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van der Miesen AIR, Shi SY, Lei HC, Ngan CL, VanderLaan DP, Wong WI. Gender diversity in a Chinese community sample and its associations with autism traits. Autism Res 2024; 17:1407-1416. [PMID: 38100234 DOI: 10.1002/aur.3075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 11/27/2023] [Indexed: 07/26/2024]
Abstract
Emerging evidence suggests that gender dysphoria or gender diversity (GD) intersects frequently with autism spectrum disorder or autism traits. However, the magnitude and interpretation of this link continue to be debated. Most child studies on this topic were performed in clinical populations, and little is known about the generalizability of this co-occurrence to the broader community, especially to non-Western samples. Also, little is known about whether specific subdomains of autism are more strongly associated with GD. Therefore, we investigated GD and its association with autism traits in a Chinese community sample of 4-12-year-olds (N = 379; 51% birth-assigned girls). Parents provided information about GD characteristics using the standardized Gender Identity Questionnaire for Children and autism traits using the Chinese version of the Autism-Spectrum Quotient-Children. In addition, broader behavioral and emotional challenges were measured by the Behavior Problem Index (BPI) to account for psychological challenges other than autism traits. In this community sample of Chinese children, increased GD was associated with increased autism traits, even after accounting for the BPI. Of the four subscales, the Imagination and Patterns subscales in birth-assigned girls and the Imagination subscale in birth-assigned boys were especially associated with GD. These findings indicate that the association between GD and autism traits generalizes to a nonclinical, non-Western sample. Clinicians and researchers working with clinical as well as community children should thus pay attention to the co-occurrence of GD and autism traits, in and outside the West.
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Affiliation(s)
- Anna I R van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Sylvia Yun Shi
- Gender Studies Programme and Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Hoi Ching Lei
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Cho Lam Ngan
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Doug P VanderLaan
- Department of Psychology, University of Toronto, Mississauga, Ontario, Canada
- Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Wang Ivy Wong
- Gender Studies Programme and Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong
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Mittertreiner EJ, Ng-Cordell E, McVey AJ, Kerns CM. Research methods at the intersection of gender diversity and autism: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241245595. [PMID: 38661070 DOI: 10.1177/13623613241245595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
LAY ABSTRACT Research has increasingly focused on the intersection between gender diversity and autism. To better understand this literature, this scoping review systematically searched five databases for peer-reviewed literature on gender diversity and autism published between 2018 and 2023. Included studies (N = 84) were of English language, featured original qualitative or quantitative findings, and examined a psychosocial connection between autism and gender spectra variables. Most studies focused on measuring prevalence of autism among gender-diverse individuals. While the overall study rigor was acceptable, weaknesses in measurement, sample selection, and definition of key terms were noted. Promisingly, studies in this area appear to be shifting away from a pathologizing lens and towards research methods that engage in meaningful collaboration with the autistic, gender-diverse community to investigate how to best enhance the quality of life and wellbeing of this population.
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Affiliation(s)
| | | | - Alana J McVey
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Autism Center, Seattle Children's Hospital, Seattle, WA, United States
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Kung KTF. Autistic Traits, Gender Minority Stress, and Mental Health in Transgender and Non-Binary Adults. J Autism Dev Disord 2024; 54:1389-1397. [PMID: 36652125 DOI: 10.1007/s10803-022-05875-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 01/19/2023]
Abstract
The present study investigated the relation between autistic traits and gender minority stress and the relative importance of autistic traits and gender minority stress in predicting mental health outcomes in gender minority adults. An online survey was completed by 90 transgender women, 72 transgender men, 48 non-binary individuals assigned male at birth (AMAB), and 98 non-binary individuals assigned female at birth (AFAB). Autistic traits positively correlated with internalised transphobia in the non-binary groups. In general, higher autistic traits and gender minority stress correlated with poorer mental health outcomes. After controlling for gender minority stress, autistic traits accounted for additional variance of suicidality across gender minority groups, anxiety symptoms in the non-binary groups, and all mental health outcomes in non-binary AFAB.
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Affiliation(s)
- Karson T F Kung
- Department of Psychology, University of Hong Kong, Pokfulam, Hong Kong.
- Gender Development Research Centre, Department of Psychology, University of Cambridge, Cambridge, United Kingdom.
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Shimoyama S, Endo T. Revisiting the Link: A qualitative analysis of the diverse experiences of gender dysphoria as a subset of pervasive social dysphoria co-occurring with autism in Japan. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241235722. [PMID: 38465656 DOI: 10.1177/13623613241235722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
LAY ABSTRACT Studies have suggested that autistic people are more likely to experience gender dysphoria, which refers to the gender-related distress emerging from personal factors and gender norms that some transgender people experience. Transgender people are diverse; some experience gender incongruence (i.e. an incompatibility between a person's gender identity and that expected of them based on their birth-assigned gender), whereas others do not. Therefore, the association of autistic transgender people's gender dysphoria with gender incongruence varies, and the literature has overlooked such diversity. Interviews with 15 Japanese autistic transgender adults revealed diverse gender dysphoria experiences independent of gender incongruence, such as resistance to the societal gender norms themselves, physical dysphoria caused by the imposition of gender, sensory disgust related to autistic sensory sensitivities, uncertainty about the gender norms of the social majority, and the autistic burden of living in a gendered society. Moreover, we found that most participants had not only accumulated distress over gender norms (i.e. gender dysphoria) but also over pervasive social norms, termed Pervasive Social Dysphoria. Our findings suggests that future co-occurrence research and practice must affirm these internal perspectives more, such as by providing support for both gender dysphoria and Pervasive Social Dysphoria, as autistic transgender people may experience gender dysphoria as a subset of Pervasive Social Dysphoria.
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Furente F, Matera E, Margari L, Lavorato E, Annecchini F, Scarascia Mugnozza F, Colacicco G, Gabellone A, Petruzzelli MG. Social Introversion Personality Trait as Predictor of Internalizing Symptoms in Female Adolescents with Gender Dysphoria. J Clin Med 2023; 12:jcm12093236. [PMID: 37176675 PMCID: PMC10178967 DOI: 10.3390/jcm12093236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/18/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The personality trait of social introversion refers to the individual inclination toward the inner/outer world. Moreover, adolescents who experience Gender Dysphoria (GD) can be involved in relationship conflicts with family, peers, and friends and experience stigmatization and rejection from society. This leads higher distress in females which are more sensitive to this kind of feelings. This leads in them frequently developing a negative sense of well-being and low self-esteem which increases their risk of internalizing symptoms. So, the aims of this study were: (1) to investigate the presence of significant differences in Social Introversion (SI) dimensions between an assigned-female at birth (AFAB) GD group and a cisgender female group both diagnosed with a depressive disorder, (2) to verify whether the two clinical groups may be characterized by different profiles of internalizing symptoms, (3) to investigate if the SI dimensions could promote the internalizing symptomatology. Our results confirmed the presence of significantly higher score in GD sample for MMPI-SI scale and subscales and showed no significant difference in depressive profiles. Lastly, SI could promote internalizing symptomatology in AFAB underlying a link between SI and depression in this condition which should be further investigated.
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Affiliation(s)
- Flora Furente
- DiBraiN-Department of Translational Biomedicine Neurosciences, University of Bari "Aldo Moro", 70100 Bari, Italy
| | - Emilia Matera
- DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, University of Bari "Aldo Moro", 70100 Bari, Italy
| | - Lucia Margari
- DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, University of Bari "Aldo Moro", 70100 Bari, Italy
| | - Elisabetta Lavorato
- Psychiatry Unit, Azienda Ospedaliero-Universitaria Policlinico di Bari, 70100 Bari, Italy
| | - Federica Annecchini
- DiBraiN-Department of Translational Biomedicine Neurosciences, University of Bari "Aldo Moro", 70100 Bari, Italy
| | - Francesca Scarascia Mugnozza
- DiBraiN-Department of Translational Biomedicine Neurosciences, University of Bari "Aldo Moro", 70100 Bari, Italy
| | - Giuseppe Colacicco
- DiBraiN-Department of Translational Biomedicine Neurosciences, University of Bari "Aldo Moro", 70100 Bari, Italy
| | - Alessandra Gabellone
- DiBraiN-Department of Translational Biomedicine Neurosciences, University of Bari "Aldo Moro", 70100 Bari, Italy
| | - Maria Giuseppina Petruzzelli
- DiBraiN-Department of Translational Biomedicine Neurosciences, University of Bari "Aldo Moro", 70100 Bari, Italy
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Maggio MG, Calatozzo P, Cerasa A, Pioggia G, Quartarone A, Calabrò RS. Sex and Sexuality in Autism Spectrum Disorders: A Scoping Review on a Neglected but Fundamental Issue. Brain Sci 2022; 12:1427. [PMID: 36358354 PMCID: PMC9688284 DOI: 10.3390/brainsci12111427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/19/2023] Open
Abstract
ASD consists of a set of permanent neurodevelopmental conditions, which are studded with social and communication differences, limited interests, and repetitive behaviors. Individuals with ASD have difficulty reading eye gestures and expressions, and may also have stereotyped or repetitive language, excessive adherence to routines, fixed interests, and rigid thinking. However, sexuality in adolescents and young adults with ASD is still a poorly studied and neglected issue. This review aims to evaluate sexual function and behavior in individuals with ASD to foster a greater understanding of this important, although often overlooked, issue. This review was conducted by searching peer-reviewed articles published between 01 June 2000 and 31 May 2022 using the following databases: PubMed, Embase, Cochrane Database, and Web of Science. A comprehensive search was conducted using the terms: "Autism" OR "ASD" AND "Sexuality" OR "Romantic relation" OR "sexual behavior" AND/OR "sexual awareness". After an accurate revision of 214 full manuscripts, 11 articles satisfied the inclusion/exclusion criteria. This review found that, although individuals with ASD may have sexual functioning, their sexuality is characterized by higher prevalence rates of gender dysphoria and inappropriate sexual behavior. Furthermore, sexual awareness is reduced in this patient population, and the prevalence of other variants of sexual orientation (i.e., homosexuality, asexuality, bisexuality, etc.) is higher in adolescents with ASD than in non-autistic peers. Sexual health and education should be included in the care path of patients with ASD in order to improve their quality of life and avoid/reduce inappropriate and risky behaviors.
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Affiliation(s)
- Maria Grazia Maggio
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy
| | - Patrizia Calatozzo
- Studio di Psicoterapia Relazionale e Riabilitazione Cognitiva, 98124 Messina, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation, National Research Council of Italy (IRIB-CNR), 98164 Messina, Italy
- Sant’Anna Institute, 88900 Crotone, Italy
- Pharmacotechnology Documention and Transfer Unit, Preclinical and Traslation Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Calabria, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation, National Research Council of Italy (IRIB-CNR), 98164 Messina, Italy
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