Archives of Sexual Behavior

, Volume 43, Issue 2, pp 387–393 | Cite as

Traits of Autism Spectrum Disorders in Adults with Gender Dysphoria

  • Vickie PasterskiEmail author
  • Liam Gilligan
  • Richard Curtis
Original Paper


The literature examining the co-occurrence of gender dysphoria (GD) and autistic traits has so far been limited to a series of small case studies and two systematic studies, one looking at autistic traits in gender dysphoric children and the other set within the context of the extreme male brain hypothesis and looking at adults. The current study examined this co-occurrence of GD and autistic traits in an adult population, to see whether this heightened prevalence persisted from childhood as well as to provide further comparison of MtF versus FtM transsexuals and homosexual versus nonhomosexual individuals. Using the Autistic Spectrum Quotient (AQ), 91 GD adults (63 male-to-female [MtF] and 28 female-to-male [FtM]) undertaking treatment at a gender clinic completed the AQ. The prevalence of autistic traits consistent with a clinical diagnosis for an autism spectrum disorder (ASD) was 5.5 % (n = 3 MtF and n = 2 FtM) compared to reports of clinical diagnoses of 0.5–2.0 % in the general population. In contrast to the single previous report in adults, there was no significant difference between MtF and FtM on AQ scores; however, all of those who scored above the clinical cut-off were classified as nonhomosexual with respect to natal sex. Results were considered in the context of emerging theories for the observed co-occurrence of GD and autistic traits.


Autism spectrum disorder Asperger’s Disorder Comorbidity Gender dysphoria Transsexualism 



This research was supported by the UK Gender Identity Research and Education Society (GIRES).


  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
  2. Auyeung, B., Baron-Cohen, S., Ashwin, E., Knickmeyer, R., Taylor, K., Hackett, G., & Hines, M. (2009). Fetal testosterone predicts sexually differentiated childhood behaviour in girls and in boys. Psychological Science, 20, 144–148.Google Scholar
  3. Baron-Cohen, S. (2002). The extreme male brain theory of autism. Trends in Cognitive Sciences, 6, 248–254.CrossRefPubMedGoogle Scholar
  4. Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism Spectrum Quotient (AQ): Evidence from Asperger syndrome/high functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31, 5–17.CrossRefPubMedGoogle Scholar
  5. Blanchard, R. (1985). Typology of male-to-female transsexualism. Archives of Sexual Behavior, 14, 247–261.CrossRefPubMedGoogle Scholar
  6. Blanchard, R. (1988). Nonhomosexual gender dysphoria. Journal of Sex Research, 24, 188–193.CrossRefPubMedGoogle Scholar
  7. Blumberg, S. J., Bramlet, M. D., Kogan, M. D., Schieve, L. A., Jones, J. R., & Lu, M. C. (2013). Changes in prevalence of parent-reported autism spectrum disorder in school-aged U.S. children: 2007–2012. National Health Statistics Reports, 65, 1–11.PubMedGoogle Scholar
  8. 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, 930–936.PubMedCentralCrossRefPubMedGoogle Scholar
  9. Fombonne, E. (2005). Epidemiology of autistic disorder and other pervasive developmental disorders. Journal of Clinical Psychiatry, 66(Suppl. 10), 3–8.PubMedGoogle Scholar
  10. Gallucci, G., Hackerman, F., & Schmidt, C. W. (2005). Gender identity disorder in an adult male with Asperger syndrome. Sexuality and Disability, 23, 35–40.CrossRefGoogle Scholar
  11. Hines, M., Brook, C., & Conway, G. S. (2004). Androgen and psychosexual development: Core gender identity, sexual orientation, and recalled childhood gender role behavior in women and men with congenital adrenal hyperplasia (CAH). Journal of Sex Research, 41, 75–81.CrossRefPubMedGoogle Scholar
  12. Howlin, P., Mawhood, L., & Rutter, M. (2000). Autism and developmental receptive language Disorder—A follow-up comparison in early adult life. II: Social, behavioural and psychiatric outcomes. Journal of Child Psychology and Psychiatry, 41, 561–578.CrossRefPubMedGoogle Scholar
  13. Jones, R. M., Wheelwright, S., Farrell, K., Martin, E., Green, R., Di Ceglie, D., & Baron-Cohen, S. (2012). Female-to-male transsexual people and autistic traits. Journal of Autism and Developmental Disorders, 42, 301–306.Google Scholar
  14. Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia: W. B. Saunders.Google Scholar
  15. Knickmeyer, R., Baron-Cohen, S., Fane, B. A., Wheelwright, S., Matthews, G. A., Conway, G. S., et al. (2006). Androgens and autistic traits: A study of individuals with congenital adrenal hyperplasia. Hormones and Behavior, 50, 148–153.CrossRefPubMedGoogle Scholar
  16. Kraemer, B., Delsignore, A., Gundelfinger, R., Schnyder, U., & Hepp, U. (2005). Comorbidity of Asperger syndrome and gender identity disorder. European Child and Adolescent Psychiatry, 14, 292–296.CrossRefPubMedGoogle Scholar
  17. Landén, M., & Rasmussen, P. (1997). Gender identity disorder in a girl with autism—A case report. European Child and Adolescent Psychiatry, 6, 170–173.CrossRefPubMedGoogle Scholar
  18. Lawrence, A. A. (2010). Sexual orientation versus age of onset as bases for typologies (subtypes) for gender identity disorder in adolescents and adults. Archives of Sexual Behavior, 39, 514–545.CrossRefPubMedGoogle Scholar
  19. Mukaddes, N. M. (2002). Gender identity problems in autistic children. Child: Care, Health and Development, 28, 529–532.Google Scholar
  20. Pasterski, V., Golombok, S., & Hines, M. (2011) Sex differences in social behaviour. In P. Smith & C. Hart (Eds.), Blackwell handbook of childhood social development (2nd ed.) (pp. 117–136). Oxford: Blackwell.Google Scholar
  21. Perera, H., Gadambanathan, T., & Weerasiri, S. (2003). Gender identity disorder presenting in a girl with Asperger’s disorder and obsessive compulsive disorder. Ceylon Medical Journal, 48, 57–58.PubMedGoogle Scholar
  22. Robinow, O., & Knudson, G. A. (2005, April). Asperger’s disorder and GID. Paper presented at the meeting of the Harry Benjamin International Gender Dysphoria Association, Bologna, Italy.Google Scholar
  23. Smith, Y. L. S., van Goozen, S. H. M., Kuiper, A. J., & Cohen-Kettenis, P. T. (2005). Transsexual subtypes: Clinical and theoretical significance. Psychiatry Research, 137, 151–160.CrossRefPubMedGoogle Scholar
  24. Tateno, M., Ikeda, J., & Saito, T. (2011). Gender dysphoria in pervasive developmental disorders. Shishin Shinkeigaku Zasshi, 113, 1173–1183.Google Scholar
  25. Tateno, M., Tateno, Y., & Saito, T. (2008). Comorbid childhood gender identity disorder in a boy with Asperger syndrome. Psychiatry and Clinical Neurosciences, 62, 238.CrossRefPubMedGoogle Scholar
  26. Williams, P. G., Allard, A. M., & Sears, L. (1996). Case study: Cross-gender preoccupations with two male children with autism. Journal of Autism and Developmental Disorders, 26, 635–642.CrossRefPubMedGoogle Scholar
  27. Woodbury-Smith, M., Robinson, J., & Baron-Cohen, S. (2005). Screening adults for Asperger syndrome using the AQ: Diagnostic validity in clinical practice. Journal of Autism and Developmental Disorders, 35, 331–335.CrossRefPubMedGoogle Scholar
  28. Zucker, K. J., & Lawrence, A. A. (2009). Epidemiology of gender identity disorder: Recommendations for the Standards of Care of the World Professional Association for Transgender Health. International Journal of Transgenderism, 11, 8–18.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Vickie Pasterski
    • 1
    Email author
  • Liam Gilligan
    • 2
  • Richard Curtis
    • 3
  1. 1.Department of PsychologyNew Museum SiteCambridgeUK
  2. 2.Department of Psychological SciencesUniversity of East AngliaNorwichUK
  3. 3.Transhealth, Gender ClinicLondonUK

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