Potentially Reversible Social Deficits Among Transgender Youth.
High autism-screen scores in transgender youth may be stress, not autism—re-assess after gender support.
01Research in Context
What this study did
Turban (2018) wrote a position paper, not a lab study. The author asked: Why do so many transgender teens score high on autism screens?
The paper says the high scores may come from social stress, not true autism. If the youth get gender-affirming care, the social problems could fade.
What they found
The paper argues that social rejection, bullying, and hiding identity can look like autism. A teen who avoids eye contact after years of harassment is not necessarily autistic.
The author urges clinicians to re-test after the teen lives in their affirmed gender. The social deficits may reverse.
How this fits with other research
Cohen et al. (2018) measured real scores. They gave the CSBQ to kids with gender dysphoria and found mild autism traits across every area. Turban (2018) uses this data to say, "See, the scores are high, but maybe the cause is stress."
George et al. (2018) flips the lens. They show that autistic youth report more gender-dysphoric feelings than peers. Together the papers draw a two-way street: gender stress can mimic autism, and autism can increase gender exploration.
Chang et al. (2022) followed autistic youth into adulthood. Those with low family support and more bullying were more likely to wish to be the opposite sex. This long view supports L's idea that social hardship, not fixed disorder, drives many symptoms.
Why it matters
Before you write "suspects ASD" on a transgender teen's chart, pause. Ask if the social struggles started after rejection or before. Provide gender-affirming spaces, then re-screen. You may spare the youth an incorrect label and unnecessary therapy hours.
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02At a glance
03Original abstract
Recently, there has been increased attention to a putative relationship between Autism Spectrum Disorder (ASD) and gender dysphoria, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnosis for those whose gender assigned at birth does not match their gender identity. Studies have shown an over-representation of ASD symptoms among transgender youth. These studies, however, have used scales that are non-specific for ASD. These ASD symptoms may represent social deficits that are secondary to social stress and deprivation, as transgender youth suffer high rates of peer and family rejection. These social deficits may not represent true ASD and may be reversible as patients are affirmed in their gender identities and social stress is reduced.
Journal of autism and developmental disorders, 2018 · doi:10.1007/s10803-018-3603-0