Potentially Reversible Social Deficits Among Transgender Youth

Abstract

Recently, there has been increased attention to a putative relationship between Autism Spectrum Disorder (ASD) and gender dysphoria, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) diagnosis for those whose gender assigned at birth does not match their gender identity. Studies have shown an over-representation of ASD symptoms among transgender youth. These studies, however, have used scales that are non-specific for ASD. These ASD symptoms may represent social deficits that are secondary to social stress and deprivation, as transgender youth suffer high rates of peer and family rejection. These social deficits may not represent true ASD and may be reversible as patients are affirmed in their gender identities and social stress is reduced.

This is a preview of subscription content, log in to check access.

References

  1. Clark, T. C., et al. (2014). The health and well-being of transgender high school students: Results from the New Zealand adolescent health survey (Youth’12). The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 55, 93–99. https://doi.org/10.1016/j.jadohealth.2013.11.008.

    Article  Google Scholar 

  2. de Vries, A. L., Kreukels, B. P., Steensma, T. D., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2011). Comparing adult and adolescent transsexuals: An MMPI-2 and MMPI-A study. Psychiatry Research, 186, 414–418. https://doi.org/10.1016/j.psychres.2010.07.033.

    Article  PubMed  Google Scholar 

  3. de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134, 696–704. https://doi.org/10.1542/peds.2013-2958.

    Article  PubMed  Google Scholar 

  4. de Vries, A. L., Noens, I. L., 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. https://doi.org/10.1007/s10803-010-0935-9.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Durwood, L., McLaughlin, K. A., & Olson, K. R. (2017). Mental health and self-worth in socially transitioned transgender youth. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 116–123. https://doi.org/10.1016/j.jaac.2016.10.016.

    Article  PubMed  Google Scholar 

  6. Holt, V., Skagerberg, E., & Dunsford, M. (2016). Young people with features of gender dysphoria: Demographics and associated difficulties. Clinical child Psychology and Psychiatry, 21, 108–118. https://doi.org/10.1177/1359104514558431.

    Article  PubMed  Google Scholar 

  7. James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. a. (2016). The Report of the 2015 US Transgender Survey. Washington, DC: National Center for Transgender Equality.

    Google Scholar 

  8. McGuire, J. K., Anderson, C. R., Toomey, R. B., & Russell, S. T. (2010). School climate for transgender youth: A mixed method investigation of student experiences and school responses. Journal of Youth and Adolescence, 39, 1175–1188. https://doi.org/10.1007/s10964-010-9540-7.

    Article  PubMed  Google Scholar 

  9. Olson, J., Schrager, S. M., Belzer, M., Simons, L. K., & Clark, L. F. (2015). Baseline physiologic and psychosocial characteristics of transgender youth seeking care for gender dysphoria. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 57, 374–380. https://doi.org/10.1016/j.jadohealth.2015.04.027.

    Article  Google Scholar 

  10. Olson, K. R., Durwood, L., DeMeules, M., & McLaughlin, K. A. (2016). Mental health of transgender children who are supported in their identities. Pediatrics, 137, 1–8. https://doi.org/10.1542/peds.2015-3223.

    Article  Google Scholar 

  11. Pine, D. S., Guyer, A. E., Goldwin, M., Towbin, K. A., & Leibenluft, E. (2008). Autism spectrum disorder scale scores in pediatric mood and anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 652–661. https://doi.org/10.1097/CHI.0b013e31816bffa5.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rider, G. N., McMorris, B. J., Gower, A. L., Coleman, E., & Eisenberg, M. E. (2018). Health and care utilization of transgender and gender nonconforming youth: A population-based study. Pediatrics, 2018, e20171683.

    Article  Google Scholar 

  13. Rutter, M., et al. (2007). Early adolescent outcomes of institutionally deprived and non-deprived adoptees. III. Quasi-autism. Journal of Child Psychology and Psychiatry, 48, 1200–1207.

    Article  Google Scholar 

  14. Shields, J. P., Cohen, R., Glassman, J. R., Whitaker, K., Franks, H., & Bertolini, I. (2013). Estimating population size and demographic characteristics of lesbian, gay, bisexual, and transgender youth in middle school. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 52, 248–250 https://doi.org/10.1016/j.jadohealth.2012.06.016.

    Article  Google Scholar 

  15. Shumer, D. E., Reisner, S. L., Edwards-Leeper, L., & Tishelman, A. (2016). Evaluation of Asperger syndrome in youth presenting to a gender dysphoria clinic. LGBT Health, 3, 387–390.

    Article  Google Scholar 

  16. 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, 2628–2632. https://doi.org/10.1007/s10803-015-2413-x.

    Article  PubMed  Google Scholar 

  17. Spack, N. P., et al. (2012). Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics, 129, 418–425. https://doi.org/10.1542/peds.2011-0907.

    Article  PubMed  Google Scholar 

  18. Strang, J. F., et al. (2016). Initial clinical guidelines for co-occurring autism spectrum disorder and gender dysphoria or incongruence in adolescents. Journal of Clinical Child and Adolescent Psychology, 53, 1–11. https://doi.org/10.1080/15374416.2016.1228462.

    Article  Google Scholar 

  19. Tonge, N. A., Rodebaugh, T. L., Fernandez, K. C., & Lim, M. H. (2016). Self-reported social skills impairment explains elevated autistic traits in individuals with generalized social anxiety disorder. Journal of Anxiety Disorders, 38, 31–36.

    Article  Google Scholar 

  20. Turban, J. L. (2017). Transgender youth: The building evidence base for early social transition. Journal of the American Academy of Child & Adolescent Psychiatry, 56, 101–102.

    Article  Google Scholar 

  21. Van Der Miesen, A. I., Hurley, H., & De Vries, A. L. (2016). Gender dysphoria and autism spectrum disorder: A narrative review. International Review of Psychiatry, 28, 70–80. https://doi.org/10.3109/09540261.2015.1111199.

    Article  Google Scholar 

  22. van der Miesen, A. I. R., de Vries, A. L. C., Steensma, T. D., & Hartman, C. A. (2017). Autistic symptoms in children and adolescents with gender dysphoria. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-017-3417-5.

    Article  PubMed Central  Google Scholar 

  23. VanderLaan, D. P., Leef, J. H., Wood, H., Hughes, S. K., & Zucker, K. J. (2015). Autism spectrum disorder risk factors and autistic traits in gender dysphoric children. Journal of Autism and Developmental Disorders, 45, 1742–1750. https://doi.org/10.1007/s10803-014-2331-3.

    Article  PubMed  Google Scholar 

  24. White, S. W., Bray, B. C., & Ollendick, T. H. (2012). Examining shared and unique aspects of social anxiety disorder and autism spectrum disorder using factor analysis. Journal of Autism and Developmental Disorders, 42, 874–884.

    Article  Google Scholar 

Download references

Acknowledgments

The author thanks Christopher McDougle MD, Massachusetts General Hospital for his thoughtful comments on this letter to the editor.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Jack L. Turban.

Ethics declarations

Conflict of interest

Dr. Turban declares that he has no potential conflicts of interest.

Research Involving Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Turban, J.L. Potentially Reversible Social Deficits Among Transgender Youth. J Autism Dev Disord 48, 4007–4009 (2018). https://doi.org/10.1007/s10803-018-3603-0

Download citation

Keywords

  • Autism
  • Gender dysphoria
  • Transgender youth
  • Quasi-autism
  • Social deficits