Mental health correlates and potential childhood predictors for the wish to be of the opposite sex in young autistic adults.
Autistic teens with low family support and high repetitive behaviors are twice as likely to wish they were the opposite sex and carry heavier mental-health loads into adulthood.
01Research in Context
What this study did
Jung-Chi and colleagues tracked 178 autistic and 178 neurotypical young adults in Taiwan. They asked each person, 'Do you wish you were the opposite sex?' and scored mental health, bullying, and quality of life.
They then looked back at childhood records to see what predicted the wish. They checked family support, repetitive behaviors, IQ, and early social skills.
What they found
Twice as many autistic adults (18 %) said they wished to be the opposite sex compared to neurotypical peers (9 %). These autistic adults also had more depression, more bullying, and lower life satisfaction.
Childhood signs pointed to the wish: low family support and high repetitive behaviors at were the strongest predictors.
How this fits with other research
Cohen et al. (2018) found that children with gender dysphoria already show mild ASD traits across the board. Jung-Chi et al. flip the lens—showing that autistic kids, especially those with low family warmth and rigid routines, are the ones who later report gender-related wishes.
Boets et al. (2011) showed that autistic-like traits predict later puberty timing. Jung-Chi adds another sex-related outcome: gender-dysphoric wishes. Both papers flag that early repetitive behaviors are a red flag for later sex-linked development issues.
Del Bianco et al. (2024) found that poor family-system support raises mental-health symptoms in autistic people across cultures. Jung-Chi narrows this to gender-dysphoric wishes, showing the same family factor predicts both mental-health and gender distress.
Why it matters
Add two quick boxes to your intake screen for teens: family support level and repetitive behavior score. If both are low, ask the teen privately about gender identity and mood. Offer family coaching or peer support early; it may cut later depression and bullying.
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02At a glance
03Original abstract
Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item "I wish I was the opposite sex" was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.
Autism : the international journal of research and practice, 2022 · doi:10.1177/13623613211024098