Abstract
Background: Recent research has shown that a high percentage of treatment-seeking transgender adults who were assigned female at birth (AFAB) reported scores above the clinical cutoff for autistic traits. It is unclear whether those scores reflect a stable trait or may be inflated by the high levels of anxiety typically associated with transgender people attending clinical services.Aims: This longitudinal study aims to explore the impact of Cross-sex Hormone Treatment (CHT) on levels autistic traits, independent of changes in anxiety.Method: Transgender adults who were assessed at a national transgender health service in the UK, who had not previously received CHT and who had completed the AQ-Short as a measure of autistic traits pre- and one-year post-CHT were included in the study (n = 118). Anxiety was assessed at the same time points using the Hospital Anxiety and Depression Scale.Results: AQ-Short scores remained very stable over time (ICC = 0.7; CIs 0.591-0.779) but anxiety showed little consistency (ICC = 0.386; CIs 0.219 to 0.531). Repeated measures ANOVA found a main effect of assigned sex with AFAB having higher AQ-Short scores. There was no change in AQ-Short scores and no significant interaction between assigned sex and change in AQ-Short scores.Conclusion: This study confirmed that treatment seeking transgender AFAB people have higher levels of autistic traits at follow-up compared to AMAB transgender people and that these traits are stable following one year of CHT regardless of assigned sex. This may have clinical implications regarding the support that transgender people may require following medical transition.
Highlights
A number of studies suggest a link between the presence of Autistic Spectrum Conditions (ASC) in children and young people and higher rates of gender dysphoria: a discrepancy between sex assigned at birth and gender identity (Glidden, Bouman, Jones, & Arcelus, 2016)
The present study explored the following research questions; do levels of autistic traits remain stable from pre-treatment to one-year post-Cross-sex Hormone Treatment (CHT), when controlling for change in anxiety and age? If autistic traits change from baseline to follow-up, what is the impact of sex assigned at birth and change in anxiety on changes in levels of autistic traits? As this is an exploratory study and the first research longitudinally investigating the impact of CHT upon levels of autistic traits, no hypotheses were formulated
Of the 118 participants who completed the questionnaires at follow-up, there were the equal numbers of assigned female at birth (AFAB) and assigned male at birth (AMAB)
Summary
A number of studies suggest a link between the presence of Autistic Spectrum Conditions (ASC) in children and young people and higher rates of gender dysphoria: a discrepancy between sex assigned at birth and gender identity (Glidden, Bouman, Jones, & Arcelus, 2016). Recent research has shown that a high percentage of treatment-seeking transgender adults who were assigned female at birth (AFAB) reported scores above the clinical cut-off for autistic traits. It is unclear whether those scores reflect a stable trait or may be inflated by the high levels of anxiety typically associated with transgender people attending clinical services
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