Gender-Identity in High-Functioning Individuals with Autism Spectrum Disorder

Background:  Clinical impressions indicate that within the Autism Spectrum Disorder (ASD) population that there is an overrepresentation of gender-dysphoria. However, little is presently known about the demographics of gender-identity issues in ASD.

Objectives:  We hypothesized that there would be an increased prevalence of gender-dysphoria among those with ASD when compared to a typically developing (TD) population.

Methods:  We surveyed gender-dysphoria with the Gender Identity and Gender Dysphoria Questionnaire in an international sample of individuals with ASD (N= 309, M=90, F= 219), aged (M=32.30 years, SD=11.93) and compared these rates to those of typically-developing individuals (N=261, M= 103, F= 158), aged (M=29.82 years, SD=11.85).

Results:  When compared to TD individuals, individuals with ASD reported increased gender diversity (χ2= 34.06, p< 0.001, φ=0.25). Furthermore, individuals with ASD reported a higher number of gender-dysphoric traits (t₍₅₆₉₎ =8.6, p< 0.001, d= 0.73). Rates of GD in the group with ASD were significantly higher than reported in the wider population (OR=304.91, p<0.001). Relative to TD individuals, individuals with ASD prioritized personality aspects over gender in their romantic partner (χ²= 52.48, p< 0.001, φ=0.56), expressed an androgynous self-concept (χ²= 22.99, p< 0.001, φ=0.50) and reported gender as being unimportant to personal identity (χ2= 101.07, p< 0.001, φ=0.78). The ASD group reported poorer mental health than controls and belonging to a sexual or gender-diverse group worsened this effect.

Conclusions:  Results suggest that ASD presents unique challenges to the formation and consolidation of gender identity. It is important that clinicians working with ASD are aware of the gender-diversity in this population, so that the necessary support for healthy socio-sexual functioning and mental well-being is provided.