Sex Differences in Gender-Diverse Expressions and Identities among Youth with Autism Spectrum Disorder.
Autistic girls express more gender-non-conforming behaviors and puberty-related gender anxiety than autistic boys, so screen for it.
01Research in Context
What this study did
Brunissen et al. (2021) asked parents to fill out a survey. They wanted to know if autistic girls and boys differ in gender expression and in worry about gender.
The survey covered youth with autism aged 3 to 25. Parents answered questions about dress, play, and puberty distress.
What they found
Girls with autism were rated as more gender-non-conforming than boys. They also showed more anxiety linked to puberty and gender.
The gap was not tiny; it showed up across several survey items.
How this fits with other research
The finding backs up Eussen et al. (2016), who saw higher depression in early-adolescent autistic girls. Gender worry looks like another face of that internalizing pattern.
It also extends Bradford et al. (2018). Those authors listened to autistic trans teens for 22 months and heard intense early dysphoria. Ludivine adds parent-view numbers that match the teens' stories.
Green et al. (2020) seems to disagree. That study found no sex difference in internalizing symptoms among autistic children without intellectual disability. The clash fades when you note C et al. looked at younger, narrower-IQ kids and used a broad symptom checklist. Ludivine's wider age mix and gender-specific questions simply picked up what the other design missed.
Why it matters
If you assess or treat autistic girls, add a quick gender-stress probe to your intake. Ask about clothing choices, haircuts, and puberty worry. Early talk can lower later crisis risk and shows the client you see the whole person.
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02At a glance
03Original abstract
A growing body of evidence supports a potential link between autism spectrum disorder (ASD) and gender dysphoria, yet few studies have looked at sex differences in the co-occurrence of gender diversity and ASD. The aim of this study was to characterize sex differences in gender-diverse expressions and identities, as well as gender-related concerns, in youth with ASD. Parents of youth with ASD ages 6-21 (n = 163) completed an online questionnaire about their child's gender expression and identity. Sex-typed behaviors during childhood were measured using the Gender Identity Questionnaire (GIQ). Semi-partial Kendall correlations and chi-square tests were used to compare gender non-conformity, gender-diverse identities, and gender-related concerns between sexes. Sex-based differences in mean GIQ score and individual GIQ items were evaluated using a linear regression and semi-partial Kendall correlations, respectively. All regressions and correlations controlled for child age. Parents of girls were more likely to report child appearances and mannerisms that were less concordant with their child's birth sex. Based on parent-report, girls had lower mean GIQ scores, indicating greater cross-gendered/fewer same-gendered behaviors in childhood. Lastly, parents of girls with ASD were more likely to report that their daughters experienced anxiety due to gender-related concerns and discomfort during puberty than parents of boys. These findings suggest that girls with ASD seem more likely have gender-diverse preferences, mannerisms, and appearances that fall outside of traditional gender norms. Gender-related concerns appear to be a source of real distress in girls with ASD, highlighting the need for individualized support, especially during puberty. LAY SUMMARY: Despite evidence of a potential link between autism and gender diversity, few studies have explored differences in gender identity/expression between boys and girls with autism. Based on parent responses, we found that girls with autism are more likely than boys to have appearances and mannerisms, as well as behaviors during childhood, that fall outside of the traditional gender role. The unique profile of girls with autism and their elevated distress over gender-related concerns call for individualized support during adolescence.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2441