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

Abstract

Several studies have suggested an overrepresentation of (symptoms of) autism spectrum disorder (ASD) among individuals with gender dysphoria. Three studies have taken the inverse approach in children with ASD and showed increased parent report of the wish to be of the opposite gender in this group. This study compared the self-reported wish to be of the opposite gender (one item of the Youth Self-Report [YSR] and the Adult Self-Report [ASR]) of 573 adolescents (469 assigned boys and 104 assigned girls) and 807 adults (616 assigned males and 191 assigned females) with ASD to 1016 adolescents and 846 adults from the general population. Emotional and behavioral problems were measured by the DSM-oriented scales of the YSR and ASR. In addition, the Children’s Social Behavior Questionnaire and the Adult Social Behavior Questionnaire were used to measure specific subdomains of the ASD spectrum to test whether specific subdomains of ASD were particularly involved. Significantly more adolescents (6.5%) and adults (11.4%) with ASD endorsed this item as compared to the general population (3–5%). In adolescents, assigned girls endorsed this item more than assigned boys. No significant gender differences were found in the adults with ASD. In addition, on all DSM-oriented scales of both the YSR and ASR, adolescents and adults with ASD who endorsed the gender item had significantly higher scores compared to those without. There were no significant associations between endorsement of the gender item and any specific subdomain of ASD, providing no evidence for a sole role of one of the ASD subdomains and endorsement of the wish to be the opposite gender.

Autismus-Spektrum-Störungen und Geschlechtsdysphorie bei Kindern und Jugendlichen: Systematisches Review zur gemeinsamen Prävalenz

“…Aktuelle Studien zeigen, dass GD/Gendervarianz und ASS sowohl bei Kindern und Jugendlichen [13][14][15][16] als auch bei Erwachsenen [17] im Vergleich zu den einfachen Prävalenzen in der Allgemeinbevölkerung häufiger gemeinsam auftreten. Im Kontrast zum englischsprachigen Raum, in dem dieser Zusammenhang bereits in Übersichtsarbeiten dargestellt wurde [18], existiert bisher keine deutschsprachige Übersichtsarbeit.…”

“…Hierbei stellte sich zum einen heraus, dass 4,7-13,3 % der in den Studien untersuchten Kinder und Jugendlichen mit GD/ Gendervarianz gleichzeitig auch eine ASS-Diagnose aufwiesen [13,23,24,31,32]. Zum anderen war gender-nonkonformes Erleben oder Gendervarianz in den Stichproben von Kindern und Jugendlichen mit ASS mit 4-6,5 % überrepräsentiert [14,[27][28][29].…”

“…Die gegengeschlechtliche Identifikation könnte somit auch als Lösungsversuch sozialer Probleme und Kommunikationsschwierigkeiten verstanden werden [13]. Zum anderen wird diskutiert, dass bei Kindern und Jugendlichen mit ASS eine repetitive Beschäftigung (ASS-Kriterium A) mit genderbezogenen Inhalten und Fragen in eine GD/Gendervarianz münden könnte [14,16,33].…”

Mentalising Moderates the Link between Autism Traits and Current Gender Dysphoric Features in Primarily Non-autistic, Cisgender Individuals

“…Within the autism population, retrospective chart reviews have shown that affected people are significantly more likely than neurotypical individuals to express the wish to be the opposite gender (Janssen et al 2016;May et al 2017;Strang et al 2014;van der Miesen et al 2018c). Furthermore, in a recently published study, George and Stokes (2018) used the Gender Identity/Gender Dysphoria Questionnaire (Deogracias et al 2007) and found that adults with autism reported significantly increased gender dysphoric traits relative to neurotypical individuals.…”

Community attitudes on genetic research of gender identity, sexual orientation, and mental health

“…Of particular interest are neuropsychiatric conditions that have strong sex biases and have shown evidence of enrichment for non-heterosexuality and gender variance. For instance, autism is highly male-biased (4:1) [10] and is also enriched for gender dysphoria [24] [13], while anorexia nervosa is highly female-biased (8:1) [23] but is enriched for gay and bisexual men [9]. More generally, there has been extensive study into the higher prevalence of neuropsychiatric conditions in the LGBTQ+ community [22].…”