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- Feb 3, 2013
http://www.pridesource.com/article.html?article=75172
http://www.huffingtonpost.com/kyle-...en-autism-and-gender-dysphoria_b_3896317.html
http://healthland.time.com/2011/05/...health+(TIME:+Top+Science+and+Health+Stories)
Nearly a quarter of young persons diagnosed with gender dysphoria, or who are transgender, screened positive for Asperger syndrome, a form of autism, according to a new paper in the academic journal LGBT Health.
The study was a small retrospective review of intake files of 39 children at Boston Children's Hospital. Lead author Dr. Daniel E. Shumer explains, "We found that 23 percent of kids fell into the 'possible, likely or very likely category' when using the evaluation tool to screen for Asperger's."
Asperger's is a term that has been used to describe "higher functioning" autism spectrum disorder, or kids that have elements of autism spectrum disorder but are still able to communicate and have social interactions, he says. Some persons with Asperger's have become particularly adept at writing computer code.
The findings complement a 2010 study from Amsterdam that used more rigorous diagnostic criteria for autism in evaluating 204 youth at a clinic for gender dysphoria. It found that 7.8 percent of those children also met the criteria for having autism; that compares with an autism rate of 0.6 to 1 percent that other studies have found in the general population.
John Strang looked to see if the reverse was also true. He examined records of 1,605 children treated at Children's National Hospital in Washington, DC, in a paper published in 2013, and found that 5.4 percent of the parents of children with autism and 4.8 percent with attention deficit hyperactivity disorder (ADHD) also reported gender variant behavior in their child.
"Having autism is a burden; a lot of things in the world change when you have autism," says Strang. "But adding transgenderism, or maybe some of them aren't transgender but they are just exploring gender, that is complicated in itself."
He anticipated that dealing with both issues might increase the level of anxiety for these kids. But it turns out, that was not always the case.
Often the kids with autism "weren't really noticing the social expectations or the social biases as much as someone without autism," says Strang. "They were less anxious about the trans piece, they were less worried about what people thought," and more accepting of their own sense of identity.
But at the same time, having both conditions adds another layer of complexity. He says, "Knowing how to navigate in a world that is not really friendly with people who are trans can be tricky when you are missing social cues."
Shumer says it is important that parents and medical providers be aware of the increased possibility for co-occurrence of autism and gender variance. If treating patients for one condition, they should screen for the other and be prepared to treat it.
"There also may be implications for how to provide informed consent for things like hormonal interventions," he adds.
Strang shares those concerns. He has been working with others to develop recommendations on how to best address the needs of people dealing with both autism and gender dysphoria. They hope to publish that paper later this year.
http://www.huffingtonpost.com/kyle-...en-autism-and-gender-dysphoria_b_3896317.html
When autism is mentioned, that mention will almost certainly include a statistic. One of the more common autism-related numbers thrown around these days is the fact that it is four times more likely to occur in boys than in girls. A less commonly discussed phenomenon in the autism community (and in the greater mental health community) is that autism spectrum disorders (ASD) occur at a higher rate in transgender people than in the general population. This trend, documented in dozens of case studies and prevalence studies, causes some uncertainty around the four-times-more-common-in-males statistic and raises questions about autism and gender identity.
A study conducted by a team of British scientists in 2012 found that of a pool of individuals not diagnosed on the autism spectrum, female-to-male (FTM) transgender people have higher rates of autistic features than do male-to-female (MTF) transgender people or cisgender males and females. Another study, which looked at children and adolescents admitted to a gender identity clinic in the Netherlands, found that almost 8 percent of subjects were also diagnosed with ASD. That figure is nearly four times higher than the rate of ASD in the general population, according to the Centers for Disease Control and Prevention (CDC). Turkish researcher N. M. Mukaddes suggests that this number may even be low, citing the fact that individuals with lower levels of language may be unable to communicate their feelings of dissatisfaction with their assigned gender.
A core theory of autism is that it is an exaggeration of the typically male characteristic of systemizing with a low level of empathizing, considered a female characteristic. Called the extreme male brain (EMB) theory of autism, this theory developed from a body of research that found that males typically exhibit higher performance on tasks designed to test systemization, and lower performance on tasks measuring empathy. The British researcher who originally published this theory, Simon Baron-Cohen, applied it to individuals on the autism spectrum, observing that individuals with ASD generally perform even higher on systemization tasks than do neurotypical males, hence the term “extreme male brain.” As bizarre as these findings may sound, they have been supported by several other studieslooking at sex and ASD. However, this theory has been criticized as being based on an “unpersuasive gendering of certain capacities or aptitudes in the human population,” Timothy Krahn and Andrew Fenton wrote. Krahn and Fenton go even further to suggest that this theory may inadvertently favor males in the diagnostic process, thereby reducing access to services by females with symptoms of ASD.
While the EMB theory focuses on cognitive abilities, other factors related to sex and gender have been found to correlate with ASD. An international team of researchers found significantly higher levels of male hormones in both males and females diagnosed with ASD than in the neurotypical control group. These findings raise questions regarding both ASD and gender nonconformity. For example, could higher levels of male hormones be the cause of both ASD and feelings of gender dysphoria (the newly published clinical term for being transgender)? Or could the presence of one cause the higher levels of hormones, which in turn causes the other? Is it only more masculine women who are diagnosed with ASD, while others who show symptoms go undiagnosed? Only time and much more research on the topic will reveal the answers to these questions.
One thing we do know for sure is that transgender individuals with ASD need an extra level of treatment. Research has found that transgender individuals diagnosed with developmental disabilities are at increased risk of sexually unhealthy behavior. The authors of that study suggest that caretakers’ efforts to protect these individuals may inadvertently limit their autonomy and push them toward riskier sexual behavior. Therefore, it is important that people providing care to these unique individuals remain mindful of the unique needs and limitations that they face.
http://healthland.time.com/2011/05/...health+(TIME:+Top+Science+and+Health+Stories)
Female-to-male transgendered people — known as transmen — have more autistic traits than typical heterosexual men and women, and more than those who wish to switch gender in the opposite direction, according to new research.
Scientists led by Simon Baron-Cohen, a professor of developmental psychopathology, at Cambridge University looked for autistic traits, such as problems parsing social signals and difficulty in dealing with changes in routine, in 61 transmen, 198 transwomen, 98 typical females, 76 typical males and 125 people with actual diagnoses of Asperger’s syndrome, a mild form of autism.
“Those in the female-to-male group scored above average in terms of the number of autistic traits,” says Baron-Cohen. Indeed, the transmen outscored all but those with Asperger’s diagnoses on the Autism Spectrum Quotient, a scale devised by Baron-Cohen.
Baron-Cohen has long theorized that people with autism may have what he calls an “extreme male” brain — dominated by a style of thinking called “systemizing,” which focuses on predictable patterns like those found in mathematics or mechanical devices. He contrasts this with a cognitive style called “empathizing,” which allows for better understanding of the minds and emotions of others.
Typically, women do better at empathizing and men at systemizing, but there is, of course, wide variability: some women outperform men at systemizing, and some men are better empathizers than women.
Why the difference? Baron-Cohen and his colleagues recently found that giving testosterone to women decreases their ability to empathize, particularly among women whose bodies show evidence that they were exposed to higher levels of testosterone in utero. And previous research has linked high levels of testosterone in the womb to autistic traits. (Interestingly, in-utero exposure to testosterone can be estimated by looking at the ratio between the length of the ring finger and index finger.)
But because the transmen in the study had already transitioned to their preferred gender — a process that requires taking male hormones — the research could not show whether their autistic traits resulted from the hormones or led to the desire to change gender in the first place.
Baron-Cohen says the idea for his study arose when one of his collaborators, Dr. Domenico Di Ceglie, a child psychiatrist who directs the Gender Identity Development Service at London’s Tavistock Clinic, observed that the girls he was seeing with gender identity problems seemed to have more autistic traits than he expected.
“He thought [that their focus on changing gender] might be similar to some of the very strong fixed beliefs you see in people with high levels of autistic traits,” says Baron-Cohen, explaining that girls with more autism-related traits may also find that they share more interests with boys.
Similarly, some people who focus compulsively on eating — symptoms that are characteristic of anorexia — may also be driven by an underlying obsessive nature that turns in that direction. Past research has suggested that some cases of anorexia may in fact be attributed to girls with Asperger’s developing an obsession with being thin.
(More on TIME.com: A Genetic Link Between Anorexia and Autism?)
Baron-Cohen is quick to say that these findings do not mean that the gender identity issue for transmen is just another autistic obsession like an interest in railroads — but that understanding these kinds of connections could lead to better care for people with both conditions.
His co-author, Emma Martin, herself a transwoman, said in a statement, “This new research reminds us that gender incongruence is incredibly complex. Every possibility should be discussed with new clients, but should not delay what can be a painfully slow process for those affected.”
