Autism and gender dysphoria are linked, according to a study

A new study reveals an overlap between the two conditions that could lead to understanding both better

By Matthew Rozsa

Staff Writer

Published November 9, 2022 10:15AM (EST)

Vector of a man looking in the mirror and seeing themself as a woman (Getty Images/SIphotography)
Vector of a man looking in the mirror and seeing themself as a woman (Getty Images/SIphotography)

At first glance, it may not seem apparent that autism and gender dysphoria would be linked. Autism is a developmental disorder that, among other things, leads to difficulty with social interaction. Gender dysphoria, by contrast, involves a person experiencing mental health issues because their assigned sex does not match their gender identity. When describing autism and gender dysphoria in strictly clinical terms, they do not seem to inherently overlap.

The authors concluded that there is likely a link between autism and gender dysphoria, one that "warrants the investigation."

Yet a new study published in the Journal of Autism and Developmental Disorders reveals that — consistent with many anecdotal experiences — there is a link between autism spectrum disorder (ASD) and gender dysphoria/incongruence (GD/GI). To do this, the authors performed a meta-analysis, or a type of study that aggregates and analyzes the data from a number of individual studies. The goal is to ascertain larger trends, and in the case of the study by researchers from the University of Kent in the United Kingdom, they found that "the chances that there is not a link between ASD and GD/GI are negligible, yet the size of it needs further investigation."

"The number of publications on the suggested overlap between ASD and GD/GI has more than doubled in the last two years, reflecting the increased attention this topic has received from clinicians, researchers, as well as the lay press," the authors explain.

Yet that does not mean the research can simply be compiled and reviewed. The authors had to create clear criteria to explain how they would ascertain overlap between ASD and GD/GI, then eliminate studies which for one reason or another fell short. Ultimately they selected 47 studies including "five were conducted with children, 13 with children and adolescents, two with adolescents, two with children, adolescents, and adults, nine with adolescents and adults, and 16 with adults."

The authors arrived at three conclusions. First, they found that there is "a positive relationship between ASD traits and GD/GI feelings among people from the general population." In addition, they found that there is "an increased prevalence of GD/GI in the autistic population." Finally, they determined that there is "an increased prevalence of ASD diagnoses and ASD traits in the GD/GI population." As a result, the authors concluded that there is likely a link between autism and gender dysphoria, one that "warrants the investigation of mechanisms that could explain that link and the intensification of clinical attention to autistic GD/GI individuals."

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The authors also noted that the intersections between ASD and GD/GI are "under recognized" by large swathes of the health care community, creating an urgency for their research.

"Evidence about a link between ASD and GD/GI might stimulate the development of appropriate trainings to raise their awareness (Strauss, et al., 2021), so that GD/GI people are screened for ASD and autistic people for gender related issues (Mahfouda et al., 2019; Strang, Meagher, et al., 2018)," the authors write.

According to the American Psychiatric Association (APA), gender dysphoria is a condition in which the patient experiences "psychological distress that results from an incongruence between one's sex assigned at birth and one's gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later." Although many transgender individuals experience gender dysphoria, that is not always the case (a transgender person in a supportive environment, for example, may not experience this distress). Someone who neither has gender dysphoria nor is transgender, but rather whose gender identity aligns with their assigned sex, is known as cisgender.

This study is significant both for scientific and social justice reasons. From a scientific perspective, it clarifies early reports that children with elevated levels of ASD traits were more likely to display gender nonconforming behaviors. As the study put it regarding a survey from 2019, "The greater the number of ASD traits reported by parents in these children, the more parent-reported gender variance in these children." The new information could lead to understanding both conditions better. In addition, the study is socially significant because it further elucidates how both ASD and GD/GI are clinically diagnosable and legitimate medical conditions, despite the claims of many naysayers. The skepticism and misunderstanding surrounding these conditions often leads to persecution.

"The number of publications on the suggested overlap between ASD and GD/GI has more than doubled in the last two years."

Despite this, transphobia is still widely used among conservative politicians and remains an issue within the general public. Homicides against transgender people nearly doubled between 2017 and 2021. Politicians like Florida Gov. Ron DeSantis, a Republican, have vilified transgender people as part of their political brand. Popular comedians like Dave Chappelle regularly target transgender people in their material.

"In a recent study conducted by the Southern Poverty Law Center and Tulchin Research to examine the extent to which the extremist beliefs and narratives that mobilize the hard right have been absorbed by the wider American public, we found concerning trends with regards to anti-LGBTQ sentiments," the Southern Poverty Law Center (SPLC) told Salon. "In the study, the 1,500 respondents were asked if they believe 'gender ideology has corrupted American culture.' The term 'gender ideology' is widespread on the right, and generally refers to a belief that LGBTQ people are a threat to children and families and that men and women should adhere to 'traditional' notions of masculinity and femininity."

People with autism also face unique challenges. Autistic individuals are more likely to be mistreated in education, face hostility and bias by both the judicial system and law enforcement, and struggle to both obtain and maintain employment. Like transgender individuals, autistic people often face skepticism and even outright denial about the realities of their experiences. Additionally, just as there is a spectrum of sex and gender identities, there is also a wide spectrum of ways in which people process reality through their neurology. This latter concept is referred to as neurodiversity.

As Harvard Health put it, "Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one 'right' way of thinking, learning, and behaving, and differences are not viewed as deficits."

By Matthew Rozsa

Matthew Rozsa is a staff writer at Salon. He received a Master's Degree in History from Rutgers-Newark in 2012 and was awarded a science journalism fellowship from the Metcalf Institute in 2022.

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Autism Autism Spectrum Disorder Furthering Gender Dysphoria Gender Incongruence Transgender