<h3>Objective:</h3> To examine sex differences in Tourette Syndrome (TS) and Persistent Motor or Vocal Tic Disorder (PMVT) individuals. <h3>Background:</h3> TS and PMVT are more prevalent in males compared to females. Females with TS may have a delayed diagnosis and more complex tics than males. Obsessive-compulsive disorder (OCD) is more prevalent in females; attention-deficit hyperactivity disorder (ADHD) is more prevalent in males. This study analyzes sex differences in outcomes among TS and PMVT. <h3>Design/Methods:</h3> Data from 2405 individuals (N=2109 TS; N=168 PMVT) from the Tourette Association of America International Consortium for Genetics were analyzed to explore the relationship between sex and TS or PMVT outcomes: 1) age at tic onset; 2) time-to-diagnosis; 3) tic severity; and 4) comorbidity rates. Regression models adjusted for age, sex, and family relationships. <h3>Results:</h3> Females with TS (25.5% of the sample) compared to males had a later age of symptom onset (6.5±2.8 vs. 6.0±2.7; p=0.001), and a longer time-to-diagnosis [3 (1,7) vs. 2 (1,5), p=0.01]. OCD was more prevalent in females (55% vs. 48.7%; p=0.01) as well as ADHD (61.1% vs. 55.7%; p<0.001). After adjusting for sex, age, and family relationships, females had lower odds of ADHD [0.6 (0.5, 0.7)]. Females with PMVT (42.9% of the sample) compared to males had an earlier age of symptom onset (7.9±3.3 vs. 8.9±3.7; p=0.05). OCD was more prevalent in females (41.9% vs. 22.2%; p<0.001), but not ADHD. Results were significant after adjusting for sex, age, and family relationships. <h3>Conclusions:</h3> Females with TS may be clinically different than males with TS. ADHD appeared more prevalent in females with TS in univariate analyses, but less prevalent in regression models. In contrast, females with PMVT appear similar compared to males with PMVT. Age of symptom onset is later in females with TS, but earlier in females with PMVT. Meta-analyses may help to better understand these findings. <b>Disclosure:</b> The institution of Dr. Dy-Hollins has received research support from CNCDP-K12. Lori B. Chibnik has nothing to disclose. Lisa Osiecki has nothing to disclose. Dr. Sharma has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Dr. Sharma has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley. Dr. Sharma has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Cambridge Expert Witness. The institution of Dr. Sharma has received research support from NIH. The institution of Carol Mathews has received research support from NIH. Carol Mathews has received publishing royalties from a publication relating to health care. The institution of Dr. Scharf has received research support from the TLC Foundation for Body-Focused Repetitive Behaviors. Dr. Scharf has received personal compensation in the range of $500-$4,999 for serving as a Speaker for a TAA/CDC Family Day Symposium with the Tourette Association of America. Dr. Scharf has a non-compensated relationship as a Scientific Advisory Board Member with the Tourette Association of America that is relevant to AAN interests or activities.
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