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Corbett BA, Muscatello RA, Cyperski M, Sadikova E, Edmiston EK, McGonigle TW, Calvosa R, Vandekar S. Gender diversity in autistic and neurotypical youth over adolescence and puberty: A longitudinal study. Autism Res 2024; 17:1450-1463. [PMID: 38661056 DOI: 10.1002/aur.3141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
Recent research in autism spectrum disorder (ASD) has suggested a higher prevalence of gender diversity in individuals diagnosed with ASD. Adolescence is a critical period for the consolidation of gender identity, yet the extent to which the experience of gender diversity is stable over adolescence and puberty in autistic youth is poorly understood. The aim of the study was to examine the consistency of gender diversity using the gender diversity screening questionnaire for self- and parent-report of youth (GDSQ-S, GDSQ-P) over a four-year longitudinal study of pubertal development in youth with ASD (N = 140, 36 assigned-female-at birth (AFAB)) and typical development (TD, N = 104, 58 assigned-male-at-birth [AMAB]) and their parents. The extent to which diagnosis (ASD vs. TD), assigned sex (AFAB vs. AMAB) and developmental level (age, puberty) predict GDSQ trajectory over time was explored. There was a significant diagnosis by sex-assigned-at-birth by age interaction for GDSQ-S Gender Diversity, p = 0.002, showing higher scores in autistic AFAB youth over adolescence, and TD AFAB showing initially lower, then increasing levels over adolescence. For GDSQ-P, Gender Incongruence was significantly different between the groups, p = 0.032, showing higher incongruence for autistic AFAB around age 10, decreasing between age 12-14 before increasing again, while TD AFAB evidence the inverse trend. AMAB trends were stable. The significant diagnostic, developmental and sex-based differences indicate AFAB youth experience greater gender diversity that evolves over development. Findings suggest gender identity formation is nuanced and may be influenced by pubertal progression, hormonal patterns, and psychosocial factors. Results underscore the need for enhanced understanding of the unique, dynamic profiles of females-assigned-at-birth.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA
| | - Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Melissa Cyperski
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eleonora Sadikova
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - E Kale Edmiston
- Department of Psychiatry, University of Massachusetts Chan School of Medicine, Worcester, Massachusetts, USA
| | - Trey William McGonigle
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rachel Calvosa
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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2
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Koss MP, Anderson R, Peterson ZD, Littleton H, Abbey A, Kowalski R, Thompson M, Canan S, White J, McCauley H, Orchowski L, Fedina L, Lopez E, Allen C. The Revised Sexual Experiences Survey Victimization Version (SES-V): Conceptualization, Modifications, Items and Scoring. JOURNAL OF SEX RESEARCH 2024; 61:839-867. [PMID: 38973060 DOI: 10.1080/00224499.2024.2358407] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
The Sexual Experiences Survey [SES] is considered the gold standard measure of non-consensual sexual experiences. This article introduces a new victimization version [SES-V] developed by a multidisciplinary collaboration, the first revision since 2007. The 2024 SES-V is designed to measure the construct of sexual exploitation since the 14th birthday. Notable revisions are adoption of a freely given permission standard for non-consent, introduction of new tactics and acts, including made to perform or to penetrate another person's body, tactics-first wording order, and emphasis on gender and sexual orientation inclusivity. The SES-V is modularized to allow whole or partial administration. Modules include Non-contact, Technology-facilitated, Illegal (largely penetrative), and Verbally pressured sexual exploitation. Tables provide item text, multiple scoring approaches, module follow-up, specific incident description and demographics. Future plans include developing a scoring algorithm based on weighting our hypothesized dimensions of sexual exploitation severity: invasiveness, pressure, and norm violation combined with frequency. This article is the first in a special issue on the SES-V. Subsequent articles focus on the taxonomies and literature that informed each module. The issue concludes with two empirical papers demonstrating the feasibility and validity of the SES-V: (1) psychometric comparison with the 2007 SES-SFV; and (2) prevalence data from a census-matched adult community sample.
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Affiliation(s)
| | - RaeAnn Anderson
- University of Missouri - Kansas City School of Nursing and Health Sciences
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3
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Potter AS. Leveraging Polygenic Scores to Go Beyond Examinations of Pathology Among Gender-Diverse Individuals. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100311. [PMID: 38800640 PMCID: PMC11116981 DOI: 10.1016/j.bpsgos.2024.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Alexandra S. Potter
- Clinical Neuroscience Research Unit, The University of Vermont, Burlington, Vermont
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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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Fischbach AL, Hindenach A, van der Miesen AIR, Yang JS, Buckley OJ, Song M, Campos L, Strang JF. Autistic and non-autistic transgender youth are similar in gender development and sexuality phenotypes. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2024. [PMID: 38613223 DOI: 10.1111/bjdp.12486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Abstract
Increasing rhetoric regarding the common intersection of autism and gender diversity has resulted in legislation banning autistic transgender youth from accessing standard of care supports, as well as legislative efforts banning all youth gender care in part justified by the proportional over-occurrence of autism. Yet, no study has investigated whether autistic and non-autistic transgender youth present fundamentally different gender-related phenotypes. To address this gap, we extensively characterized autism, gender diversity, and sexuality among autistic and non-autistic transgender binary youth (N = 66, Mage = 17.17, SDage = 2.12) in order to investigate similarities and/or differences in gender and sexuality phenotypes. Neither autism diagnostic status nor continuous autistic traits were significantly related to any gender or sexuality phenotypes. These findings suggest that the developmental and experiential features of gender diversity are very similar between autistic and non-autistic transgender adolescents. Future research is needed to determine whether the similarity in profiles is maintained over time into adulthood.
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Affiliation(s)
- Abigail L Fischbach
- Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA
| | - Andy Hindenach
- Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA
| | - Anna I R van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, The Netherlands
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Ji Seung Yang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Olivia J Buckley
- Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA
| | - Minneh Song
- Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA
| | - Laura Campos
- Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA
| | - John F Strang
- Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA
- Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA
- Department of Psychiatry, and Behavioral Sciences, George Washington University School of Medicine, Washington, DC, USA
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McQuaid GA, Ratto AB, Jack A, Khuu A, Smith JV, Duane SC, Clawson A, Lee NR, Verbalis A, Pelphrey KA, Kenworthy L, Wallace GL, Strang JF. Gender, assigned sex at birth, and gender diversity: Windows into diagnostic timing disparities in autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241243117. [PMID: 38587289 DOI: 10.1177/13623613241243117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
LAY ABSTRACT Later autism diagnosis is associated with risk for mental health problems. Understanding factors related to later autism diagnosis may help reduce mental health risks for autistic people. One characteristic associated with later autism diagnosis is female sex. However, studies often do not distinguish sex assigned at birth and gender identity. Gender diversity may be more common in autistic relative to neurotypical people, and autism is more common in gender-diverse populations. We studied age at autism diagnosis by sex assigned at birth, gender identity, and gender diversity (gender-diverse vs cisgender) status, separately. We studied three separate autistic samples, each of which differed in how they were diagnosed and how they were recruited. The samples included 193 persons (8.0-18.0 years) from a research-recruited academic medical center sample; 1,550 people (1.3-25.4 years) from a clinic-based sample; and 244 people (18.2-30.0 years) from a community-enriched sample. We found significant differences in the clinic-based and community-enriched samples. People assigned female sex at birth were diagnosed with autism significantly later than people assigned male at birth. People of female gender were diagnosed significantly later than people of male gender. Gender-diverse people were diagnosed significantly later than cisgender people. Sex assigned at birth, gender identity, and gender diversity may each show unique relationships with age of autism diagnosis. Differences in how autistic people are diagnosed and recruited are important to consider in studies that examine sex assigned at birth or gender identity. More research into autism diagnosis in adulthood is needed.
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Mo K, Anagnostou E, Lerch JP, Taylor MJ, VanderLaan DP, Szatmari P, Crosbie J, Nicolson R, Georgiadis S, Kelley E, Ayub M, Brian J, Lai MC, Palmert MR. Gender diversity is correlated with dimensional neurodivergent traits but not categorical neurodevelopmental diagnoses in children. J Child Psychol Psychiatry 2024. [PMID: 38433429 DOI: 10.1111/jcpp.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Gender clinic and single-item questionnaire-based data report increased co-occurrence of gender diversity and neurodevelopmental conditions. The nuances of these associations are under-studied. We used a transdiagnostic approach, combining categorical and dimensional characterization of neurodiversity, to further the understanding of its associations with gender diversity in identity and expression in children. METHODS Data from 291 children (Autism N = 104, ADHD N = 104, Autism + ADHD N = 17, neurotypical N = 66) aged 4-12 years enrolled in the Province of Ontario Neurodevelopmental Network were analyzed. Gender diversity was measured multi-dimensionally using a well-validated parent-report instrument, the Gender Identity Questionnaire for Children (GIQC). We used gamma regression models to determine the significant correlates of gender diversity among age, puberty, sex-assigned-at-birth, categorical neurodevelopmental diagnoses, and dimensional neurodivergent traits (using the Social Communication Questionnaire and the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scales). Internalizing and externalizing problems were included as covariates. RESULTS Neither a categorical diagnosis of autism nor ADHD significantly correlated with current GIQC-derived scores. Instead, higher early-childhood dimensional autistic social-communication traits correlated with higher current overall gender incongruence (as defined by GIQC-14 score). This correlation was potentially moderated by sex-assigned-at-birth: greater early-childhood autistic social-communication traits were associated with higher current overall gender incongruence in assigned-males-at-birth, but not assigned-females-at-birth. For fine-grained gender diversity domains, greater autistic restricted-repetitive behavior traits were associated with greater diversity in gender identity across sexes-assigned-at-birth; greater autistic social-communication traits were associated with lower stereotypical male expression across sexes-assigned-at-birth. CONCLUSIONS Dimensional autistic traits, rather than ADHD traits or categorical neurodevelopmental diagnoses, were associated with gender diversity domains across neurodivergent and neurotypical children. The association between early-childhood autistic social-communication traits and overall current gender diversity was most evident in assigned-males-at-birth. Nuanced interrelationships between neurodivergence and gender diversity should be better understood to clarify developmental links and to offer tailored support for neurodivergent and gender-diverse populations.
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Affiliation(s)
- Kelly Mo
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jason P Lerch
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Oxford, Oxford, UK
| | - Margot J Taylor
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Doug P VanderLaan
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | | | - Jessica Brian
- University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Cambridge, Cambridge, UK
- National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Mark R Palmert
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
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Thomas TR, Tener AJ, Pearlman AM, Imborek KL, Yang JS, Strang JF, Michaelson JJ. Polygenic Scores Clarify the Relationship Between Mental Health and Gender Diversity. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:100291. [PMID: 38425476 PMCID: PMC10901838 DOI: 10.1016/j.bpsgos.2024.100291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 03/02/2024] Open
Abstract
Background Gender-diverse individuals are at increased risk for mental health problems, but it is unclear whether this is due to shared environmental or genetic factors. Methods In two SPARK samples, we tested for associations of 16 polygenic scores (PGSs) with quantitative measures of gender diversity and mental health. In study 1, 639 independent adults (59% autistic) reported their mental health with the Adult Self-Report and their gender diversity with the Gender Self-Report (GSR). The GSR has 2 dimensions: binary (degree of identification with the gender opposite that implied by sex designated at birth) and nonbinary (degree of identification with a gender that is neither male nor female). In study 2 (N = 5165), we used a categorical measure of gender identity. Results In study 1, neuropsychiatric PGSs were positively associated with Adult Self-Report scores: externalizing was positively associated with the attention-deficit/hyperactivity disorder PGS (β = 0.10 [0.03-0.17]), and internalizing was positively associated with the PGSs for depression (β = 0.07 [0-0.14]) and neuroticism (β = 0.10 [0.03-0.17]). Interestingly, GSR scores were not significantly associated with any neuropsychiatric PGS. However, GSR nonbinary was positively associated with the cognitive performance PGS (β = 0.11 [0.05-0.18]), with the effect size comparable in magnitude to the associations of the neuropsychiatric PGSs with the Adult Self-Report. Additionally, GSR binary was positively associated with the nonheterosexual sexual behavior PGS (β = 0.07 [0-0.14]). In study 2, the cognitive performance PGS effect replicated; transgender and nonbinary individuals had higher PGSs (t316 = 4.16). Conclusions We showed that while gender diversity is phenotypically positively associated with mental health problems, the strongest PGS associations with gender diversity were with the cognitive performance PGS, not the neuropsychiatric PGSs.
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Affiliation(s)
| | - Ashton J. Tener
- Department of Psychiatry, University of Iowa, Iowa City, Iowa
| | | | | | - Ji Seung Yang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | - John F. Strang
- Gender and Autism Program, Center for Neuroscience, Children’s National Hospital, George Washington University School of Medicine, Washington, District of Columbia
| | - Jacob J. Michaelson
- Department of Psychiatry, University of Iowa, Iowa City, Iowa
- Iowa Neuroscience Institute, University of Iowa, Iowa City, Iowa
- Hawkeye Intellectual and Developmental Disabilities Research Center, University of Iowa, Iowa City, Iowa
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9
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McClellan LS, van der Miesen AIR, Tishelman AC, Fischbach AL, Song M, Campos LA, Strang JF. Cognitive and Developmental Profiles Associated with Self-Reported Sexual and Gender Minority Stigmatization Among Binary Transgender Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-17. [PMID: 38118056 DOI: 10.1080/15374416.2023.2292045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
OBJECTIVE Sexual and gender minority (SGM) stigmatization is a key factor related to transgender adolescent mental health. While previous research has focused on direct associations between stigmatization and mental health, the present study of transgender youth, equitably recruited across the autism spectrum, examines cognitive and developmental factors in relation to the self-report of experienced and perceived SGM stigmatization. METHOD 65 binary transgender adolescents (43% transfeminine; ages 13-21 years) were intentionally recruited across the spectrum of autism traits from no traits to full criteria autism. Participants completed measures of autism-related social differences, cognitive abilities, and self-reported directly experienced and perceived SGM stigma. Autism-related social differences, cognitive abilities, and age were studied in relation to both SGM stigma factors. RESULTS Autism-related social differences were negatively associated with level of directly experienced SGM stigma but unassociated with perceived stigma. Greater cognitive ability was positively associated with level of perceived SGM stigma, but unassociated with report of directly experienced stigma. Older age was positively associated with level of perceived SGM stigma. There was a statistical trend toward older age positively associated with level of directly experienced stigma. CONCLUSIONS The present study identifies candidate cognitive and developmental influences on self-reported SGM stigmatization among transgender adolescents, evenly recruited across the autism spectrum. The factors which may impact the perception and experience of stigmatization have been notably under-explored in the mental health field. The examination of these individual characteristics may allow for more precise predictive models for research with transgender youth, and ultimately, in clinical care.
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Affiliation(s)
- Lucy S McClellan
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital
| | - Anna I R van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location Vrije Universiteit
| | | | - Abigail L Fischbach
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital
| | - Minneh Song
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital
| | - Laura A Campos
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital
| | - John F Strang
- Center for Neuroscience, Children's National Research Institute, Children's National Hospital
- Departments of Pediatrics, Neurology, and Behavioral Science, George Washington University School of Medicine
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Tishelman A, Rider GN. Assessment of Gender Diverse Children: Incorporating the Standard of Care 8th Edition. Child Adolesc Psychiatr Clin N Am 2023; 32:719-730. [PMID: 37739630 DOI: 10.1016/j.chc.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
This article provides an overview of the World Professional Association of Transgender Health (WPATH) Standard of Care 8th edition (SOC8) chapter on transgender and gender diverse (TGD) prepubescent children (see Scott Leibowitz's article, "Assessment of Transgender and Gender Diverse Adolescents: Incorporating the Standard of Care 8th Edition," in this issue). This is the first WPATH SOC chapter in history, specifically devoted to children, acknowledging that the developmental needs and experiences of these youth can be distinguished from those of TGD adolescents. The child standards are based on the consensus of a range of expert authors and a broader consensus derived from a Delphi process involving the entire international interdisciplinary SOC8 authorship. The child SOC draw upon general developmental literature and employ an ecological framework to establish practice recommendations, including an assessment framework which engages family members and community outreach as warranted. The primary authors of the Child chapter of the SOC 8 include the following: Amy Tishelman, Ph.D. (lead author); Dianne Berg, Ph.D., Laura Edwards-Leeper, Ph.D., Diane Ehrensaft, Ph.D.; Susie Green, Aron Janssen, M.D., Jiska Ristori, Psy.D., Thomas Steensma, Ph.D., and John Strang, Psy.
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Affiliation(s)
- Amy Tishelman
- Department of Psychology and Neuroscience, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| | - G Nic Rider
- Department of Family Medicine and Community Health, Institute for Sexual and Gender Health, University of Minnesota Medical School, 1300 South 2nd Street, Suite 180, Minneapolis, MN 55454, USA
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11
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Strang JF, van der Miesen AIR, Fischbach AL, Wolff M, Harris MC, Klomp SE. Common Intersection of Autism and Gender Diversity in Youth: Clinical Perspectives and Practices. Child Adolesc Psychiatr Clin N Am 2023; 32:747-760. [PMID: 37739632 DOI: 10.1016/j.chc.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Autism and gender diversity often intersect. Many transgender youth seeking gender-related medical interventions are autistic. Clinicians serving these youth lack an autism-specific evidence base to guide gender care decisions. At present, care decisions are based on extrapolation of care models from transgender youth samples, generally. At this point, there is no evidence to suggest that autistic youth are likely to experience shifts in gender or gender-related medical requests, although this has been insufficiently studied. In this article, cowritten by expert clinicians and autistic gender-diverse collaborators, an overview of clinical care considerations and the current evidence base is provided.
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Affiliation(s)
- John F Strang
- Gender and Autism Program, Division of Pediatric Neuropsychology, Children's National Hospital, 15245 Shady Grove Suite 350, Rockville, MD 20850, USA; Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA; Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA; Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine, Washington, DC, USA.
| | - Anna I R van der Miesen
- Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, the Netherlands; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Abigail L Fischbach
- Gender and Autism Program, Division of Pediatric Neuropsychology, Children's National Hospital, 15245 Shady Grove Suite 350, Rockville, MD 20850, USA
| | - Milana Wolff
- College of Engineering and Physical Sciences, University of Wyoming, Laramie, WY, USA
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12
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Strang JF, Fischbach AL. A Special Issue of Autism in Adulthood Dedicated to the Intersection of Autism and the Broad LGBTQ. AUTISM IN ADULTHOOD 2023; 5:109-111. [PMID: 37346992 PMCID: PMC10280169 DOI: 10.1089/aut.2023.0056.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Affiliation(s)
- John F. Strang
- Autism and LGBTQ+ Intersection Special Issue Guest Editor, Gender and Autism Program, Division of Neuropsychology, Children's National Hospital, Washington, District of Columbia, USA
| | - Abigail L. Fischbach
- Gender and Autism Program, Children's National Hospital, Washington, District of Columbia, USA
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