Autistic traits, systemising, empathising, and theory of mind in transgender and non-binary adults

Karson T F Kung

doi:10.1186/s13229-020-00378-7

Abstract

BackgroundPrior research examining autistic traits in gender minority adults has reported mixed findings. Most prior studies did not include non-binary individuals. Little is known about the mechanisms shaping autistic traits in gender minority adults. This study examined autistic traits, as well as constructs related to the extreme male brain theory of autism and the mindblindness theory, in transgender and non-binary adults.MethodsAn online survey was conducted to assess autism-related traits in 323 gender minority adults, including 74 transgender men (individuals assigned female at birth and identify as a man), 95 transgender women (individuals assigned male at birth and identify as a woman), 104 non-binary AFAB (individuals assigned female at birth and identify as non-binary), and 50 non-binary AMAB (individuals assigned male at birth and identify as non-binary). Autistic traits, systemising, empathising, and Theory of Mind (ToM) were measured using the Autism Spectrum Quotient (AQ), the short forms of the Systemising Quotient (SQ-Short) and the Empathy Quotient (EQ-Short), the 10-item version of the Empathy Quotient (EQ-10) and the Reading the Mind in the Eyes Test (Eyes Test). Participants’ scores on these measures were compared with previously published scores based on large-scale general population samples including thousands of participants.ResultsOn average, compared with control females in the general population samples, both transgender men and non-binary AFAB scored significantly higher on the AQ and the SQ-Short but scored significantly lower on the EQ-Short, the EQ-10, and the Eyes Test. No clear or consistent group differences emerged when transgender women and non-binary AMAB were compared with control males.LimitationsThe present study does not have a large sample of gender minority adults. It has been argued that the measures employed may not provide a precise assessment of the psychological constructs of interest. The present study has a “non-clinical” sample. However, not all gender minorities have access to or require clinical services, and so a “non-clinical” sample may be more representative of the gender minority community as a whole than samples recruited through clinics.ConclusionsThe current findings suggest a “masculinised” autism-related profile and reduced ToM in transgender men and in non-binary AFAB. These findings might be interpreted to support the extreme male brain theory of autism and the mindblindness theory. Further research is needed to corroborate these findings.

Highlights

Prior research examining autistic traits in gender minority adults has reported mixed findings
Jones et al [1] conducted the first study on this topic and found elevated autistic traits in gender minority adults assigned female at birth compared with control females [1]
This study found lower empathising and unaltered systemising in adolescent transgender boys compared with control females, whilst there were no differences in empathising or systemising between adolescent transgender girls and control males [29]

Summary

Introduction

Prior research examining autistic traits in gender minority adults has reported mixed findings. Regarding comparisons between gender minority adults assigned male at birth and control males, findings from these prior studies were mixed [1,2,3,4,5,6]. All these studies employed versions of the Autism Spectrum Quotient, a self-reported questionnaire, to assess autistic traits [1,2,3,4,5,6]. A recent large-scale study has reported higher rates of autism and other neurodevelopmental and psychiatric conditions in gender minority individuals [11]

Methods

Results

Discussion

Conclusion