Category: Autism
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Rates of autism are much higher in trans-identified people.
In an analysis1 of five large datasets, “trangender and gender diverse” individuals were 3.03 to 6.36 times more likely to be autistic than those who do not claim an alternative gender identity.
- Warrier, V., Greenberg, D.M., Weir, E. et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications 11, 3959 (2020). https://doi.org/10.1038/s41467-020-17794-1 ↩︎
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Autistic traits are more common in trans-identified girls than trans-identified boys.
A cohort study of Australian children with trans identities1 found that 74.5% of the autistic group were female, compared to 64% of the non-autistic group. Females formed a significant majority of both groups.
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
Tollit, Michelle A. et al.
The Lancet Regional Health – Western Pacific, Volume 47, 101084 ↩︎
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
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Autistic children with gender dysphoria were also more likely to be dissatisfied with other parts of their bodies.
A cohort study of Australian children with trans identities1 found that children with autistic traits were more likely to express dissatisfaction with body parts unrelated to sex (e.g. nose, feet.) The study also found that frequency of voice dysphoria was higher in the autistic trait group.
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
Tollit, Michelle A. et al.
The Lancet Regional Health – Western Pacific, Volume 47, 101084
↩︎
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
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Autistic young people are more likely to socially transition than those without autistic traits.
A cohort study of Australian children with trans identities1 found that the difference in rates of social transition between “trans” children with and without autistic traits was 11.7%.
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
Tollit, Michelle A. et al.
The Lancet Regional Health – Western Pacific, Volume 47, 101084 ↩︎
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
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Autism and gender dysphoria occur together at significantly high rates.
The connection between autism and gender dysphoria has emerged through increasingly robust research over the past decade. Early systematic reviews (Glidden et al., 2016)1 first identified unexpectedly high autism rates among youth with gender dysphoria diagnoses.
Clinical studies then provided stronger evidence. Hisle-Gorman et al. (2019)2 found children with autism diagnoses were over four times more likely to receive a gender dysphoria diagnosis. Warrier et al. (2020)3 confirmed elevated rates across five large independent datasets.
Kallitsounaki & Williams’ 2023 meta-analysis4 synthesized 47 studies – including the ones above – finding that 11% of individuals with gender dysphoria have autism diagnoses—compared to 1% in the general population. The analysis also showed statistically significant differences in autism traits between those with gender dysphoria and control groups (g=0.67), with the authors noting the rising number of publications on this overlap.
Kahn et al.’s 2023 study5 analyzed 919,898 youth across eight U.S. hospital systems, revealing that 0.05% had diagnoses of both autism and gender dysphoria. The probability of having a gender dysphoria diagnosis was 0.019 for those with autism, compared to 0.006 for those without—representing three times higher odds (aOR=3.00).
- Glidden, D., Bouman, W. P., Jones, B. A., & Arcelus, J. (2016). Gender dysphoria and autism spectrum disorder: A systematic review of the literature. Sexual Medicine Reviews, 4(1), 3–14. ↩︎
- Hisle-Gorman, E., Landis, C. A., Susi, A., Schvey, N. A., Gorman, G. H., Nylund, C. M., & Klein, D. A. (2019). Gender dysphoria in children with autism spectrum disorder. LGBT Health, 6(3), 95–100. ↩︎
- Warrier, V., Greenberg, D. M., Weir, E., Buckingham, C., Smith, P., Lai, M. C., … & Baron-Cohen, S. (2020). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications, 11(1), 3959. ↩︎
- Kallitsounaki, A., & Williams, D. M. (2023). Autism spectrum disorder and gender dysphoria/incongruence: A systematic literature review and meta-analysis. Journal of Autism and Developmental Disorders, 53(8), 3103–3117. ↩︎
- Kahn, N. F., Sequeira, G. M., Garrison, M. M., Orlich, F., Christakis, D. A., Aye, T., … & Richardson, L. P. (2023). Co-occurring autism spectrum disorder and gender dysphoria in adolescents. Pediatrics, 152(2), e2023061363. ↩︎
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People with psychiatric conditions – and sometimes neurodiverse conditions – are much more likely to die by suicide than gender dysphoric people
A Swedish study1 found that suicide rates for personality disorder, schizophrenia, substance addiction, bipolar and (among males) depression and autism were all higher than suicide rates for gender dysphoric people:
These high suicide rates for schizophrenia are confirmed by another study2 which puts the lifetime risk of suicide death for schizophrenics at 5.6%. This study also finds “the absolute risk of suicide in different psychiatric disorders to vary from 2% to 8%, higher for men than for women and highest for men and women with bipolar disorder, unipolar affective disorder, schizophrenia, and schizophrenialike disorder.”
- Swedish National Board of Health and Welfare (2020). Utvecklingen av diagnosen könsdysfori: Förekomst, samtidiga psykiatriska diagnoser och dödlighet i suicid. Socialstyrelsen. [Link] ↩︎
- Nordentoft, M., Madsen, T. & Fedyszyn, I. (2015). Suicidal behavior and mortality in first-episode psychosis. J Nerv Ment Dis. 203 (5): 387-92. [Link] ↩︎
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Obsessive-compulsive traits are more common in people with gender dysphoria
At least two studies1 2 have found a particular connection between intense interests or repetitive behaviors – associated with autism spectrum disorders – and gender dysphoria.
It has also been noted3 that:
With the intensified public awareness and media coverage of issues concerning gender identity and gender incongruence, distinguishing true gender dysphoria or incongruence from the sexual obsessions of obsessive-compulsive disorder (OCD) is especially important. Although intrusive sexual obsessions are not uncommon in OCD, obsessions concerning sexual content are more difficult for clinicians to identify as OCD than other types of obsessions (e.g., obsessions concerning contamination).
- Zucker, K.J., Nabbijohn, A.N., Santarossa, A., Wood, H., Bradley, S.J., Matthews, J., & VanderLaan, D.P. (2017). Intense/obsessional interests in children with gender dysphoria: a cross-validation study using the Teacher’s Report Form. Child and adolescent psychiatry and mental health 11, 51. [Link] ↩︎
- VanderLaan, D.P., Postema, L., Wood, H., Singh, D., Fantus, S., Hyun, J., Leef, J., Bradley, S.J. & Zucker, K.J.. (2015). Do children with gender dysphoria have intense/obsessional interests? J Sex Res. 52 (2): 213-9. [Link] ↩︎
- Safer, D., Bullock, K. & Safer, J. (2016). Obsessive-Compulsive Disorder Presenting as Gender Dysphoria/Gender Incongruence: A Case Report and Literature Review. AACE Clinical Case Reports 2. [Link] ↩︎
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Children referred to the UK’s largest gender clinic were vastly more likely than average to present with autistic traits
One study1 noted that:
48% of children and young people who were seen in GIDS and whose parents completed the social responsiveness scale (SRS), a quantitative measure of autistic behaviours in children and young people, scored in the mild to severe range.
A BMJ paper2 reported:
Around 35% of referred young people [i.e. referred to the GIDS] present with moderate to severe autistic traits.
- Churcher Clarke, A. & Spiliadis, A. (2019). ‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties. Clin Child Psychol Psychiatry 24 (2): 338-352. [Link] ↩︎
- Butler, G., De Graaf, N., Wren, B. & Carmichael, P. (2018) Assessment and support of children and adolescents with gender dysphoria. Archives of Disease in Childhood103:631-636. [Link] ↩︎