Increased Gender Variance in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder

Abstract

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.

Prevalence of the Wish to be of the Opposite Gender in Adolescents and Adults with Autism Spectrum Disorder

“…Four hypotheses were examined in the current study. First, in agreement with the studies in children with ASD (Janssen et al, 2016; May et al, 2017; Strang et al, 2014), a higher prevalence of the wish to be of the opposite gender was expected in the adolescents with ASD. We expected to find a higher prevalence of endorsement of this item in adults with ASD as well, as previous studies suggested that symptoms of ASD are increased in adults with GD (Jones et al, 2012; Pasterski et al, 2014).…”

“…So far, only three studies have examined symptoms of GD, defined as gender variance, in a population with ASD (Janssen, Huang, & Duncan, 2016; May, Pang, & Williams, 2017; Strang et al, 2014). In the study of Strang et al, children diagnosed with ASD and children diagnosed with other neurodevelopmental disorders (e.g., attention deficit hyperactivity disorder; ADHD) were investigated.…”

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

“…Out of the 19 studies eligible in this systematic review, one was a chart review, which explored rates of gender incongruence as reported by parents on the CBCL in children with different neurodevelopmental disorders, including ASD [37]. All studies used clinical samples.…”

“…Whereas most of the literature is concerned with the presence of ASD among referrals at a gender identity clinic, Strang et al [37] set out to examine gender variance among children (n=554) and adolescents (n=147) who were primarily diagnosed with a range of neurodevelopment disorders, including ASD. A chart review was conducted and ASD was measured using the ADI/ADI-R [45,46], which is a detailed parent interview of developmental history and autism symptoms.…”

Autism and the ghost of gender

“…Feminist literary scholar Jordyn Jack develops a fascinating and thorough engagement with this subject in terms of 'gendercopia', 'copia' being a "tool for inventing multiple possibilities through available sex/gender discourses". There has also been some recognition of gender variance in recent clinical literature (Jacobs et al, 2014;Strang, 2014).…”