Female-to-male transsexual people have more autistic traits

A new study from Cambridge University has for the first time found that female-to-male transsexual people have a higher than average number of autistic traits.

The Medical Research Council (MRC) funded study, published today in the Journal of Autism and Developmental Disorders, has important implications for the clinical management of biological girls with gender incongruence that persists into adulthood, and for the 'extreme male brain' theory of autism.

Professor Simon Baron-Cohen, Director of the Autism Research Centre at University of Cambridge, led the study with Rebecca Jones, now at Weill Cornell Graduate School of Medical Sciences. The team included Professor Richard Green and Dr Domenico Di Ceglie, world experts in transsexualism and gender incongruence in young people respectively, and by Emma Martin, a clinical psychotherapist and herself transsexual.

The researchers measured autistic traits using the Autism Spectrum Quotient (AQ), and compared AQ scores from five groups: 61 transmen, 198 transwomen; 76 typical males; 98 typical females; and 125 individuals with Asperger Syndrome (AS). They found transmen had a higher average AQ than typical females, typical males and transwomen, but lower than individuals with AS.

Simon Baron-Cohen interpreted the results as follows: "Girls with a higher than average number level of autistic traits tend to have male-typical interests, showing a preference for systems over emotions. They prefer not to socialise with typical girls because they have different interests, and because typical girls on average have more advanced social skills. Both of these factors may lead girls with a higher number of autistic traits to socialize with boys, to believe they have a boy's mind in a girl's body, and to attribute their unhappiness to being a girl."

Rebecca Jones added "If such girls do believe they have a boy's mind in a girl's body, their higher than average number of autistic traits may also mean they hold their beliefs very strongly, and pursue them to the logical conclusion: opting for sex reassignment surgery in adulthood."

Domenico Di Ceglie, Director of Training and Research at the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust in London, commented: "These are important findings in the field of gender incongruence, which need to be replicated. The awareness of the presence of autistic features may help these young people to explore the reasons behind their perceptions, and help them make more informed decisions about treatment."

Emma Martin, who runs a Gender Identity Support and research group in Little Downham, UK, welcomed the new findings, and added two important caveats: "This new research reminds us that gender incongruence is incredibly complex. Every possibility should be discussed with new clients, but should not delay what can be a painfully slow process for those affected."

For additional information please contact:
Genevieve Maul, Office of Communications, University of Cambridge
Tel: direct, +44 (0) 1223 765542, +44 (0) 1223 332300
Mob: +44 (0) 7774 017464
Email: Genevieve.maul@admin.cam.ac.uk

1. Authors: Rebecca M. Jones, Sally Wheelwright, Krista Farrell, Emma Martin, Richard Green, Domenico Di Ceglie, and Simon Baron-Cohen (2011) Brief Report: Female-To-Male Transsexual People and Autistic Traits. Journal of Autism and Developmental Disorders DOI 10.1007/s10803-011-1227-8

2. Author affiliations: Autism Research Centre, Department of Psychiatry, Cambridge University, Cambridge CB2 8AH, UK, (www.autismresearchcentre.com); Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Gender Identity Support and Research Division, Lima House Group, Little Downham, UK; Imperial College, London, UK; Gender Identity Development Service, Tavistock and Portman NHS Foundation Trust, London, UK; Department of Neuroscience, Weill Cornell Graduate School of Medical Sciences, NY, USA.

3. Funding sources: Research grants from the Medical Research Council (UK); Gates Cambridge Trust; and the Nancy Lurie Marks Family Foundation; NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust.