Sexual Orientation and Gender-Identity in High-Functioning Individuals with Autism Spectrum Disorder
Clinical impressions indicate a sexual profile within the Autism Spectrum Disorder (ASD) population unlike that seen in the general population that is suggestive of a wide range of sexual orientations and an overrepresentation of gender-dysphoria.
We hypothesized that there would be an increased prevalence of non-heterosexual orientations and increased gender dysphoria.
We surveyed sexual orientations with the Sell Scale of Sexual Orientation, and gender-dysphoric symptomology with the Gender Identity and Dysphoria Questionnaire, in an international sample of individuals with ASD (N = 159, M=50, F = 109), aged (M=31.8 years, SD=12.2) and compared these rates to those of typically-developing individuals (N =242, M = 63, F= 179), aged (M=27.2 years, SD=10.2).
When compared to controls, individuals with ASD demonstrated significantly higher sexual diversity, reported gender-identities incongruent with their biological sex, and higher gender-dysphoric symptomatology. Females with ASD reported higher rates of homosexuality and bisexuality than males with ASD, and higher rates of gender-dysphoric symptomatology. When compared to heterosexual and gender-normative ASD individuals, ASD persons with a minority sexual orientation who reported gender deviance were more likely to have lower levels of education; report the gender of their romantic partner as not important; reported being on sex-hormone replacement therapy; experienced better friendship quality and higher social satisfaction with peers of the opposite-sex than with the same-sex during their schooling years; reported lower levels of personal well-being, and higher rates of depression, anxiety and stress. Overall, individuals who identified with a minority sexual orientation and reported gender-identity deviance demonstrated a higher loading of ASD traits.
Individuals with ASD may be ambivalent about gender, which could be related to autistic-type cognition/behaviors and social experiences. Higher rates of homosexuality, bisexuality and gender-dysphoria among females in the sample with ASD may be partially supported by the fetal-testosterone theory of autism. These may be some of the factors underlying the high prevalence of minority sexual orientations among those with ASD.