Gender identity profiles in autistic and non‐autistic cisgender and gender diverse youth, and their caregivers

This preregistered study examined whether the gender identity phenotype differs between autistic and non‐autistic children and adolescents, as well as whether gender identity traits aggregate similarly within their families. Study 1 involved four matched groups of autistic and non‐autistic gender diverse youth referred to a UK specialist gender clinic, as well as cisgender autistic and non‐autistic youth (n = 45 per group). Participants completed measures of gender typicality, discontentedness, anticipated future identity, and (parent‐reported) dysphoria. Despite large and significant differences between cisgender and gender diverse youth across all gender‐related measures, there were no significant differences between autistic and non‐autistic participants within either gender group. Study 2 assessed recalled childhood gender behaviors and current gender dysphoria in the caregivers of participants from each group (N = 203). Caregivers of gender‐referred youth, regardless of autism status, reported higher current dysphoric traits than caregivers of cisgender youth, but no differences were observed in recalled childhood gender‐related behavior. Overall, the findings indicate that the gender phenotype of autistic youth is comparable to that of non‐autistic youth within the same gender identity group, challenging the assumption that gender diversity in autism arises from different underlying mechanisms. Clinically, these results support equitable access to gender‐related care for autistic and non‐autistic gender diverse youth.