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

Background Prior 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. Methods An 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. Results On 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. Limitations The 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. Conclusions The 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.

Autistic traits, empathizing-systemizing, and gender variance

Previous research indicates a link between autism and gender variance, though the basis for this association is not fully understood. The current study examined autistic traits (as measured by the Autism Spectrum Quotient [AQ]) and empathizing and systemizing (as measured by the Empathizing Quotient-Short [EQ-S] and Systemizing Quotient-Short [SQ-S]) in a sample of n=89 UK adults representing a broad range of gender identities and sexual orientations. Compared with cisgender individuals (i.e. those who identify as the same gender as that assigned at birth), gender variant participants had significantly higher AQ and SQ-S scores, and stronger systemizing relative to empathizing (D-score). Further analysis revealed that there were significant differences between cisgender females and those assigned female at birth who do not identify as female (transgender AFAB), but not between cisgender males and those assigned male at birth who do not identify as male (transgender AMAB). These findings are broadly in line with the extreme male brain theory of autism, and may be relevant for developing effective support for gender variant and/or autistic individuals.

AMBRA1, Autophagy, and the Extreme Male Brain Theory of Autism

The extreme male brain theory of autism posits that its male bias is mediated by exaggeration of male-biased sex differences in the expression of autism-associated traits found in typical populations. The theory is supported by extensive phenotypic evidence, but no genes have yet been described with properties that fit its predictions. The autophagy-associated gene AMBRA1 represents one of the top genome-wide “hits” in recent GWAS studies of schizophrenia, shows sex-differential expression, and has been linked with autism risk and traits in humans and mice, especially or exclusively among females. We genotyped the AMBRA1 autism-risk SNP in a population of typical humans who were scored for the dimensional expression of autistic and schizotypal traits. Females, but not males, homozygous for the GG genotype showed a significant increase in score for the single trait, the Autism Quotient-Imagination subscale, that exhibits a strong, significant male bias in typical populations. As such, females with this genotype resembled males for this highly sexually dimorphic, autism-associated phenotype. These findings support the extreme male brain hypothesis and indicate that sex-specific genetic effects can mediate aspects of risk for autism.

The psychometric properties of a brief version of the Systemizing Quotient

The construct of systemizing—the drive to construct or understand systems—has an important role in the Extreme Male Brain theory of autism. While a brief version of the Systemizing Quotient (SQ) has been proposed, there is a need to assess its psychometric properties. This study assessed factorial and construct validity of an 8-item version of the SQ on a sample of 639 participants. A single-factor latent variable model with a single correlated error term showed adequate fit. This model also demonstrated metric invariance across genders. Reliability was acceptable, α = .72. As further evidence for construct validity, SQ scores showed expected relationships with mental rotation performance, finger length ratio, study area, trait anxiety, childhood extroversion, childhood agreeableness, and gender. In a cross-validation analysis, the psychometric properties of the scale also generalized well to a sample of 506 transgender participants. Overall, the results indicated good psychometric properties for the brief version of the SQ.

Autism and Gender

The reasons behind the increase in autism diagnoses have become hotly contested in the media as well as within the medical, scholarly, and autistic communities. This book suggests the proliferating number of discussions point to autism as a rhetorical phenomenon that engenders attempts to persuade through arguments, appeals to emotions, and representational strategies. The book focuses on the ways gender influences popular discussion and understanding of autism's causes and effects. It identifies gendered theories like the “refrigerator mother” theory, for example, which blames emotionally distant mothers for autism, and the “extreme male brain” theory, which links autism to the modes of systematic thinking found in male computer geeks. The book's analysis reveals how people employ such highly gendered theories to craft rhetorical narratives around stock characters—fix-it dads, heroic mother warriors rescuing children from autism—that advocate for ends beyond the story itself while also allowing the storyteller to gain authority, understand the disorder, and take part in debates. The book reveals the ways we build narratives around controversial topics while offering new insights into the ways rhetorical inquiry can and does contribute to conversations about gender and disability.