Autism and gender identity

16 Jun

Two abstracts from IMFAR (the International Meeting for Autism Research) caught my eye as they discussed an area I haven’t seen discussed much (if at all): gender identity and autism.

The 2008 paper was from the Autism Research Centre (ARC), R.M. Jones first author, and Simon Baron-Cohen‘s group:

Female-to-male transsexuals and autistic traits.

The second paper had first author I. L. J. Noens ( Katholieke Universiteit Leuven) with collaborators from the Netherlands.

Co-Occurrence of Autism Spectrum Disorders in Individuals with Gender Dysphoria

It isn’t surprising that the ARC paper was looking for support for the Extreme Male Brain theory of autism. They tested transsexuals, female-to-male and male-to-female, “typical” [edit: typical is their term in the abstract] males and females and people with Asperger syndrome. They used the Autism Quotient test. What they found was that male-to-female transexuals and “typical” males and females scored about the same. Female-to-male transexuals scored significantly higher than these groups in AQ, but significantly lower than people with Asperger syndrome. The concluding sentences in the abstract stated:

We speculate that these biological females, being masculinized in their autistic traits, may have had difficulties socializing with a female peer group and therefore found it easier to identify with a male peer group. This research illustrates how carefully selected groups in the population (e.g., congenital adrenal hyperplasia) can inform the extreme male brain (EMB) theory of autism.

I think this speculation is just that–speculation. I am not really comfortable with the speculation either. However, the idea of studying gender identity and autism stayed with me. So, I was very interested when I saw the abstract for the Noens study in the 2009 IMFAR abstracts.

Noens et al. took a different approach. They tested people for autism who were referred to the Amsterdam Gender Identity Clinic.

From April 2004 to December 2007, all children and adolescents referred to the Amsterdam Gender Identity Clinic were screened for ASD features.

Their preliminary results?

Preliminary results indicate that at least 6 % of the 233 referred children and adolescents has an ASD. This percentage remains almost the same for the referrals with a confirmed Gender Idenity Disorder (GID) or Gender Identity Disorder-Not Otherwise Specified (GID-NOS) diagnosis. The group of individuals with ASD and GID (seven adults included) is heterogeneous in various respects: sex (both male and female), GID classification (GID, GID-NOS, transvestic fetishism), ASD classification (AD, Asperger syndrome, PDD-NOS), age of onset of GID (before or after puberty), and developmental trajectory (cross-sex behavior temporary or persistent).

Pretty interesting, if you ask me. 6% of people referred to the clinic had an ASD. Unlike the results from the ARC group, there appears to be similarity in the male and female subgroups.

6%–about 6x the prevalence of autism in the general public. That is worth following up on.

There is, of course, another study one could consider: how many people with ASD’s have GID’s?

Note: I hope I have treated gender identity with respect. If I have made any disrepectful comments, I would welcome suggestions for correction.

12 Responses to “Autism and gender identity”

  1. gonzo June 16, 2009 at 21:56 #

    For a moment I thought you’re quoting The Onion.

    Well, at least Homosexuality isn’t a disorder anymore.

  2. hammiesays June 17, 2009 at 19:17 #

    This is fascinating! Thinking about it I would say that my son isnt that fixated on gender roles, but I always thought that it was because he is closer to me, than his father. Also he doesnt see anything socially unacceptable about putting on my make up or painting his toenails. But then he isn’t remotely socially interested.

    It is also interesting to consider how I am in relation to feeling more comfortable relating to males or females. I have to say I prefer straight forwardness, and men tend to be more that way in the work place (my previous life) but since I have been mixing with auties, I find I get along quite well with the other mums. xx

  3. chen_gershuni June 17, 2009 at 20:53 #

    The ARC’s finding does not support the Extreme Male Brain theory of autism.
    Had the theory been correct, we would expect typical males to score much higher than typical females on the Autism Quotient test.
    Since both typical males and typical females scored about the same, it does not support the Extreme Male Brain theory.
    In addition, the huge numbers of undiagnosed autistic females (as reported here: ) do not support the Extreme Male Brain theory.

  4. nextofkynn June 19, 2009 at 08:43 #

    Note: I hope I have treated gender identity with respect. If I have made any disrepectful comments, I would welcome suggestions for correction.

    No, you didn’t treat the topic with respect.

    Try using another term other than “typical” for people who are not transgender.

    “Cisgender” would work. “Non-transgender” might work. But no, “typical” is not respectful.

    I know the paper you are citing used it, but the paper also did not ask me for feedback on its terminology — you did.

  5. rajensen088 June 21, 2009 at 17:49 #

    Neither of those studies used DSM-IV or ICD-10 diagnostic tools. The intruments used were the Autism Spectrum Quotient or DISCO. These tools are used to measure social impairments, not the presence of a Pervasive Developmental Disorder. The diagnostic criteria (DSM-IV-TR) for Gender Identity Disorders includes “The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning”.…..l/38/14/32

    This continue a trend by cognitive psychologists (Baron-Cohen)and child psychiatrists (Constantino) to redefine the definition of autism, away from a profoundly handicapping disorder to a ‘trait’ disorder associated with ‘qualitative impairment in social reciprocity’.

    Anorexia has recently been posited as being associated with ASD.…..nking.html

    Some cognitive psychologists have recommended placing anorexia as a sub-category of ASD

    Constantino has posited the theory that ADHD and ASD have common genetic architures and autistic traits and ADHD children with cutoff scores high enough to qualify should be another sub-category of ASD, perhaps ADHD ASD:…..o=EJ813466

    This study did not use DSM-IV or ICD-10 diagnostic criteria but used what Constantino calls his SRS or Social Responsiveness Scale, a checklist of personality behaviors related to his concept of social impairments which he defines as autistic traits.

    Perhaps the cognitive psychologists and child psyhiatrists would add several sub-categories to what will be called ‘Autism Spectrum Disorders’, GID ASD and Anorexia ASD along with Constantino’s recommendation for a ADHD ASD sub-category with the ‘Autism Spectrum Disorders.

    Here is the current recommendations:…..eport.aspx

    It will be interesting to see what the Autism Working Group finally comes up with with the new definition of autism. Whatever it will be, one thing is certain, the current prevalence rates will pale by comparison to what prevalence rates will be when DSM-V is published.

  6. Mike Stanton June 21, 2009 at 23:15 #

    I think you are too harsh on Sullivan. Typical was used to describe people in the study who were neither transgender nor autistic. It was not meant to suggest that there is anything inferior in being transgendered. Within the autism community the word typical does not carry any connotations of worth. The term “neurotypical” was coined by autistic people as a neutral alternative to “normal” to describe nonautistic people. Autistic people themselves are, in contrast, “neurodiverse.”

    These expressions are gaining currency amongst academics and advocacy groups because they are descriptive without being judgemental. Just as importantly, they are are easily understood by outsiders, which cannot be said of “cisgender.” We need to find new words that remove barriers rather than acting as barriers to understanding.

  7. Sullivan June 23, 2009 at 19:32 #

    Try using another term other than “typical” for people who are not transgender.

    “Cisgender” would work. “Non-transgender” might work. But no, “typical” is not respectful.

    Sorry for that–I put it in quotes the first time I used it because that is the term used in the abstract by the ARC group. In other words, I was quoting them but trying to denote that I don’t find the term “typical” to be a good term.

    I hope that explains the use of the term in this post.

  8. Mike Stanton June 23, 2009 at 23:51 #

    I sgree that “typical” is not respectful. But neither is it disrespectful. It simply means conforming to type. Transgendered people do not conform to type. There is nothing wrong with that and there is nothing wrong with language which reflects that.

    Problems arise with language that has a negative connotation. if there were a negative connotation to being atypical why did Autism Network International coin the phrase neurologically typical to refer to the non-autistic population? Here is the relevant quote from Martijn Dekker writing for the very first online international autism conference, Autism 99.

    To avoid having to use the term “normal” to describe people who are not autistic, people at Autism Network International have invented a new term for people without neurological conditions such as Autism: NT, which means “neurologically typical”. This term has found widespread use in the entire online Autism community, including even parents of autistic children. The opposite term is AC, meaning “autistics and cousins”, or people with Autism and related conditions. This terminology is analogous to similar words in other disability communities, and can in fact help shape a community. (ON OUR OWN TERMS: Emerging Autistic Culture, Martijn Dekker 1999)

    Martijn’s original essay is no longer available online and the quote is taken from my book. I also have the original essay on my hard drive and will publish it on the web if Martijn consents. Since then the abbreviated term neuro[logically]diverse has gained in popularity as an antonym for neuro[logically]typical inpreference to the more awkward expression, “autistics and cousins.”

    If typical is an accepted descriptor of non-autistic people I fail to see why it should not be acceptable as a descriptor of non-transgendered people.

    We should also remmeber that all language evolves. NT or neurotypical has survived. AC or autistics and cousins has largely been replaced by ND or neurodiverse. The important point is that the concepts behind the use Neuroligically typical and Autistics and Cousins have entered the mainstream, even if the words we use to express them have been modified.

    My argument with the movement for politically correct language has always been that I think they are in error if they insist on the correct form of words as a way to create respectful attitudes. In my opinion it is more important to encourage debate that challenges people’s ideas. And that debate should not insist in advance on the form of words people are allowed to use.

    New ways of thinking and new ways of speaking may emerge from that debate. By and large changes in language reflect changed attitudes rather than creating new attitudes. In the same way that censorship is powerless against an idea whose time has come, PC attempts at outlawing hate speech and legislating what is correct are powerless in outlawing hateful ideas.

  9. nt4i June 24, 2009 at 12:39 #

    Mike – I agree entirely. Respect, understanding and non-discrimiation is about belief and action not about how up to date I am on the current terminology
    Its perfectly possible to use all the correct words and phrases but still beleive something different. There should not be a witchhunt for people accidentally using out-dated terminology if they have the best intentions.

  10. Just Some Trans Guy July 21, 2009 at 17:51 #

    Words reflect actions.

    Just as people with autism have the right to correctly identify people who are not autistic in ways that are not “othering” of people with autism, so too do trans people have the right to identify non-trans people in ways that do not “other” us. Moreover, cis people do not get to decide for us what does and does not other us.

    Intentions do not matter. If someone accidentally steps on my foot, it is still important that this person LIFTS HIR FOOT. If the person does so, then I’m certainly inclined to be forgiving. But if I tell this person, “Ouch! You’re standing on my foot!” and this person stares at me blankly, leaves hir foot there, and shrugs, “Well, I didn’t mean to, so you shouldn’t be upset” … then I am much less inclined to be forgiving.

    The blog Questioning Transphobia has some good posts on the topic of terminology:

  11. Just some AS guy February 18, 2010 at 07:09 #

    Because everyone commenting on this blog is absolutely a cis person. And you can absolutely tell this over the internet.

    The poster approached this topic with delicacy and care not to offend. Transgender people are less numerous than non, so they are, by definition, less typical, just as redheads are not “typical” of the population. To get offended over someone’s terminology when he’s obviously trying so hard to be inclusive is ludicrous and confuses who the real enemy is.

    Similarly, JSTG, every person does not have an obligation to run around learning every term that every group would prefer to have themselves referred by, especially since some members of those groups are STILL going to find those terms offensive. Someone using the word “typical” does not equate to someone stepping on your foot. If this happened in real life, the one wouldn’t give you the right to physically assault someone and claim it was “equivalent.” This type of thinking is extremely divorced from reality.

    If YOU want to use some term other than typical (or gendertypical, or whatever) to refer to non-trans people, that’s fine. Everybody else can use whatever term they like. I certainly don’t try to police what people in groups that do not include me call themselves.

    But maybe I just don’t understand the point of being offended or the process by which this occurs.

  12. griff1964 March 6, 2010 at 06:16 #

    Well now I’m not a cis person. I’m a Transman with a son(currently) with Asperger’s who is in the process of transitioning also.
    I also believe, though not diagnosed that I have ADD.
    I read somewhere else, forget where, that there is a significantly higher proportion of Transmen parents of kids with ASD.
    Very interesting. Seems like a good idea to research more on this.

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