Case study: cross-gender preoccupations with two male children with autism.
Cross-gender preoccupations can appear in young boys with autism—treat as part of the autism profile, not a gender identity disorder.
01Research in Context
What this study did
Two boys with autism kept talking about girl toys, dresses, and female cartoon heroes.
The clinician wrote a short case note. He asked other pros to watch for similar themes.
What they found
The boys did not have gender dysphoria. Their intense, narrow interests just landed on girl-coded items.
The author said, “Count this as part of autism, not as a separate gender disorder.”
How this fits with other research
Bradley et al. (2026) later asked dozens of autistic boys to fill out a gender quiz. Self-report showed the same wider range the 1996 note saw.
Waldron et al. (2023) surveyed both boys and girls. Autistic tweens reported more binary and non-binary identities than peers.
Michiels et al. (2026) interviewed autistic adults. They said gender feelings and autism felt tangled together, not separate.
Together these papers move us from “two quirky kids” to “common autism trait worth asking about.”
Why it matters
If a boy with autism lines up Barbies or calls himself Elsa, note it, but skip the panic. Ask open questions, use the child’s words, and add gender items to your intake form. Share the pattern with parents so they see it as autism flavor, not crisis.
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02At a glance
03Original abstract
Persons with autism frequently exhibit circumscribed interests and unusual preoccupations. In this case study, two young males with autism are presented who have preoccupations with feminine gender-stereotyped activities and objects. These types of preoccupations in children with autism have not been reported in the literature, but may be more prevalent than realized due to parental underreporting given the negative stigma associated with feminine interests in young boys. The development of gender identity in young children with autism has rarely been addressed in the literature. It seems unlikely that these two cases can be categorized as gender identity disorders. Understanding these preoccupations in the context of autism rather than focusing on the gender identity issues has important implications for treatment. These cases point to the need for further study of the complex interplay of environmental and neurobiologic factors affecting gender identity roles and preoccupations in autism.
Journal of autism and developmental disorders, 1996 · doi:10.1007/BF02172352