Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals

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Strang, J. F., Janssen, A., Tishelman, A. C., Leibowitz, S., Kenworthy, L., McGuire, J. K., Edwards-Leeper, L., Mazefsky, C. A., Rofey, D. L., Bascom, J., Caplan, R., Gomez‐Lobo, V., Berg, D., Zaks, Z., Wallace, G. L., Wimms, H., Pine-Twaddell, E., Shumer, D. E., Register‐Brown, K.,..., & Anthony, L. G. (2018). Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals. Journal of the American Academy of Child & Adolescent Psychiatry, 57(11), 885-887. https://doi.org/10.1016/j.jaac.2018.04.023

Publication date: 1 Nov 2018 Added to AutiHub: 4 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
21
Publication authors identified as autistic
2 / 21 (9.5%)
  1. John F. Strang
  2. Aron Janssen
  3. Amy C. Tishelman
  4. Scott Leibowitz
  5. Lauren Kenworthy
  6. Jenifer K. McGuire
  7. Laura Edwards-Leeper
  1. Carla A. Mazefsky
  2. Dana L. Rofey
  3. Julia Bascom *
  4. Reid Caplan *
  5. Veronica Gomez‐Lobo
  6. Dianne Berg
  7. Zosia Zaks
  1. Gregory L. Wallace
  2. Harriette Wimms
  3. Elyse Pine-Twaddell
  4. Daniel E. Shumer
  5. Kelly Register‐Brown
  6. Eleonora Sadikova
  7. Laura G. Anthony

Abstract

Turban and van Schalkwyk assert in their Translations article, "'Gender Dysphoria' and Autism Spectrum Disorder: Is the Link Real?" that an over-representation of autism spectrum disorder (ASD) in gender dysphoria is unsupported based on current evidence. Turban and van Schalkwyk discuss 7 of the currently 19 available empirical studies (excluding reviews and case reports) of the over-occurrence of ASD and/or autism traits with gender dysphoria/diversity. They are correct to note that some ASD screeners may lack specificity; that is, a clinical-range total score could indicate non-ASD-related mental health conditions or other developmental difference. However, they do not account for the 7 available studies which specifically report rates of clinical diagnoses of ASD among unselected gender-diverse samples. We suggest also that many of the studies that assess ASD-symptoms in gender-diverse groups are more convincing than suggested by Turban and van Schalkwyk because they employ measures assessing the multi-dimensionality of ASD symptoms and report significant elevations not only for socially-related symptoms but also for the various components of restricted and repetitive behaviors and interests (RRBI) core to ASD. We come together to write this response as gender clinicians and researchers, autism clinicians and researchers, and key stakeholders, including autistic and autistic transgender self-advocates. We work and live with the co-occurrence of autism and gender diversity on a daily basis, and we are concerned that perpetuating misunderstanding about the co-occurrence places individuals at risk.

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Cited references
11
Total cited references integrated for this publication.
Cited references with an identified autistic author
0 / 11 (0.0%)
Cited author occurrences identified as autistic
0 / 59 (0.0%)
Among occurrences linked to AutiHub author records: 0 / 6 (0.0%). Distinct cited authors identified as autistic: 0 / 57 (0.0%).
Cited author occurrences linked to AutiHub author records
6 / 59 (10.2%)
Distinct linked cited authors: 5 / 57 (8.8%)
Linked cited-author occurrences not identified as autistic
6 / 6 (100.0%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 6 / 59 (10.2%). Distinct linked cited authors not identified as autistic: 5 / 5 (100.0%).
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