Abstract
Research shows elevated gender variance among autistic people and more autistic traits among gender diverse people, each of which is related to mental health concerns. Little work has explored broad features of these presentations in a non-clinical sample. College students (n = 174) ages 18–22 years completed questionnaires assessing the broader autism phenotype (BAP), autistic features, nonconformity to gender norms, and internalizing symptoms. Those with more BAP features or autistic communication reported more nonconformity to gender norms. Higher levels of internalizing symptoms were related to more gender nonconformity, BAP, and autistic features. Gender nonconformity marginally moderated the effect of BAP on depression but not anxiety. The BAP, autistic features, and gender nonconformity are important in understanding mental well-being.
Notes
Gender dysphoria is an understandable discomfort or distress that is caused by a discrepancy between a person’s gender identity and their sex assigned at birth, the associated gender role, and/or primary and secondary sex characteristics (APA, 2013).
The terms Broader Autism Phenotype and Broad Autism Phenotype have been used in the literature and are synonymous.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®) (5th ed.). American Psychiatric Publishing.
Bailey, J. M., Bechtold, K. T., & Berenbaum, S. A. (2002). Who are tomboys and why should we study them? Archives of Sexual Behavior, 31(4), 333–341. https://doi.org/10.1023/A:1016272209463
Baker, A. R. (2002). Invisible at the end of the spectrum: Shadows, residues,‘BAP’, and the female Aspergers experience. World Autism Congress.
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from asperger syndrome/high-functioning autism, malesand females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17. https://doi.org/10.1023/A:1005653411471
Botha, M. (2020). Autistic community connectedness as a buffer against the effects of minority stress. University of Surrey. https://doi.org/10.15126/thesis.00854098
Botha, M., & Frost, D. M. (2020). Extending the minority stress model to understand mental health problems experienced by the autistic population. Society and Mental Health, 10(1), 20–34. https://doi.org/10.1177/2156869318804297
Connolly, M. D., Zervos, M. J., Barone, C. J., II., Johnson, C. C., & Joseph, C. L. M. (2016). The mental health of transgender youth: Advances in understanding. Journal of Adolescent Health, 59(5), 489–495. https://doi.org/10.1016/j.jadohealth.2016.06.012
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
Deogracias, J. J., Johnson, L. L., Meyer-Bahlburg, H. F. L., Kessler, S. J., Schober, J. M., & Zucker, K. J. (2007). The gender identity/gender dysphoria questionnaire for adolescents and adults. Journal of Sex Research, 44(4), 370–379
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, 47(9), 2927–2934. https://doi.org/10.1007/s10803-017-3199-9
Ehrensaft, D. (2018). Double helix rainbow kids. Journal of Autism and Developmental Disorders, 48(12), 4079–4081. https://doi.org/10.1007/s10803-018-3716-5
George, R., & Stokes, M. A. (2018a). A quantitative analysis of mental health among sexual and gender minority groups in ASD. Journal of Autism and Developmental Disorders, 48(6), 2052–2063. https://doi.org/10.1007/s10803-018-3469-1
George, R., & Stokes, M. A. (2018b). Gender identity and sexual orientation in autism spectrum disorder. Autism, 22(8), 970–982. https://doi.org/10.1177/1362361317714587
Hendricks, M. L., & Testa, R. J. (2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the Minority Stress Model. Professional Psychology: Research and Practice, 43(5), 460. https://doi.org/10.1037/a0029597
Heylens, G., Aspeslagh, L., Dierickx, J., Baetens, K., Van Hoorde, B., De Cuypere, G., & Elaut, E. (2018). The co-occurrence of gender dysphoria and autism spectrum disorder in adults: An analysis of cross-sectional and clinical chart data. Journal of Autism and Developmental Disorders, 48(6), 2217–2223. https://doi.org/10.1007/s10803-018-3480-6
Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2018). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological Medicine. https://doi.org/10.1017/S0033291718002283
Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological Medicine, 49(4), 559–572. https://doi.org/10.1017/S0033291718002283
Hurley, R. S. E., Losh, M., Parlier, M., Reznick, J. S., & Piven, J. (2007). The broad autism phenotype questionnaire. Journal of Autism and Developmental Disorders, 37(9), 1679–1690. https://doi.org/10.1007/s10803-006-0299-3
Ingersoll, B., & Wainer, A. (2014). The broader autism phenotype. Handbook of Autism and Pervasive Developmental Disorders, Fourth Edition. https://doi.org/10.1002/9781118911389.hautc02
Jobe, L. E., & White, S. W. (2007). Loneliness, social relationships, and a broader autism phenotype in college students. Personality and Individual Differences, 42(8), 1479–1489. https://doi.org/10.1016/j.paid.2006.10.021
Julian, L. J. (2011). Measures of anxiety. Arthritis Care & Research. https://doi.org/10.1002/acr.20561
Kerns, C. M., Newschaffer, C. J., & Berkowitz, S. J. (2015). Traumatic childhood events and autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(11), 3475–3486. https://doi.org/10.1007/s10803-015-2392-y
Landry, O., & Chouinard, P. A. (2016). Why we should study the broader autism phenotype in typically developing populations. Journal of Cognition and Development, 17(4), 584–595. https://doi.org/10.1080/15248372.2016.1200046
Lipson, S. K., Raifman, J., Abelson, S., & Reisner, S. L. (2019). Gender minority mental health in the US: Results of a national survey on college campuses. American Journal of Preventive Medicine, 57(3), 293–301. https://doi.org/10.1016/j.amepre.2019.04.025
Matelski, A. M., Yadlosky, L. B., Andrus, J., Plunkett, E., & de St. Aubin, E. (2016). Conceptualizing gender conformity and well-being: Breaking down the binary. Midwestern Psychological Association.
May, T., Pang, K., & Williams, K. J. (2017). Gender variance in children and adolescents with autism spectrum disorder from the National Database for Autism Research. International Journal of Transgenderism, 18(1), 7–15. https://doi.org/10.1080/15532739.2016.1241976
McVey, A. J., Dolan, B. K., Willar, K. S., Pleiss, S., Karst, J. S., Casnar, C. L., Caiozzo, C., Vogt, E. M., Gordon, N. S., & Van Hecke, A. V. (2016). A replication and extension of the PEERS® for young adults social skills intervention: Examining effects on social skills and social anxiety in young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(12), 3739–3754. https://doi.org/10.1007/s10803-016-2911-5
Medicine, I. (2011). The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. The National Academies Press. https://doi.org/10.17226/13128
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674
Murphy, J., Prentice, F., Walsh, R., Catmur, C., & Bird, G. (2020). Autism and transgender identity: Implications for depression and anxiety. Research in Autism Spectrum Disorders. https://doi.org/10.1016/j.rasd.2019.101466
Nishiyama, T., & Kanne, S. M. (2014). On the misapplication of the BAPQ in a study of autism. Journal of Autism and Developmental Disorders, 44(8), 2079. https://doi.org/10.1007/s10803-014-2077-y
Piven, J., & Sasson, N. J. (2014). On the misapplication of the broad autism phenotype questionnaire in a study of autism. Journal of Autism and Developmental Disorders, 44(8), 2077. https://doi.org/10.1007/s10803-014-2076-z
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. https://doi.org/10.1177/014662167700100306
Rieger, G., & Savin-Williams, R. C. (2012). Gender nonconformity, sexual orientation, and psychological well-being. Archives of Sexual Behavior, 41(3), 611–621. https://doi.org/10.1007/s10508-011-9738-0
Schiltz, H. K., McVey, A. J., Dolan, B. K., Willar, K. S., Pleiss, S., Karst, J. S., Carson, A. M., Caiozzo, C., Vogt, E. M., Yund, B. D., & Van Hecke, A. V. (2018). Changes in depressive symptoms among adolescents with ASD completing the PEERS® social skills intervention. Journal of Autism and Developmental Disorders, 48(3), 834–843. https://doi.org/10.1007/s10803-017-3396-6
Schiltz, H. K., McVey, A. J., Dolan Wozniak, B., Haendel, A. D., Stanley, R., Arias, A., Gordon, N., & Van Hecke, A. V. (2020). The role of loneliness as a mediator between autism features and mental health among autistic young adults. Autism. https://doi.org/10.1177/1362361320967789
Schohl, K. A., Van Hecke, A. V, Carson, A. M., Dolan, B., Karst, J., & Stevens, S. (2014). A replication and extension of the PEERS intervention: Examining effects on social skills and social anxiety in adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44(3), 532–545. https://doi.org/10.1007/s10803-013-1900-1
Shumer, D. E., Roberts, A. L., Reisner, S. L., Lyall, K., & Austin, S. B. (2015). Brief report: Autistic traits in mothers and children associated with child’s gender nonconformity. Journal of Autism and Developmental Disorders, 45(5), 1489–1494. https://doi.org/10.1007/s10803-014-2292-6
Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the state-trait anxiety scale. Consulting Psychologists.
Stice, L. V., & Lavner, J. A. (2019). Social connectedness and loneliness mediate the association between autistic traits and internalizing symptoms among young adults. Journal of Autism and Developmental Disorders, 49(3), 1096–1110. https://doi.org/10.1007/s10803-018-3812-6
Strang, J. F., Kenworthy, L., Dominska, A., Sokoloff, J., Kenealy, L. E., Berl, M., Walsh, K., Menvielle, E., Slesaransky-Poe, G., & Kim, K.-E. (2014). Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Archives of Sexual Behavior, 43(8), 1525–1533. https://doi.org/10.1007/s10508-014-0285-3
Strang, J. F., Powers, M. D., Knauss, M., Sibarium, E., Leibowitz, S. F., Kenworthy, L., Sadikova, E., Wyss, S., Willing, L., & Caplan, R. (2018). “They thought it was an obsession”: Trajectories and perspectives of autistic transgender and gender-diverse adolescents. Journal of Autism and Developmental Disorders, 48(12), 4039–4055. https://doi.org/10.1007/s10803-018-3723-6
Uljarević, M., Hedley, D., Rose-Foley, K., Magiati, I., Cai, R. Y., Dissanayake, C., Richdale, A., & Trollor, J. (2019). Anxiety and depression from adolescence to old age in Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-019-04084-z
van Beusekom, G., Baams, L., Bos, H. M. W., Overbeek, G., & Sandfort, T. G. M. (2016). Gender nonconformity, homophobic peer victimization, and mental health: How same-sex attraction and biological sex matter. The Journal of Sex Research, 53(1), 98–108. https://doi.org/10.1080/00224499.2014.993462
van der Miesen, A. I. R., de Vries, A. L. C., Steensma, T. D., & Hartman, C. A. (2018). Autistic symptoms in children and adolescents with gender dysphoria. Journal of Autism and Developmental Disorders, 48(5), 1537–1548. https://doi.org/10.1007/s10803-017-3417-5
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. https://doi.org/10.3109/09540261.2015.1111199
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(6), 1742–1750. https://doi.org/10.1007/s10803-014-2331-3
Wainer, A. L., Ingersoll, B. R., & Hopwood, C. J. (2011). The structure and nature of the broader autism phenotype in a non-clinical sample. Journal of Psychopathology and Behavioral Assessment, 33(4), 459. https://doi.org/10.1007/s10862-011-9259-0
Warren, J. C., Smalley, K. B., & Barefoot, K. N. (2016). Psychological well-being among transgender and genderqueer individuals. International Journal of Transgenderism, 17(3–4), 114–123. https://doi.org/10.1080/15532739.2016.1216344
Warrier, V., Greenberg, D. M., Weir, E., Buckingham, C., Smith, P., Lai, M.-C., Allison, C., & Baron-Cohen, S. (2020). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications, 11(1), 1–12
Wylie, S. A., Corliss, H. L., Boulanger, V., Prokop, L. A., & Austin, S. B. (2010). Socially assigned gender nonconformity: A brief measure for use in surveillance and investigation of health disparities. Sex Roles, 63(3–4), 264–276. https://doi.org/10.1007/s11199-010-9798-y
Zucker, K. J., Mitchell, J. N., Bradley, S. J., Tkachuk, J., Cantor, J. M., & Allin, S. M. (2006). The recalled childhood gender identity/gender role questionnaire: Psychometric properties. Sex Roles, 54(7–8), 469–483. https://doi.org/10.1007/s11199-006-9019-x
Acknowledgments
The authors would like to thank the Marquette Autism Project research team without whose efforts this work would not be possible. HKS would also like to acknowledge the funding support of the Rev. John P. Raynor, S. J. Fellowship at Marquette University (2020–2021). The authors would also like to extend gratitude to Dr. Lauren Yadlowsky for her guidance on selecting measure of identity for the present study, and Dr. Ed de St. Aubin for creating and sharing the MMGC with us.
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All authors contributed to the study conception and design. Material preparation and data collection were conducted by Hillary K. Schiltz. Data entry and management was supervised by Elyse Adler. Data analyses and interpretation were performed by Hillary K. Schiltz. The first draft of the manuscript was written by Hillary K. Schiltz, Alana J. McVey, and Ilana Seager van Dyk, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Schiltz, H.K., McVey, A.J., van Dyk, I.S. et al. Brief Report: Links Between Nonconformity to Gender Norms, Autistic Features, and Internalizing Symptoms in a Non-clinical College Sample. J Autism Dev Disord 53, 1717–1725 (2023). https://doi.org/10.1007/s10803-021-05033-5
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DOI: https://doi.org/10.1007/s10803-021-05033-5