Do Children With Gender Dysphoria Have Intense/Obsessional Interests?

Abstract

This study examined whether children clinically referred for gender dysphoria (GD) show increased symptoms of autism spectrum disorder (ASD). Circumscribed preoccupations or intense interests were considered as overlapping symptoms expressed in GD and ASD. In gender-referred children (n = 534; 82.2% male) and their siblings (n = 419; 57.5% male), we examined Items 9 and 66 on the Child Behavior Checklist, which measure obsessions and compulsions, respectively. Non-GD clinic-referred (n = 1,201; 48.5% male) and nonreferred (n = 1,201; 48.5% male) children were also examined. Gender-referred children were elevated compared to all other groups for Item 9, and compared to siblings and nonreferred children for Item 66. A gender-related theme was significantly more common for gender-referred boys than male siblings on Item 9 only. A gender-related theme was not significantly more common for gender-referred girls compared to their female siblings on either item. The findings for Item 9 support the idea that children with GD show an elevation in obsessional interests. For gender-referred boys in particular, gender-related themes constituted more than half of the examples provided by their mothers. Intense/obsessional interests in children with GD may be one of the factors underlying the purported link between GD and ASD.

Acknowledgments

The authors thank three anonymous reviewers for comments on an earlier draft of this article.

Notes

^a Data from a Gender Identity Service for Children and Adolescents.

^b Data from Achenbach (1991, Appendix D; iVs/group are given in Appendix B).

Note. Missing data were the result of the mother not providing a description for their ratings of a 1 or a 2.

^a Fisher's exact test; not possible to calculate odds ratio because no female siblings showed a gender theme for Item 66.