The autism spectrum among transgender youth: default mode functional connectivity

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Strang, J. F., McClellan, L. S., Li, S., Jack, A., Wallace, G. L., McQuaid, G. A., Kenworthy, L., Anthony, L. G., Lai, M. C., Pelphrey, K. A., Thalberg, A., Nelson, E. E., Phan, J. M., Sadikova, E., Fischbach, A. L., Thomas, J. G., & Vaidya, C. J. (2023). The autism spectrum among transgender youth: default mode functional connectivity. Cerebral Cortex, 33(11), 6633-6647. https://doi.org/10.1093/cercor/bhac530

Publication date: 31 Jan 2023 Added to AutiHub: 6 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
17
Publication authors identified as autistic
1 / 17 (5.9%)
  1. John F. Strang
  2. Lucy S. McClellan
  3. Sufang Li
  4. Allison Jack
  5. Gregory L. Wallace
  6. Goldie A. McQuaid
  1. Lauren Kenworthy
  2. Laura G. Anthony
  3. Meng-Chuan Lai
  4. Kevin A. Pelphrey
  5. Alexandra Thalberg
  6. Eric E. Nelson
  1. Jenny Mai Phan *
  2. Eleonora Sadikova
  3. Abigail L. Fischbach
  4. J. Graham Thomas
  5. Chandan J. Vaidya

Abstract

The common intersection of autism and transgender identities has been described in clinical and community contexts. This study investigates autism-related neurophenotypes among transgender youth. Forty-five transgender youth, evenly balanced across non-autistic, slightly subclinically autistic, and full-criteria autistic subgroupings, completed resting-state functional magnetic resonance imaging to examine functional connectivity. Results confirmed hypothesized default mode network (DMN) hub hyperconnectivity with visual and motor networks in autism, partially replicating previous studies comparing cisgender autistic and non-autistic adolescents. The slightly subclinically autistic group differed from both non-autistic and full-criteria autistic groups in DMN hub connectivity to ventral attention and sensorimotor networks, falling between non-autistic and full-criteria autistic groups. Autism traits showed a similar pattern to autism-related group analytics, and also related to hyperconnectivity between DMN hub and dorsal attention network. Internalizing, gender dysphoria, and gender minority-related stigma did not show connectivity differences. Connectivity differences within DMN followed previously reported patterns by designated sex at birth (i.e. female birth designation showing greater within-DMN connectivity). Overall, findings suggest behavioral diagnostics and autism traits in transgender youth correspond to observable differences in DMN hub connectivity. Further, this study reveals novel neurophenotypic characteristics associated with slightly subthreshold autism, highlighting the importance of research attention to this group.

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3 / 97 (3.1%)
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Among occurrences linked to AutiHub author records: 3 / 205 (1.5%). Distinct cited authors identified as autistic: 2 / 518 (0.4%).
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202 / 205 (98.5%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 202 / 685 (29.5%). Distinct linked cited authors not identified as autistic: 104 / 106 (98.1%).
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