Study finds higher rates of gender diversity among autistic individuals

A September 2020 study published in Nature Communications found that transgender and gender-diverse individuals have higher rates of autism than their cisgender peers.

Researchers found that transgender and gender-diverse individuals were 3 to 6 percent more likely to be diagnosed with autism with scores higher in areas of sensory sensitivity and autistic traits and lower in empathetic traits. They found their participants experienced challenges outside of autism, citing other psychiatric conditions that play a role in their everyday lives.

“This research is crucial to understanding the need transgender and gender-diverse people have for appropriate medical and mental health care that can improve their quality of life,” said Thomas W. Frazier, Ph.D., chief science officer at Autism Speaks. “By looking at groups of autistic people across several different types of data collected, this study gives us a more realistic idea of how much gender identity and autism overlap.”

The study analyzed data from 641,860 participants across five datasets, including survey data, population studies and online questionnaires. Researchers found that 24 percent of the gender-diverse and transgender respondents were autistic compared with 5 percent of the study’s cisgender participants.

The researchers analyzed data that included formal autism diagnosis as well as autistic traits, which can include hyper-recognition of patterns, sensitivity to sensory input and levels of empathy. The researchers also looked at perceptions of transgender and gender-diverse individuals—if they believed that they were misdiagnosed or believed they should be diagnosed with autism.

These data sets confirmed what researchers expected to find, including their participants feeling they had been misdiagnosed or underdiagnosed for autism. They also confirmed previous findings of higher rates of other psychiatric conditions among transgender and gender-diverse individuals like schizophrenia, ADHD and depression. Previous studies have also estimated that about 30 to 50 percent of transgender teens attempt suicide, underscoring the need to screen for these risk factors in transgender, gender-diverse and autistic teens.

Almost 70 percent of autistic individuals who also identify as transgender and gender diverse said they needed gender identity related medical care but could not get appropriate care due to their autism diagnosis. In study published in June 2020, more than 35 percent of autistic LGBTQ adults surveyed said they were refused services by a medical provider, despite this group having greater health care needs overall.

Researchers concluded that current medical and mental health care for transgender and gender-diverse autistic people is inadequate.

“This study underscores the huge disparity in health care needs for transgender and gender-diverse autistic people,” said Dr. Frazier. “Future research should focus on how to better meet their healthcare needs and what medical and mental health providers can do to best support their patients.”

Read more about how parents can support autistic, gender-diverse youth in this Got Questions? article from Dr. Eric Butter, a clinician at the Division of Psychology in the Department of Pediatrics at The Ohio State University College of Medicine.