Gender diversity in a Chinese community sample and its associations with autism traits.
In Chinese community children, parent-reported gender diversity and autism traits co-occur modestly even after controlling for general behavior problems.
01Research in Context
What this study did
Parents of 4- to 12-year-old children in China filled out two short forms. One form asked about gender diversity: how often the child played with toys or dressed in ways typical of the other gender. The other form asked about autism traits: how often the child showed rigid routines or social quirks.
The researchers then looked for a link between the two scores. They also checked if any connection was just due to general behavior problems.
What they found
Children with higher gender-diversity scores also had slightly higher autism-trait scores. The link stayed small but real even after removing the effect of overall behavior issues.
In plain words: kids who bend gender norms also show a few more autistic features, and the pattern is not simply because they act out more.
How this fits with other research
Austin et al. (2015) saw the same pattern in U.S. families nine years earlier. Both child and mom traits predicted gender non-conformity, giving an early heads-up that the link is not culture-bound.
George et al. (2018) and Heylens et al. (2018) flipped the lens: they started with diagnosed autistic adults and found high rates of gender dysphoria. The new child survey extends that story downward—showing the overlap exists even before any clinic visit.
Sun et al. (2019) gave the Chinese autism-trait form its seal of approval, so we can trust the scores parents reported in this study.
Why it matters
If you assess Chinese children, expect a modest overlap between gender diversity and autism traits. Do not jump to “either-or” labels. Instead, ask about play preferences and social style on the same intake form. A child who ticks both boxes may need support for flexible thinking and for gender identity exploration—two needs, one plan.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add two quick questions about toy and clothing choices to your intake form; if parents mark “often opposite-gender,” also run an autism-trait screener.
02At a glance
03Original abstract
Emerging evidence suggests that gender dysphoria or gender diversity (GD) intersects frequently with autism spectrum disorder or autism traits. However, the magnitude and interpretation of this link continue to be debated. Most child studies on this topic were performed in clinical populations, and little is known about the generalizability of this co-occurrence to the broader community, especially to non-Western samples. Also, little is known about whether specific subdomains of autism are more strongly associated with GD. Therefore, we investigated GD and its association with autism traits in a Chinese community sample of 4-12-year-olds (N = 379; 51% birth-assigned girls). Parents provided information about GD characteristics using the standardized Gender Identity Questionnaire for Children and autism traits using the Chinese version of the Autism-Spectrum Quotient-Children. In addition, broader behavioral and emotional challenges were measured by the Behavior Problem Index (BPI) to account for psychological challenges other than autism traits. In this community sample of Chinese children, increased GD was associated with increased autism traits, even after accounting for the BPI. Of the four subscales, the Imagination and Patterns subscales in birth-assigned girls and the Imagination subscale in birth-assigned boys were especially associated with GD. These findings indicate that the association between GD and autism traits generalizes to a nonclinical, non-Western sample. Clinicians and researchers working with clinical as well as community children should thus pay attention to the co-occurrence of GD and autism traits, in and outside the West.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3075