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

Glidden, Derek; Bouman, Walter Pierre; Jones, Beth; Arcelus, Jon

doi:10.1016/j.sxmr.2015.10.003

Cited by 186 publications

(126 citation statements)

References 59 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…43–45 The most widely cited evidence supporting this hypothesis comes from a study of 204 children and/or adolescents referred to the Gender Identity Clinic in Amsterdam. 46 The presence of an autism spectrum disorder was established via a standardized diagnostic interview, 47 yielding a prevalence of 10% among transfeminine patients and 4% among transmasculine patients, which was reported by the authors to be higher than the 1% estimate reported in the general population.…”

Section: Discussionmentioning

confidence: 99%

Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

Liu²,

et al. 2018

View full text Add to dashboard Cite

BACKGROUND Understanding the magnitude of mental health problems, particularly life-threatening ones, experienced by transgender and/or gender nonconforming (TGNC) youth can lead to improved management of these conditions. METHODS Electronic medical records were used to identify a cohort of 588 transfeminine and 745 transmasculine children (3–9 years old) and adolescents (10–17 years old) enrolled in integrated health care systems in California and Georgia. Ten male and 10 female referent cisgender enrollees were matched to each TGNC individual on year of birth, race and/or ethnicity, study site, and membership year of the index date (first evidence of gender nonconforming status). Prevalence ratios were calculated by dividing the proportion of TGNC individuals with a specific mental health diagnosis or diagnostic category by the corresponding proportion in each reference group by transfeminine and/or transmasculine status, age group, and time period before the index date. RESULTS Common diagnoses for children and adolescents were attention deficit disorders (transfeminine 15%; transmasculine 16%) and depressive disorders (transfeminine 49%; transmasculine 62%), respectively. For all diagnostic categories, prevalence was severalfold higher among TGNC youth than in matched reference groups. Prevalence ratios (95% confidence intervals [CIs]) for history of self-inflicted injury in adolescents 6 months before the index date ranged from 18 (95% CI 4.4–82) to 144 (95% CI 36–1248). The corresponding range for suicidal ideation was 25 (95% CI 14–45) to 54 (95% CI 18–218). CONCLUSIONS TGNC youth may present with mental health conditions requiring immediate evaluation and implementation of clinical, social, and educational gender identity support measures.

show abstract

Section: Discussionmentioning

confidence: 99%

Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

Liu²,

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Individuals with GD may undergo hormonal and surgical interventions in order to align their experienced and assigned genders, and/or may socially transition by changing their pronouns and appearance to that of their identified gender. Higher rates of GD have been found amongst autistic individuals than in the general population [86], and the rate of ASD traits and ASD within individuals with GD is also significantly higher than average [87]. This again suggests there may be shared factors between both conditions, and suggests populations in which to examine for ASD.…”

Section: Gender Dysphoriamentioning

confidence: 96%

Protective Effect or Missed Diagnosis? Females with Autism Spectrum Disorder

Hull

Mandy

2017

Future Neurol.

View full text Add to dashboard Cite

Autism Spectrum Disorder (ASD) has historically been diagnosed more frequently in males than females. One explanation for this is the 'female protective effect': that there is something inherent in being female that makes girls and women less susceptible to ASD.Another possibility is that ASD is under-diagnosed in girls and women, due to the existence of a 'female autism phenotype', which is not well captured by current, male-biased diagnostic criteria. To evaluate the 'female protective effect' and 'female autism phenotype' hypotheses, this narrative review describes recent developments exploring the genetic underpinning and behavioural expression of ASD in females. We then look at ways to better identify females with ASD who may be missed under the current diagnostic criteria. KeywordsAutism, Autism Spectrum Disorders, Gender Differences, Sex Differences, Genetics, Diagnosis, Person-Environment Fit IntroductionAutism Spectrum Disorder (ASD) is a group of neurodevelopmental conditions characterised by deficits in social communication and reciprocity, and by restricted and repetitive interests and behaviours 1 . ASD is the current term used to integrate the previously separate diagnostic categories of autistic disorder, Asperger's disorder, childhood disintegrative disorder and pervasive developmental disorder -not otherwise specified (aka 'atypical autism' [2]). ASD is a lifelong condition that is present from birth. Although adult diagnosis is possible, symptoms must be reported as present from early developmental stages in order for the 1 In line with preferences from a majority of the autism community [1], we use identity-first language (e.g. 'autistic person') to refer to individuals with an ASD throughout this paper, while recognising that others might prefer person-first language (e.g. 'person with autism'). Gender differences in diagnosisASD affects approximately one to two per cent of the population [3,4], and is much more likely to be diagnosed in males than in females. Gender ratios in diagnosis vary depending on the country, cohort, and characteristics of those included, but average ratios are reported at around four males for every one female [3][4][5]. However, when looking at those individuals with intellectual disability, the male-to-female ratio narrows significantly to around two-toone [6]. In addition, population-based studies, which screen all participants in order to identify cases regardless of whether they have already been diagnosed by local services, suggest that the male-to-female ratio is closer to 3:1 [7,8]. This is in contrast to the average of around 4-5:1 generally reported in studies based on clinically-diagnosed cases [9]. The fact that a lower proportion of females are found in clinical samples than in community-based, epidemiological samples suggests that there is a bias against autistic girls and women coming to clinical attention. This bias may have existed from the very first conceptions of ASD; only 3 of 11 children in Kanner's original cases were female, and no gi...

show abstract

“…Transgender issues in the context of ASD have shown new developments that were not captured when the search for the current study was conducted, including two case studies of high-functioning individuals diagnosed with ASD and gender dysphoria (Jacobs, Rachlin, Erickson-Schroth, & Janssen, 2014), a report documenting autistic features in young people with gender dysphoria (Skagerberg, Di Ceglie, & Carmichael, 2015), two reviews about co-occurring gender dysphoria and ASD (up to 20%) (Glidden, Bouman, Jones, & Arcelus, 2016;Van Der Miesen, Hurley, & De Vries, 2016), and initial clinical guidelines for co-occurring ASD and gender dysphoria or incongruence in adolescents (Strang et al, 2016).…”

Section: Intellectual Disability/autism Spectrum Disordersmentioning

confidence: 99%

Changing the culture of neurodisability through language and sensitivity of providers: Creating a safe place for LGBTQIA+ people

Moreno

Laoch

Zasler

2017

NRE

View full text Add to dashboard Cite

Abstract. BACKGROUND:There is an increasing interest in sexual and gender diversity in neurorehabilitation. Healthcare professionals wanting to improve their practice know the importance of understanding the needs and expectations of specific communities. OBJECTIVE: To critically review the literature about neurological disorders in people who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and people with other sexual orientations and forms of gender expression (LGBTQIA+). METHODS: Systematic search in electronic databases (CINAHL, EMBASE, Medline, PsycINFO, Scopus, and Web of Science) and identification of relevant studies. RESULTS: Quantitative and qualitative findings are summarized and reported by neurological disorders: a) neurodisability/epilepsy (17.7%), b) intellectual disability/autism spectrum disorders (19.6%), c) dementia/HIV-related dementia (39.2%), d) spinal cord injury (7.8%), and e) traumatic brain injury/stroke (15.7%). CONCLUSIONS:LGBTQIA+ people with neurodisabilities and their partners/families of choice can conceal their sexual orientation or gender identity for fear of diminished quality of care. Their invisibility translates into health disparities, lack of policies and services that meet their unique needs. Dementia is the most common neurodisability documented in LGBTQIA+ people. We provide recommendations to increase LGBTQIA+ cultural competency for clinical practice, research, and policy to help different stakeholders to promote a positive change in the culture of neurodisability.

show abstract

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

Abstract: Introduction. There is a growing clinical recognition that a significant proportion of patients

Cited by 186 publications

References 59 publications

Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

Protective Effect or Missed Diagnosis? Females with Autism Spectrum Disorder

Changing the culture of neurodisability through language and sensitivity of providers: Creating a safe place for LGBTQIA+ people

Contact Info

Product

Resources

About