Autistic Characteristics in a Nationally Representative Clinical Sample of Adolescents Seeking Medical Gender-Affirming Treatment in Norway.
Linda W David, Nina Stenberg, Trond H Diseth and 4 others
PMID 38055182WHAT IT FOUND
In adolescents seeking gender-affirming care, 9.6% had an autism diagnosis, all assigned female at birth.
Parent-reported autistic traits were higher than norms in this group, particularly social motivation difficulties. However, no significant difference in total trait scores was found between assigned female and male groups.
Key findings
019.6% of participants had a registered ASD diagnosis, and all of these were assigned female at birth.
02There was no significant difference in total or subscale raw scores of autistic traits between those assigned female and those assigned male at birth.
03Compared to norm populations, adolescents assigned female at birth had significantly higher total autistic trait scores, driven largely by social motivation and autistic mannerisms.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (83 participants). Data was collected during the first year of the COVID-19 pandemic, which may have affected referral patterns or assessment conditions. The study excluded individuals with an IQ below 70, active psychotic symptoms, or limited Norwegian language skills. Autistic traits were measured by parent report, not self-report, which may miss internal experiences or camouflaging strategies. The SRS was compared to American norms, which may not be directly applicable to a Norwegian population. The study did not include non-binary youth, as all participants were registered with a binary gender identity.
Declared interests
The study was funded by the University of Oslo (including Oslo University Hospital). No other conflicts of interest were declared.
The easy way to misread this
Do not interpret the lack of significant difference in total SRS scores between AFAB and AMAB groups as evidence that autistic traits are equally prevalent or severe in both. The AFAB group had significantly higher scores compared to their gender-norms, and all registered ASD diagnoses were in the AFAB group. Parent-report measures may also underestimate traits in adolescents who camouflage.