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Autism Spectrum Disorder and Anxiety Among Transgender Youth: Use of the Social Communication Questionnaire (SCQ)

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Abstract

Autism spectrum disorder (ASD) and ASD symptoms are overrepresented among gender-diverse youth across studies. Gender-diverse and ASD youth are at risk for anxiety, but anxiety is unclear among gender-diverse youth with ASD. The Social Communication Questionnaire (SCQ) is a commonly used ASD screener, including in multidisciplinary gender-affirming programs, but scholars have disagreed on the most optimal cut-off score. To date, no study has investigated the sensitivity and specificity of its established cut-off score of 15 with a sample of transgender youth. Gaining more accurate information about the utility of ASD screening tools with gender diverse youth is critical in order to help refer youth to needed services. Among a sample of 325 transgender youth, this study sought to determine an optimal cut-off score for the SCQ, the prevalence of ASD and ASD symptoms, and the relationship between ASD and anxiety within this population. The current study found that a lower cut-off score of 11 yielded optimal sensitivity and specificity (i.e., the best balance of accurately identifying individuals with ASD based on the screener), and analyses found an overrepresentation of ASD (5.2%) and ASD traits (12.1%). Transgender youth with ASD or ASD symptoms had higher anxiety, and all youth perceived themselves as more anxious than their parents. Future research is needed to identify the needs of this population, with particular consideration for the lived experiences of gender diverse and transgender youth.

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Acknowledgements

The present study was made possible by support from Children’s Health Texas, but there is no funding source to disclose.

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  1. Children’s Health System of Texas, 1935 Medical District Dr., Mail Code CH 12.01, Dallas, TX, 75235, USA

    Alexis Clyde & Laura E. Kuper

  2. University of Texas Southwestern Medical Center, Dallas, TX, USA

    Alexis Clyde, Gabrielle Agnew & Laura E. Kuper

  3. University of North Texas, Denton, TX, USA

    Danna Bismar

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed Laura Kuper. The first draft of the manuscript was written by Alexis Clyde and Danna Bismar and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Alexis Clyde.

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Presentation Citation L. E. Kuper, D. Bismar, A. Clyde (November 2020). Exploring childhood autism spectrum traits and their relationship to current social and emotional functioning among youth presenting for care at a multidisciplinary gender affirming program. Oral presentation at the 26th Scientific Symposium of the World Professional Association of Transgender Health, Virtual Conference.

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Clyde, A., Bismar, D., Agnew, G. et al. Autism Spectrum Disorder and Anxiety Among Transgender Youth: Use of the Social Communication Questionnaire (SCQ). J Autism Dev Disord 54, 615–627 (2024). https://doi.org/10.1007/s10803-022-05814-6

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