(PS3-A20) Assessing Gender Diversity Among Autistic Children by Self Report and Parent Report: A Replication and Expansion of Current Research

Introduction: There has been a growing understanding of the relationship between autism spectrum disorders (ASD) and gender identity (Heylens et al., 2018, van der Miesen et al., 2018). Additionally, the rate of gender dysphoria in autistic individuals is greater than that seen in the general population. (Corbett et. al., 2023; De Vries et. al., 2010). In a large-scale study of autistic adults, 15% of the sample reported that they identified as nonbinary or transgender. Evidence suggests that autistic individuals who also identify as gender diverse or transgender face significant barriers to gender-related health care including challenges with self-advocacy (Strang et al., 2018). Additionally, Corbett et al. (2023) found significant, positive correlations between gender diversity and internalizing symptoms. This study proposes to replicate these findings in a larger, more diverse sample, as well as expand understanding of how race, SES, and parent education may influence this relationship.

Method: This study used pre-treatment data collected as part of a multi-site, randomized clinical intervention targeting social competence in 249 autistic youth. Gender diversity was measured using the Gender Diversity Screening Questionnaire, Parent Report (GDSQ-P; Pelphrey, 2017; Strange et. al., 2017). Internalizing symptoms were measured using the CBCL anxiety, depression, and withdrawn subscales. Pearson correlations were used to assess the relationship between gender diversity and internalizing symptoms. A regression analysis was conducted to understand the degree to which gender diversity predicts internalizing symptoms. Lastly, demographic data were used to run a mediation analysis between gender diversity and internalizing symptoms.

Results: Parents of 249 of autistic youth aged 9 to 17 years old (M= 12.78, SD= 1.96) completed assessments. About 21% of the sample self-identified as racially minoritized and about 71% of the children were male. Initial correlations showed that GDSQ-P total score was significantly correlated with the CBCL anxiety (r= 0.146, p=.022), CBCL withdrawn (r= 0.231, p=< .001), and CBCL depression (r= .168, p< .009). When controlling for autism symptoms using the ADOS Calibrated Severity Score, the total GDSQ-P score significantly predicted only withdrawn symptoms (F(2, 241)=6.33, p= .002, R²=.050). Additionally, when assessing the relationship between GDSQ-P and anxiety (DF(1, 241)=2.314, p=.130, DR²=.009) and depression (DF(1, 241)=3.41, p=.066, DR²=.013), the GDSQ-P was not a significant predictor, but the model remained significant for both anxiety (F(2, 242)=6.67, p= .002, R²=.052) and depression (F(2, 241)=6.74, p= .001, R²=.053) when controlling for autism symptoms. Parent education, race, and yearly income were not moderators for any of the assessed relationships.

Discussion: Results of this study indicate that gender dysphoria is related to child psychopathology.  While the incidence and impact of gender diversity in an autistic population is being established in the literature, further understanding of the relationship between gender diversity and psychopathology, along with understanding influencing factors, is needed to be able to provide the highest level of care.