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Study finds youths with gender dysphoria have higher rates of Asperger syndrome

A new study provides clinical data to support growing evidence that autism spectrum disorder (ASD) is more prevalent in children and adolescents with gender dysphoria than in the general population. “Importantly, ASD does not preclude support of gender transition, but awareness of its existence is necessary for the provision of optimal clinical care to children and adolescents with gender dysphoria,” said LGBT Health editor in chief William Byne, MD, PhD.

A new study provides clinical data to support growing evidence that autism spectrum disorder (ASD) is more prevalent in children and adolescents with gender dysphoria than in the general population.

Among youths seen at a pediatric gender clinic who were screened for ASD, 23% possibly or likely had Asperger syndrome, according to the study published in LGBT Health, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

Based on an increased likelihood of the co-occurrence of gender dysphoria and ASD, Daniel Shumer, MD, MPH, Sari Reisner, ScD, Laura Edwards-Leeper, PhD, and Amy Tishelman, PhD, Boston Children’s Hospital (MA) and Pacific University of Professional Psychology (Hillsboro, OR), co-authors of “Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic,” recommend routine assessment of ASD in youth who seek treatment for feelings of disconnectedness between their sex at birth and their current gender identity.

“Importantly, ASD does not preclude support of gender transition, but awareness of its existence is necessary for the provision of optimal clinical care to children and adolescents with gender dysphoria,” said LGBT Health editor in chief William Byne, MD, PhD, Icahn School of Medicine at Mount Sinai, New York, NY.

The researchers conducted a retrospective review of patient chart data from 39 consecutive youth ages eight to 20 years (mean age 15.8 years, natal male: n = 22, natal female: n = 17) presenting for evaluation at a multidisciplinary gender clinic in a US pediatric hospital from 2007 to 2011 to evaluate the prevalence of ASD in this patient population. Overall, 23.1% of patients (9/39) presenting with gender dysphoria had possible, likely, or very likely Asperger syndrome as measured by the Asperger Syndrome Diagnostic Scale (ASDS).

These findings are consistent with growing evidence supporting increased prevalence of ASD in gender dysphoric children. To guide provision of optimal clinical care and therapeutic intervention, routine assessment of ASD is recommended in youth presenting for gender dysphoria.

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