Abstract
Prior research has shown an elevation in autism traits and diagnoses in individuals seen for gender related consultation and in participants self-identifying as transgender. To investigate this relationship between autism and gender identity from a new angle, we compared the self-reported autism traits and sensory differences between participants with autism who did or did not identify with their assigned sex (i.e. cisgender or trans and non-binary, respectively). We found broad elevation of most cognitive autism traits in the trans and non-binary group (those who identified with a gender other than their assigned gender), and lower visual and auditory hypersensitivity. We contrast these data to existing hypotheses and propose a role for autistic resistance to social conditioning.
Notes
Kuyper and Wijsen (2014) used the terms “ambivalent” and “incongruent”. We interpret both of these for inclusion in comparison to our trans participants, and “ambivalent” (defined as equal or greater identification with the sex not assigned at birth than the sex assigned at birth) for inclusion in comparison to our nonbinary participants.
Corbett et al. (2009) argue that the desire for routine may be driven by the anxiety that the unpredictability of social environments can cause. Therefore, it seems likely that this is suppressed relative to overall AQ scores in our sample because those individuals with the highest scores may also be those least likely to ‘come out’ or acknowledge their atypical gender identities.
References
Adams, N., Pearce, R., Veale, J., Radix, A., Castro, D., Sarkar, A., & Thom, K. C. (2017). ‘Guidance and Ethical Considerations for Undertaking Transgender Health Research and Institutional Review Boards Adjudicating this Research’. Article accepted for publication in Transgender Health.
ADDM CDC. (2012). Prevalence of autism spectrum disorders-Autism and Developmental Disabilities Monitoring Network, 14 sites, United States. MMWR Surveillance Summaries, 61, 1–19.
Ansara, Y. G., & Hegarty, P. (2011). Cisgenderism in psychology: Pathologising and misgendering children from 1999 to 2008. Psychology and Sexuality, 3(2), 137–160. https://doi.org/10.1080/19419899.2011.576696.
Auyeung, B., Wheelwright, S., Allison, C., Atkinson, M., Samarawickrema, N., & Baron-Cohen, S. (2009). The children’s empathy quotient and systemizing quotient: Sex differences in typical development and in autism spectrum conditions. Journal of Autism and Developmental Disorders, 39(11), 1509–1521. https://doi.org/10.1007/s10803-009-0772-x.
Baron-Cohen, S. (2002). Is Asperger syndrome necessarily viewed as a disability? Focus on Autism and Other Developmental Disabilities, 17(3), 186–191. https://doi.org/10.1177/10883576020170030801.
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism spectrum quotient : Evidence from Asperger syndrome/high functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17. https://doi.org/10.1023/A:1005653411471.
Berenbaum, S. A., & Bailey, J. M. (2003). Effects on gender identity of prenatal androgens and genital appearance: Evidence from girls with congenital adrenal hyperplasia. The Journal of Clinical Endocrinology & Metabolism, 88(3), 1102–1106. https://doi.org/10.1210/jc.2002-020782.
Bird, G., Leighton, J., Press, C., & Heyes, C. (2007). Intact automatic imitation of human and robot actions in autism spectrum disorders. Proceedings of the Royal Society B, 274(1628), 3027–3031. https://doi.org/10.1098/rspb.2007.1019.
Burke, S. M., Cohen-Kettenis, P. T., Veltman, D. J., Klink, D. T., & Bakker, J. (2014). Hypothalamic response to the chemo-signal androstadienone in gender dysphoric children and adolescents. Frontiers in Endocrinology, 5, 60. https://doi.org/10.3389/fendo.2014.00060.
Cage, E., Pellicano, E., Shah, P., & Bird, G. (2013). Reputation management: Evidence for ability but reduced propensity in autism. Autism Research, 6(5), 433–442. https://doi.org/10.1002/aur.1313.
Corbett, B. A., Schupp, C. W., Levine, S., & Mendoza, S. (2009). Comparing cortisol, stress, and sensory sensitivity in children with autism. Autism Research, 2(1), 39–49. https://doi.org/10.1002/aur.64.
de Vries, A. L. C., Noens, I. L. J., Cohen-Kettenis, P. T., van Berckelaer-Onnes, I. A., & Doreleijers, T. A. (2010). Autism spectrum disorders in gender dysphoric children and adolescents. Journal of Autism and Developmental Disorders, 40(8), 930–936. https://doi.org/10.1007/s10803-010-0935-9.
Dewinter, J., De Graaf, H., & Begeer, S. (2017). Sexual orientation, gender identity, and romantic relationships in adolescents and adults with autism spectrum disorder. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-017-3199-9.
Dhejne, C., Van Vlerken, R., Heylens, G., & Arcelus, J. (2016). Mental health and gender dysphoria: A review of the literature. International Review of Psychiatry, 28(1), 44–57. https://doi.org/10.3109/09540261.2015.1115753.
Edmiston, E. K. (2018). The problem with transgender neuroimaging studies [Twitter moment]. Retrieved from https://twitter.com/i/moments/1012368198069571584.
Elsabbagh, M., Divan, G., Koh, Y.-J., Kim, Y. S., Kauchali, S., Marcín, C., … Fombonne, E. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism Research, 5(3), 160–179. https://doi.org/10.1002/aur.239.
Feusner, J. D., Lidström, A., Moody, T. D., Dhejne, C., Bookheimer, S. Y., & Savic, I. (2017). Intrinsic network connectivity and own body perception in gender dysphoria. Brain Imaging and Behavior, 11(4), 964–976. https://doi.org/10.1007/s11682-016-9578-6.
Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Pediatric Research, 65(6), 591–598. https://doi.org/10.1203/PDR.0b013e31819e7203.
Gaigg, S. B., Cornell, A. S., & Bird, G. (2016). The psychophysiological mechanisms of alexithymia in autism spectrum disorder. Autism. https://doi.org/10.1177/1362361316667062.
Gallup. (2018). In U.S., estimate of LGBT population rises to 4.5%. Retrieved from https://news.gallup.com/poll/234863/estimate-lgbt-population-rises.aspx.
George, R., & Stokes, M. A. (2018). A quantitative analysis of mental health among sexual and gender minority groups in ASD. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-018-3469-1.
Golan, O., & Baron-Cohen, S. (2006). Systemizing empathy: Teaching adults with asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia. Development and Psychopathology, 18(2), 591–617. https://doi.org/10.1017/S0954579406060305.
Hahn, A., Kranz, G. S., Küblböck, M., Kaufmann, U., Ganger, S., Hummer, A., … Lanzenberger, R. (2015). Structural connectivity networks of transgender people. Cerebral Cortex, 25(10), 3527–3534. https://doi.org/10.1093/cercor/bhu194.
Hoekstra, R. A., Vinkhuyzen, A. A. E., Wheelwright, S., Bartels, M., Boomsma, D. I., Baron-Cohen, S., … Van Der Sluis, S. (2011). The construction and validation of an abridged version of the autism-spectrum quotient (AQ-short). Journal of Autism and Developmental Disorders, 41(5), 589–596. https://doi.org/10.1007/s10803-010-1073-0.
Huang, A. X., Hughes, T. L., Sutton, L. R., Lawrence, M., Chen, X., Ji, Z., & Zeleke, W. (2017). Understanding the self in individuals with autism spectrum disorders (ASD): A review of literature. Frontiers in Psychology, 8, 1422. https://doi.org/10.3389/fpsyg.2017.01422.
Jacobs, L. A., Rachlin, K., Erickson-Schroth, L., & Janssen, A. (2014). Gender dysphoria and co-occurring autism spectrum disorders: Review, case examples, and treatment considerations. LGBT Health, 1(4), 277–282. https://doi.org/10.1089/lgbt.2013.0045.
Jones, R. M., Wheelwright, S., Farrell, K., Martin, E., Green, R., Di Ceglie, D., … Baron-Cohen, S. (2012). Brief report: Female-to-male transsexual people and autistic traits. Journal of Autism and Developmental Disorders, 42(2), 301–306. https://doi.org/10.1007/s10803-011-1227-8.
Knickmeyer, R., Baron-Cohen, S., Fane, B. A., Wheelwright, S., Mathews, G. A., Conway, G. S., … Hines, M. (2006). Androgens and autistic traits: A study of individuals with congenital adrenal hyperplasia. Hormones and Behavior, 50(1), 148–153. https://doi.org/10.1016/J.YHBEH.2006.02.006.
Kristensen, Z. E., & Broome, M. R. (2016). Autistic traits in an internet sample of gender variant UK Adults. International Journal of Transgenderism, 2739(July), 234–245. https://doi.org/10.1080/15532739.2015.1094436.
Kruijver, F. P. M., Zhou, J.-N., Pool, C. W., Hofman, M. A., Gooren, L. J. G., & Swaab, D. F. (2000). Male-to-female transsexuals have female neuron numbers in a limbic nucleus. The Journal of Clinical Endocrinology & Metabolism, 85(5), 2034–2041. https://doi.org/10.1210/jcem.85.5.6564.
Kuyper, L., & Wijsen, C. (2014). Gender identities and gender dysphoria in the Netherlands. Archives of Sexual Behavior, 43(2), 377–385. https://doi.org/10.1007/s10508-013-0140-y.
Lecavalier, L. (2006). Behavioral and emotional problems in young people with pervasive developmental disorders: Relative prevalence, effects of subject characteristics, and empirical classification. Journal of Autism and Developmental Disorders, 36(8), 1101–1114. https://doi.org/10.1007/s10803-006-0147-5.
Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 466–474. https://doi.org/10.1016/j.jaac.2017.03.013.
Losin, E. A. R., Iacoboni, M., Martin, A., & Dapretto, M. (2012). Own-gender imitation activates the brain’s reward circuitry. Social Cognitive and Affective Neuroscience, 7(7), 804–810. https://doi.org/10.1093/scan/nsr055.
Luders, E., Sánchez, F. J., Tosun, D., Shattuck, D. W., Gaser, C., Vilain, E., & Toga, A. W. (2012). Increased cortical thickness in male-to-female transsexualism. Journal of Behavioral and Brain Science, 2(3), 357–362. https://doi.org/10.4236/jbbs.2012.23040.
Lyons, K. (2016). Gender identity clinic services under strain as referral rates soar. The Guardian. London. Retrieved from https://www.theguardian.com/society/2016/jul/10/transgender-clinic-waiting-times-patient-numbers-soar-gender-identity-services.
Manzouri, A., Kosidou, K., & Savic, I. (2015). Anatomical and functional findings in female-to-male transsexuals: Testing a new hypothesis. Cerebral Cortex, 27(2), bhv278. https://doi.org/10.1093/cercor/bhv278.
Mazefsky, C. A., Herrington, J., Siegel, M., Scarpa, A., Maddox, B. B., Scahill, L., & White, S. W. (2013). The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 52(7), 679–688. https://doi.org/10.1016/j.jaac.2013.05.006.
Pasterski, V., Gilligan, L., & Curtis, R. (2014). Traits of autism spectrum disorders in adults with gender dysphoria. Archives of Sexual Behavior, 43(2), 387–393. https://doi.org/10.1007/s10508-013-0154-5.
Pellicano, E., & Burr, D. (2012). When the world becomes “too real”: A Bayesian explanation of autistic perception. Trends in Cognitive Sciences, 16(10), 504–510. https://doi.org/10.1016/j.tics.2012.08.009.
Rabany, L., Diefenbach, G. J., Bragdon, L. B., Pittman, B. P., Zertuche, L., Tolin, D. F., … Assaf, M. (2017). Resting-state functional connectivity in generalized anxiety disorder and social anxiety disorder: Evidence for a dimensional approach. Brain Connectivity, 7(5), 289–298. https://doi.org/10.1089/brain.2017.0497.
Ramachandran, V. S., & McGeoch, P. D. (2007). Occurrence of phantom genitalia after gender reassignment surgery. Medical Hypotheses, 69, 1001–1003.
Ramachandran, V. S., & McGeoch, P. D. (2008). Phantom penises in transsexuals. Journal of Consciousness Studies, 15(1), 5–16.
Reed, B., Rhodes, S., Schofield, P., & Wylie, K. (2009). Gender variance in the UK: Prevalence, incidence, growth and geographic distribution. London. Retrieved from http://xa.yimg.com/kq/groups/17851560/542410794/name/GenderVarianceUK-report.pdf.
Rudolph, C. E. S., Lundin, A., Åhs, J. W., Dalman, C., & Kosidou, K. (2017). Brief report: Sexual orientation in individuals with autistic traits: Population based study of 47,000 adults in Stockholm County. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-017-3369-9.
Sanborn, A. N., & Chater, N. (2016). Bayesian brains without probabilities. Trends in Cognitive Sciences, 20(12), 883–893. https://doi.org/10.1016/j.tics.2016.10.003.
Skagerberg, E., Di Ceglie, D., & Carmichael, P. (2015). Brief report: Autistic features in children and adolescents with gender dysphoria. Journal of Autism and Developmental Disorders, 45(8), 2628–2632. https://doi.org/10.1007/s10803-015-2413-x.
Swaab, D. F. (2004). Sexual differentiation of the human brain: Relevance for gender identity, transsexualism and sexual orientation. Gynecological Endocrinology, 19(6), 301–312. https://doi.org/10.1080/09513590400018231.
Tate, C. C., Ledbetter, J. N., & Youssef, C. P. (2013). A two-question method for assessing gender categories in the social and medical sciences. Journal of Sex Research, 50(8), 767–776. https://doi.org/10.1080/00224499.2012.690110.
Tavassoli, T., Hoekstra, R. A., & Baron-Cohen, S. (2014). The Sensory perception quotient (SPQ): Development and validation of a new sensory questionnaire for adults with and without autism. Molecular Autism, 5(1), 29. https://doi.org/10.1186/2040-2392-5-29.
Werling, D. M., & Geschwind, D. H. (2013). Understanding sex bias in autism spectrum disorder. Proceedings of the National Academy of Sciences of the United States of America, 110(13), 4868–4869. https://doi.org/10.1073/pnas.1301602110.
Williams, P. G., Allard, A., & Sears, L. (1996). Case study: Cross-gender preoccupations in two male children with autism. Journal of Autism and Developmental Disorders, 26(6), 635–642. https://doi.org/10.1007/BF02172352.
Yang, M.-F., Manning, D., van den Berg, J. J., & Operario, D. (2015). Stigmatization and mental health in a diverse sample of transgender women. LGBT Health, 2(4), 306–312. https://doi.org/10.1089/lgbt.2014.0106.
Zhou, J. N., Hofman, M. A., Gooren, L. J. G., & Swaab, D. F. (1995). A sex difference in the human brain and its relation to transsexuality. Nature, 378, 68–70.
Zubiaurre-Elorza, L., Junque, C., Gomez-Gil, E., Segovia, S., Carrillo, B., Rametti, G., & Guillamon, A. (2013). Cortical thickness in untreated transsexuals. Cerebral Cortex, 23(12), 2855–2862. https://doi.org/10.1093/cercor/bhs267.
Funding
This research was funded in part by a European Research Council Consolidator Grant (Grant No. 648082).
Author information
Authors and Affiliations
Contributions
RW analysed and interpreted the data, supervised by LK and SB, assisted by JD. SB oversaw collection of the data. RW lead the writing of the manuscript with critical feedback from LK, JD and SB at every stage.
Corresponding author
Ethics declarations
Conflict of interest
Each author declares that s/he has no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research ethics committee and with the 1964 Helsinki declaration and its later amendments.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Walsh, R.J., Krabbendam, L., Dewinter, J. et al. Brief Report: Gender Identity Differences in Autistic Adults: Associations with Perceptual and Socio-cognitive Profiles. J Autism Dev Disord 48, 4070–4078 (2018). https://doi.org/10.1007/s10803-018-3702-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-018-3702-y