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Autism, ADHD linked to gender variance in children

Study findings published in the Archives of Sex Behavior show that children with autism spectrum disorder or attention deficit/hyperactivity disorder are more likely to display gender variance, the desire to be another gender.

Study participants with ADHD or ASD who displayed gender-dysphoric behavior were more likely to report near-clinical levels of anxiety and depression; however, participants with ASD were less likely to report emotional disturbance.

John F. Strang, PsyD, of the Children’s National Medical Center, and colleagues reviewed the chart histories of children aged 6 to 18 years with a current neurodevelopmental diagnosis whose parents reported signs of gender variance per the Child Behavior Checklist (CBCL), a questionnaire that gauges emotional and behavioral functioning. The CBCL was also used to identify emotional health problems within the clinical range.

Statistical analysis of study data showed the following trends:

• Gender variance was reported in 4.8% of participants with ADHD and 5.4% of participants with an ASD compared with 0% of non-CBCL-reporting control participants.
• Participants with an ASD were 7.59 times more likely and participants with ADHD were 6.64 times more likely to report gender variance than the control participants, both statistically significant differences.
• Participants with comorbid neurodevelopmental disorders and gender variance showed increased rates of anxious/depressed symptoms (P=.005) and withdrawn/depressed symptoms (P=0.006) as compared with participants with neurodevelopmental disorders and no reported gender variance.
• Participants with an ASD and gender variance had fewer reported emotional symptoms than participants with gender variance and a non-ASD neurodevelopmental disorder (P=.001).
• After accounting for sex ratio differences, gender variance occurred equally in boys and girls.

Researchers hypothesized that children with ASD or ADHD may be less inhibited or aware of social restrictions that limit gender expression, or that the rigid thinking of some children with ASD may cause them to interpret mild gender nonconforming urges as absolute.

“This study confirms the importance of examining gender variance in various neurodevelopmental disorders,” the researchers wrote. “Given our findings of elevated emotional symptoms among those children with comorbid neurodevelopmental disorders and gender variance, and our clinical experience that these children have particularly complex challenges managing gender variance in the presence of neurodevelopmental challenges, further inquiry into this comorbidity is important.”

Disclosure: The researchers report no relevant financial disclosures.