Implicit and Explicit Gender-Related Cognition, Gender Dysphoria, Autistic-Like Traits, and Mentalizing: Differences Between Autistic and Non-Autistic Cisgender and Transgender Adults

Abstract

Evidence indicates a link between autism spectrum disorder (ASD) and gender diversity, yet this intersection remains insufficiently understood. Here, we investigated whether (1) ASD affects gender-related cognition (i.e., mental processes of perceiving and interpreting one’s own gender self-concept), (2) autistic people have increased gender dysphoria and recall limited gender-typed behavior from childhood, and (3) transgender individuals have increased ASD-like traits and difficulties in mentalizing. A total of 106 non-autistic cisgender (51 birth-assigned female), 107 autistic cisgender (57 birth-assigned female), 78 non-autistic transgender (41 birth-assigned female), and 56 autistic transgender adults (27 birth-assigned female) participated in the study. The mean age of participants was 31.01 years (range = 18 to 70). Using an explicit as well as an implicit measure, for the first time, we found that ASD affected gender-related cognition only in autistic cisgender people. Sex differences were also observed in this group. Whereas autistic cisgender birth-assigned males showed a stronger implicit gender-group identification than non-autistic cisgender birth-assigned males, autistic cisgender birth-assigned females showed a weaker gender-group identification than non-autistic cisgender birth-assigned females. Furthermore, autistic cisgender people reported significantly more gender dysphoric feelings and recalled significantly less gender-typed behavior from childhood than non-autistic cisgender individuals. No difference was observed between non-autistic and autistic transgender people. We also found that relative to non-autistic cisgender individuals, both non-autistic transgender and autistic transgender people reported significantly more ASD-like traits. However, mentalizing difficulties were observed only in the latter group. This research enhances our understanding of the link between ASD and gender diversity.

Brief Report: An Exploration of Alexithymia in Autistic and Nonautistic Transgender Adults

“…We should note that the participant groups were the same as those reported in . 16 Yet, we did not report any findings related to alexithymia in the aforementioned paper. The School of Psychology Research Ethics Committee at the University of Kent has approved this study (ID: 201915670711375862).…”

“…15 Furthermore, research has shown an elevated number of autistic traits in non-autistic transgender and gender diverse people relative to non-autistic cisgender people. 16,17 There are also a number of transgender and gender diverse people who report clinical levels of autistic traits but do not meet the full diagnostic criteria for autism, forming a subclinical autistic group. 18,19 Lastly, research has found evidence of increased rates of transgender and gender diverse people in autistic samples, 20 and increased gender dysphoric feelings in cisgender autistic adults.…”

“…18,19 Lastly, research has found evidence of increased rates of transgender and gender diverse people in autistic samples, 20 and increased gender dysphoric feelings in cisgender autistic adults. 16 Despite the high co-occurrence of autism and gender diversity, we know little about alexithymia in transgender and gender diverse people. To our knowledge, only two studies have examined whether transgender adults have increased alexithymia.…”

Autism and sexual and gender minority identity in college students: Examination of self-reported rates, functional outcomes, and treatment engagement

“…Another limitation of this study is that autism diagnostic status was based on one self-reported question for autism rather than best evidence-based assessment practices which include the use of multi-informant and multi-method approaches. One recent study suggests that a diagnosis of autism spectrum disorder may be overestimated within GM populations when assessed for via self-report only (Kallitsounaki & Williams, 2022). At the same time, it is also possible that individuals who both self-identify as autistic and experience similar difficulties as autistic people with a formal diagnosis of autism may not have endorsed having an autism spectrum disorder due to challenges with receiving a formal diagnosis.…”

“…In addition, this study used only one question asking participants' gender identity, and items about biological sex were not considered, which means this study may have missed individuals identifying as transgender and/or individuals who were in the process of transitioning in our groupings. Recent studies have shown that adults who identify as transgender are more likely to report a mental health diagnosis and/or a diagnosis of autism comparative to their cisgender adult peers (Kallitsounaki & Williams, 2022;Warrier et al, 2020).…”