Autistic Symptoms in Children and Adolescents with Gender Dysphoria.
Anna I R van der Miesen, Annelou L C de Vries, Thomas D Steensma and 1 others
PMID 29189919WHAT IT FOUND
Children and adolescents with gender dysphoria show more autistic traits than peers but fewer than those diagnosed with autism.
Traits were elevated across all domains, not just rigidity. Screening for autism is warranted, but questionnaire scores do not equal a diagnosis.
Key findings
01Participants with gender dysphoria had significantly higher autistic symptom scores than typically developing peers but significantly lower scores than those diagnosed with autism.
02Elevated symptoms were found across all six subscales of the autism questionnaire, including social communication and understanding, not just in stereotyped behaviors or resistance to change.
03Using a screening cut-off, 14.5% of the gender dysphoria group scored in the range suggestive of an autism diagnosis, compared to 3.5% in the normative sample.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used a screening questionnaire, not a diagnostic interview, so the 14.5% figure likely overestimates the actual rate of autism diagnoses. The design was cross-sectional, so it cannot determine whether autism traits cause gender dysphoria, whether gender dysphoria causes social stress that looks like autism, or if they share a common origin. The comparison groups were drawn from normative data collected around 10 years earlier than the gender dysphoria sample, which may introduce historical bias. The study did not include other clinical control groups (e.g., ADHD or depression), so it is unclear if elevated autistic traits are specific to gender dysphoria or common in other clinical populations.
The easy way to misread this
Do not interpret the 14.5% screening rate as evidence that 14.5% of these patients have autism. The questionnaire is not a diagnostic tool, and the authors note this estimate is likely too high because it does not filter out false positives.