Original Paper

Archives of Sexual Behavior

, Volume 43, Issue 8, pp 1525-1533

Increased Gender Variance in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder

  • John F. StrangAffiliated withCenter for Autism Spectrum Disorders, Children’s National Medical Center Email author 
  • , Lauren KenworthyAffiliated withCenter for Autism Spectrum Disorders, Children’s National Medical Center
  • , Aleksandra DominskaAffiliated withDivision of Neuropsychology, Children’s National Medical Center
  • , Jennifer SokoloffAffiliated withCenter for Autism Spectrum Disorders, Children’s National Medical Center
  • , Laura E. KenealyAffiliated withDivision of Neuropsychology, Children’s National Medical Center
  • , Madison BerlAffiliated withDivision of Neuropsychology, Children’s National Medical Center
  • , Karin WalshAffiliated withDivision of Neuropsychology, Children’s National Medical Center
  • , Edgardo MenvielleAffiliated withDepartment of Psychiatry, Children’s National Medical Center
  • , Graciela Slesaransky-PoeAffiliated withSchool of Education, Arcadia University
    • , Kyung-Eun KimAffiliated withDepartment of Psychiatry, Children’s National Medical Center
    • , Caroline Luong-TranAffiliated withCenter for Autism Spectrum Disorders, Children’s National Medical Center
    • , Haley MeagherAffiliated withCenter for Autism Spectrum Disorders, Children’s National Medical Center
    • , Gregory L. WallaceAffiliated withLaboratory of Brain and Cognition, National Institute of Mental Health

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Abstract

Evidence suggests over-representation of autism spectrum disorders (ASDs) and behavioral difficulties among people referred for gender issues, but rates of the wish to be the other gender (gender variance) among different neurodevelopmental disorders are unknown. This chart review study explored rates of gender variance as reported by parents on the Child Behavior Checklist (CBCL) in children with different neurodevelopmental disorders: ASD (N = 147, 24 females and 123 males), attention deficit hyperactivity disorder (ADHD; N = 126, 38 females and 88 males), or a medical neurodevelopmental disorder (N = 116, 57 females and 59 males), were compared with two non-referred groups [control sample (N = 165, 61 females and 104 males) and non-referred participants in the CBCL standardization sample (N = 1,605, 754 females and 851 males)]. Significantly greater proportions of participants with ASD (5.4 %) or ADHD (4.8 %) had parent reported gender variance than in the combined medical group (1.7 %) or non-referred comparison groups (0–0.7 %). As compared to non-referred comparisons, participants with ASD were 7.59 times more likely to express gender variance; participants with ADHD were 6.64 times more likely to express gender variance. The medical neurodevelopmental disorder group did not differ from non-referred samples in likelihood to express gender variance. Gender variance was related to elevated emotional symptoms in ADHD, but not in ASD. After accounting for sex ratio differences between the neurodevelopmental disorder and non-referred comparison groups, gender variance occurred equally in females and males.

Keywords

Gender variance Gender identity Autism Attention deficit hyperactivity disorder Gender dysphoria