Diagnostic assessment of autism spectrum disorder in transgender and gender diverse youth




The landscape of adolescence is complex, marked by self-discovery, social navigation, and the emergence of identity. For transgender and gender diverse (TGD) youth, this journey can be further nuanced by the exploration of gender identity alongside potential neurodevelopmental differences. A recent study published in March 2024, titled “Diagnostic assessment of autism spectrum disorder in transgender and gender diverse youth,” sheds light on this critical intersection of ASD and TGD identities.


A Higher Prevalence of ASD in TGD Youth


The research, conducted by a team specializing in autism evaluations, investigated the co-occurrence of ASD and TGD identities in youth. Their findings revealed a significant trend: nearly half (46%) of the TGD youth who underwent autism assessments received an ASD diagnosis, compared to a much lower percentage in the cisgender control group. This suggests a higher prevalence of ASD among TGD youth, highlighting the importance of considering ASD during evaluations for this population.


Understanding the Overlap: No Difference in Gender Identity Within TGD Groups


Interestingly, the study found no significant differences in gender identity or assigned sex at birth between TGD youth diagnosed with ASD and those who weren’t. This suggests that gender identity itself isn’t a factor influencing ASD diagnosis. However, the research does open doors for further exploration into the specific ways in which ASD and TGD identities might interact and influence each other’s presentation.


Beyond Diagnosis: Lower Functioning and Additional Needs in TGD Youth with ASD


The research delved deeper by examining the characteristics of TGD youth with ASD compared to those without ASD. Here, the findings revealed a crucial aspect to consider. TGD youth with ASD scored lower on adaptive functioning scales, indicating greater challenges in daily living skills like communication, social interaction, and self-care. Additionally, they were more likely to have an Individualized Education Program (IEP) specifically designed to address their ASD needs. This highlights the importance of comprehensive support systems that address not only gender identity but also potential neurodevelopmental needs.


Mental Health Considerations for TGD Youth


The study also explored mental health presentations within the groups. While anxiety and mood disorders were more prevalent among all TGD youth compared to the control group, language disorders were more common in the cisgender controls. This suggests that mental health presentations may differ between TGD and cisgender youth, and that mental health professionals need to be aware of these potential variations.


Implications for Mental Health Professionals


The research offers valuable insights for mental health professionals working with TGD youth. It emphasizes the need for comprehensive evaluations that consider both gender identity and potential ASD diagnoses. By recognizing the co-occurrence of ASD and TGD identities, mental health professionals can provide more targeted support. This could include:

  • Utilizing gender-affirming language and practices during assessments.
  • Employing ASD-specific screening tools alongside evaluations for gender dysphoria.
  • Developing treatment plans that address both gender identity needs and potential ASD challenges.
  • Collaborating with other professionals, such as educators and therapists, to create a holistic support system.


By fostering a deeper understanding of the experiences of TGD youth, particularly those who may also be neurodivergent, mental health professionals can create more inclusive and effective support systems. This research paves the way for further exploration of this intersection and the development of evidence-based practices for supporting the well-being of TGD youth.




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