Brief Report: Sexual Orientation in Individuals with Autistic Traits: Population Based Study of 47,000 Adults in Stockholm County


We examined the association between autistic traits and sexual orientation in a general adult population (N = 47,356). Autistic traits were measured with the ten items Autistic Quotient questionnaire using a cut-off score of ≥ 6. Sexual orientation was assessed by self-report. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for sexual orientation categories. Participants with autistic traits were more likely to identify as bisexual (OR 1.73; 95% CI 1.01–2.9) and to feel that their sexual orientation could neither be described as hetero-, homo- nor bisexual (OR 3.05; 95% CI 2.56–3.63), compared to individuals without autistic traits. Autistic traits are associated with minority sexual orientation, and perhaps with uncertain self-identification and/or a defiance of traditional ways of categorizing sexual identity.

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  1. Allison, C., Auyeung, B., & Baron-Cohen, S. (2012). Toward brief “red flags” for autism screening: The short autism spectrum quotient and the short quantitative. Journal of the American Academy of Child and Adolescent Psychiatry, 51(2), 202–212.

    Article  PubMed  Google Scholar 

  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. 5th edn. Arlington, VA: American Psychiatric Association.

    Google Scholar 

  3. Baron-Cohen, S., Auyeung, B., Nørgaard-Pedersen, B., Hougaard, D. M., Abdallah, M. W., Melgaard, L., Cohen, A. S., Chakrabarti, B., Ruta, L., & Lombardo, M. V. (2015). Elevated fetal steroidogenic activity in autism. Molecular Psychiatry, 20, 369–376.

    Article  PubMed  Google 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(1), 5–17.

    Article  PubMed  Google Scholar 

  5. Bejerot, S., & Eriksson, J. M. (2014). Sexuality and gender role in autism spectrum disorder: A case control study. PLoS ONE, 9(1), 1–9.

    Article  Google Scholar 

  6. Booth, T., Murray, A. L., McKenzie, K., Kuenssberg, R., O’Donnell, M., & Burnett, H. (2013). Brief report: An evaluation of the AQ-10 as a brief screening instrument for ASD in adults. Journal of Autism and Developmental Disorders, 43, 2997–3000.

    Article  PubMed  Google Scholar 

  7. Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 Sites, United States, 2010. Morbidity and Mortality Weekly Report, 63(2), 1.

    Google Scholar 

  8. Charman, T. (2008). Autism spectrum disorders. Psychiatry, 7(8), 331–334.

    Article  Google Scholar 

  9. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Dewinter, J., Vermeiren, R., Vanwesenbeeck, I., Lobbestael, J., & Van Nieuwenhuizen, C. (2015). Sexuality in adolescent boys with autism spectrum disorder: Self-reported behaviours and attitudes. Journal of Autism and Developmental Disorders, 45(3), 731–741.

    Article  PubMed  Google Scholar 

  11. Gilmour, L., Schalomon, P. M., & Smith, V. (2012). Sexuality in a community based sample of adults with autism spectrum disorder. Research in Autism Spectrum Disorders, 6(1), 313–318.

    Article  Google Scholar 

  12. Hallmayer, J., Cleveland, S., Torres, A., Phillips, J., Cohen, B., Torigoe, T., et al. (2015). Genetic heritability and shared environmental factors among twin pairs with autism. Archives of General Psychiatry, 68(11), 1095–1102.

    Article  Google Scholar 

  13. Hellemans, H., Colson, K., Verbraeken, C., Vermeiren, R., & Deboutte, D. (2007). Sexual behavior in high-functioning male adolescents and young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(2), 260–269.

    Article  PubMed  Google Scholar 

  14. Hines, M. (2011). Prenatal endocrine influences on sexual orientation and on sexually differentiated childhood behavior. Frontiers in Neuroendocrinology, 32(2), 170–182.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Idring, S., Rai, D., Dal, H., Dalman, C., Sturm, H., Zander, E., et al. (2012). Autism spectrum disorders in the Stockholm youth cohort: Design, prevalence and validity. PLoS ONE, 7(7), e41280.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Joshi, G., Petty, C., Wozniak, J., Henin, A., Fried, R., Galdo, M., et al. (2010). The heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: A large comparative study of a psychiatrically referred population. Journal of Autism and Developmental Disorders, 40(11), 1361–1370.

    Article  PubMed  Google Scholar 

  17. Karlsson, C., Zander, E., & Bölte, S. (2011). The adult autism spectrum quotient (AQ)—Vuxenversionen: 16 år och äldre—Svensk version. Karolinska Institutet, Stockholm. Accessed 2 Feb 2017.

  18. Leitner, Y. (2014). The co-occurrence of autism and attention deficit hyperactivity disorder in children—What do we know? Frontiers in Human Neuroscience, 8, 1–8.

    Article  Google Scholar 

  19. Lundström, S., & Särndal, C.-E. (1999). Calibration as a standard method for treatment of nonresponse. Journal of Official Statistics, 15(2), 305–327.

    Google Scholar 

  20. Mehzabin, P., & Stokes, M. A. (2011). Self-assessed sexuality in young adults with high-functioning autism. Research in Autism Spectrum Disorders, 5, 614–621.

    Article  Google Scholar 

  21. Meilleur, A.-A. S., Jelenic, P., & &Mottron, L. (2015). Prevalence of clinically and empirically defined talents and strengths in autism. Journal of Autism and Developmental Disorders, 45(5), 1354–1367.

    Article  PubMed  Google Scholar 

  22. Murray, A. L., Allison, C., Smith, P. L., Baron-Cohen, S., Booth, T., & Auyeung, B. (2017). Investigating diagnostic bias in autism spectrum conditions: An item response theory analysis if sex bias in the AQ-10. Autism Research, 10, 790–800.

    Article  PubMed  Google Scholar 

  23. Ronald, A., & Hoekstra, R. A. (2011). Autism spectrum disorders and autistic traits: A decade of new twin studies. American Journal of Medical Genetics B, 156B, 255–274.

    Article  Google Scholar 

  24. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929.

    Article  PubMed  Google Scholar 

  25. Strang, J. F., Kenworthy, L., Dominska, A., Sokoloff, J., Kenealy, L. E., Berl, M., et al. (2014). Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Archives of Sexual Behavior, 43(8), 1525–1533.

    Article  PubMed  Google Scholar 

  26. Strang, J. F., Meagher, H., Kenworthy, L., de Vries, A. L. C., Menvielle, E., Leibowitz, S., et al. (2016). Initial clinical guidelines for co-occurring autism spectrum disorder and gender dysphoria or incongruence in adolescents. Journal of Clinical Child & Adolescent Psychology, 00(00), 1–11.

    Google Scholar 

  27. Svensson, A. C., Fredlund, P., Laflamme, L., Hallqvist, J., Alfredsson, L., Ekbom, A., et al. (2013). Cohort profile: The stockholm public health cohort. International Journal of Epidemiology, 42(5), 1263–1272.

    Article  PubMed  Google Scholar 

  28. Van Der Miesen, A. I. R., Hurley, H., & De Vries, A. L. C. (2016). Gender dysphoria and autism spectrum disorder: A narrative review. International Review of Psychiatry, 28(1), 70–80.

    Article  Google Scholar 

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We thank Henrik Dal for his kind help with data management and statistical analyses.


This work was supported by the Stockholm County Council and the Swedish Research Council (Grant # 2012–2264) (CD, KK) and the German Academic Exchange Service (Scholarship-ID # 57098520) (CR). The data linkages and staff costs have also been supported by grants from the Stockholm County Council (Grant # 2007008); Swedish Council for Working Life and Social Research (Grant # 2007–2064) (AL); Swedish Research Council (Grant # 523-2010-1052) (CD); and Swedish Regional agreement on medical training and clinical research (KK, JÅ).

Author Contributions

CESR contributed to the design of the study, conducted the analyses, interpreted the data and drafted the manuscript. AL assisted in statistical analyses, contributed to the interpretation of data and critically revised the manuscript. JWÅ contributed with intellectual input to the study and interpretation of data and critically revised the manuscript. CD contributed to the acquisition of data and critically revised the manuscript. KK conceived the idea for the study, together with CESR designed the study, contributed to the interpretation of data, supervised analyses and critically revised the manuscript. All authors read and approved the final manuscript.

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Corresponding author

Correspondence to Christiane E. S. Rudolph.

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Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments and comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Rudolph, C.E.S., Lundin, A., Åhs, J.W. et al. Brief Report: Sexual Orientation in Individuals with Autistic Traits: Population Based Study of 47,000 Adults in Stockholm County. J Autism Dev Disord 48, 619–624 (2018).

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  • AQ-10
  • Epidemiology
  • Sexual orientation
  • Homosexuality
  • Bisexuality