familiar, comfortable, and natural. That's why I was surprised to fi nd myself confused about how my son expressed his gender, and I wondered about the best way to support him. He seemed so happy pretending to be a princess, and he danced Adults set the tone for welcoming all students A scholar whose son is gender nonconforming allows her experience as his mother to shape her academic work and her views about how schools can become more comfortable places for all students.

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