Skip to main content
SpringerLink
Log in

A Longitudinal Study of Features Associated with Autism Spectrum in Clinic Referred, Gender Diverse Adolescents Accessing Puberty Suppression Treatment

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Literature has documented inflated rates of features associated with autism spectrum (AS) in clinic referred, gender diverse young people. This study examined scores on the Social Responsiveness Scale, Second Edition (SRS-2) over time in a group of clinic referred, gender diverse adolescents accessing gonadotropin-releasing hormone analogues (GnRHa) to supress puberty. Primary caregivers of 95 adolescents presenting to the Gender Identity Development Service (GIDS) completed the SRS-2 prior to receiving endocrine input (mean age: 13.6 ± SEM: 0.11) and after approximately one year of accessing GnRHa (mean age: 14.6 ± SEM: 0.13). No significant differences in SRS-2 scores over time and between birth assigned sex were found. No interactions between time and birth assigned sex were established for SRS-2 subscales or total scores.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Pub.

    Book  Google Scholar 

  • Baron-Cohen, S., Scott, F. J., Allison, C., Williams, J., Bolton, P., Matthews, F. E., et al. (2009). Prevalence of autism-spectrum conditions: UK school-based population study. The British Journal of Psychiatry, 194(6), 500–509.

    Article  Google Scholar 

  • Cholemkery, H., Kitzerow, J., Rohrmann, S., & Freitag, C. M. (2014). Validity of the social responsiveness scale to differentiate between autism spectrum disorders and disruptive behaviour disorders. European Child & Adolescent Psychiatry, 23(2), 81–93.

    Article  Google Scholar 

  • Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J.,... & Monstrey, S. (2012). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism, 13(4), 165–232

  • Constantino, J. N., & Gruber, C. P. (2012). Social responsiveness scale second edition (SRS-2): Manual. Torrance: Western Psychological Services.

    Google Scholar 

  • Costa, R., Dunsford, M., Skagerberg, E., Holt, V., Carmichael, P., & Colizzi, M. (2015). Psychological support, puberty suppression, and psychosocial functioning in adolescents with gender dysphoria. The Journal of Sexual Medicine, 12(11), 2206–2214.

    Article  Google Scholar 

  • De Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134(4), 696–704.

    Article  Google Scholar 

  • De Vries, A. L., Noens, I. L., Cohen-Kettenis, P. T., van Berckelaer-Onnes, I. A., & Doreleijers, T. A. (2010). Autism spectrum disorders in gender dysphoric children and adolescents. Journal of Autism and Developmental Disorders, 40(8), 930–936.

    Article  Google Scholar 

  • De Vries, A. L., Steensma, T. D., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2011). Puberty suppression in adolescents with gender identity disorder: A prospective follow-up study. The Journal of Sexual Medicine, 8(8), 2276–2283.

    Article  Google Scholar 

  • Dean, M., Harwood, R., & Kasari, C. (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678–689.

    Article  Google Scholar 

  • Frazier, T. W., Ratliff, K. R., Gruber, C., Zhang, Y., Law, P. A., & Constantino, J. N. (2014). Confirmatory factor analytic structure and measurement invariance of quantitative autistic traits measured by the social responsiveness scale-2. Autism, 18(1), 31–44.

    Article  Google Scholar 

  • Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., et al. (2015). Sex and gender differences in autism spectrum disorder: Summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism, 6, 36. https://doi.org/10.1186/s13229-015-0019-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hayes, J., Ford, T., Rafeeque, H., & Russell, G. (2018). Clinical practice guidelines for diagnosis of autism spectrum disorder in adults and children in the UK: A narrative review. BMC Psychiatry, 18(1), 222.

    Article  Google Scholar 

  • Hembree, W. C. (2011). Guidelines for pubertal suspension and gender reassignment for transgender adolescents. Child and Adolescent Psychiatric Clinics, 20(4), 725–732.

    Article  Google Scholar 

  • Hiller, R. M., Young, R. L., & Weber, N. (2016). Sex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder. Autism, 20(1), 75–84.

    Article  Google Scholar 

  • Holt, V., Skagerberg, E., & Dunsford, M. (2016). Young people with features of gender dysphoria: Demographics and associated difficulties. Clinical Child Psychology and Psychiatry, 21(1), 108–118.

    Article  Google Scholar 

  • Hus, V., Bishop, S., Gotham, K., Huerta, M., & Lord, C. (2013). Factors influencing scores on the social responsiveness scale. Journal of Child Psychology and Psychiatry, 54(2), 216–224.

    Article  Google Scholar 

  • Kaltiala-Heino, R., Bergman, H., Työläjärvi, M., & Frisén, L. (2018). Gender dysphoria in adolescence: Current perspectives. Adolescent Health, Medicine and Therapeutics, 9, 31–41. https://doi.org/10.2147/AHMT.S135432.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kaltiala-Heino, R., Sumia, M., Työläjärvi, M., & Lindberg, N. (2015). Two years of gender identity service for minors: Overrepresentation of natal girls with severe problems in adolescent development. Child and Adolescent Psychiatry and Mental Health, 9(1), 9.

    Article  Google Scholar 

  • Kirkovski, M., Enticott, P. G., & Fitzgerald, P. B. (2013). A review of the role of female gender in autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(11), 2584–2603.

    Article  Google Scholar 

  • Lai, M. C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Auyeung, B., Szatmari, P.,... & MRC AIMS Consortium. (2017). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702

  • Leef, J. H. (2018). Characteristics of autism spectrum disorder in children with gender dysphoria (Doctoral dissertation).

  • Leef, J. H., Brian, J., Van der Laan, D. P., Wood, H., Scott, K., Lai, M. C.,... & Zucker, K. J. (2019). Traits of autism spectrum disorder in school-aged children with gender dysphoria: A comparison to clinical controls. Clinical Practice in Pediatric Psychology, 7(4), 383

  • Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466–474.

    Article  Google Scholar 

  • Nordahl-Hansen, A., Cicchetti, D. V., & Øien, R. A. (2019). A review update on gender dysphoria and ASD and response to corrections. Journal of Autism and Developmental Disorders, 49(4), 1745–1748.

    Article  Google Scholar 

  • Shumer, D. E., Reisner, S. L., Edwards-Leeper, L., & Tishelman, A. (2016). Evaluation of Asperger syndrome in youth presenting to a gender dysphoria clinic. LGBT Health, 3(5), 387–390.

    Article  Google Scholar 

  • Skagerberg, E., Di Ceglie, D., & Carmichael, P. (2015). Brief report: Autistic features in children and adolescents with gender dysphoria. Journal of Autism and Developmental Disorders, 45(8), 2628–2632.

    Article  Google Scholar 

  • Spack, N. P., Edwards-Leeper, L., Feldman, H. A., Leibowitz, S., Mandel, F., Diamond, D. A., et al. (2012). Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics, 129(3), 418–425.

    Article  Google Scholar 

  • Strang, J. F., Meagher, H., Kenworthy, L., de Vries, A. L., Menvielle, E., Leibowitz, S.,... & Pleak, R. R. (2018). Initial clinical guidelines for co-occurring autism spectrum disorder and gender dysphoria or incongruence in adolescents. Journal of Clinical Child & Adolescent Psychology, 47(1), 105–115.

  • Tanner, J. M. (1981). Growth and maturation during adolescence. Nutrition Reviews, 39(2), 43–55.

    Article  Google Scholar 

  • Turban, J. L. (2018). Potentially reversible social deficits among transgender youth. Journal of Autism and Developmental Disorders, 48(12), 4007–4009.

    Article  Google Scholar 

  • Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics, 145(2), e20191725.

    Article  Google Scholar 

  • Turban, J. L., & van Schalkwyk, G. I. (2018). “Gender dysphoria” and autism spectrum disorder: Is the link real? Journal of the American Academy of Child & Adolescent Psychiatry., 57, 1.

    Article  Google Scholar 

  • Twist, J., & de Graaf, N. M. (2019). Gender diversity and non-binary presentations in young people attending the United Kingdom’s National Gender Identity Development Service. Clinical Child Psychology and Psychiatry, 24(2), 277–290.

    Article  Google Scholar 

  • Van der Miesen, A. I., de Vries, A. L., Steensma, T. D., & Hartman, C. A. (2018). Autistic symptoms in children and adolescents with gender dysphoria. Journal of Autism and Developmental Disorders, 48(5), 1537–1548.

    Article  Google Scholar 

  • Van Der Miesen, A. I., Hurley, H., & De Vries, A. L. (2016). Gender dysphoria and autism spectrum disorder: A narrative review. International Review of Psychiatry, 28(1), 70–80.

    Article  Google Scholar 

  • Wigham, S., McConachie, H., Tandos, J., Le Couteur, A. S., & Gateshead Millennium Study Core Team. (2012). The reliability and validity of the Social Responsiveness Scale in a UK general child population. Research in Developmental Disabilities, 33(3), 944–995.

    Article  Google Scholar 

  • Zucker, K. J., Bradley, S. J., Owen-Anderson, A., Kibblewhite, S. J., Wood, H., Singh, D., et al. (2012). Demographics, behavior problems, and psychosexual characteristics of adolescents with gender identity disorder or transvestic fetishism. Journal of Sex & Marital Therapy, 38(2), 151–189.

    Article  Google Scholar 

  • Zucker, K. J., Wood, H., & VanderLaan, D. P. (2014). Models of psychopathology in children and adolescents with gender dysphoria. In T. D. Steensma, B. P. C. Kreukels, & A. L. C. de Vries (Eds.), Gender dysphoria and disorders of sex development (pp. 171–192). Boston, MA: Springer.

    Chapter  Google Scholar 

Download references

Author information

Author notes

  1. Ian Russell

    Present address: Aldrington House, Sussex Partnership NHS Foundation Trust, 35 New Church Road, Aldrington Centre, Hove, BN3 4AG, East Sussex, UK

  2. Beth Pearson

    Present address: Meridian House, Bradford District Care NHS Foundation Trust, Bradford Road, Meridian House, Keighley, BD21 4AD, West Yorkshire, UK

Authors and Affiliations

  1. GIDS Tavistock and Portman NHS Foundation Trust, 120 Belsize Lane, London, NW3 5BA, UK

    Ian Russell, Beth Pearson & Una Masic

Authors
  1. Ian Russell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beth Pearson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Una Masic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Una Masic.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 15 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Russell, I., Pearson, B. & Masic, U. A Longitudinal Study of Features Associated with Autism Spectrum in Clinic Referred, Gender Diverse Adolescents Accessing Puberty Suppression Treatment. J Autism Dev Disord 51, 2068–2076 (2021). https://doi.org/10.1007/s10803-020-04698-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-020-04698-8

Keywords

Search

Navigation