A new study has found that both autistic traits and obsessional thinking are independently associated with greater levels of gender dysphoria in adults. The findings, published in Molecular Autism, are based on two large-scale investigations examining the relationship between psychological traits and gender-related distress in both clinical and non-clinical adult populations.
The research involved two separate studies. The first drew on a non-clinical sample of 145 adults who completed self-report questionnaires measuring autistic traits, obsessional thinking, and levels of gender dysphoria. The second study involved 226 individuals across four clinical groups: those diagnosed with autism, obsessive-compulsive disorder, gender dysphoria, and a control group with no psychiatric diagnoses.
In both studies, researchers found that higher scores on the Autism Spectrum Quotient and the obsessive thoughts subscale of the Obsessive-Compulsive Inventory-Revised were each uniquely associated with greater traits of gender dysphoria. This association was consistent even when accounting for age and sex assigned at birth. Notably, the interaction between autistic traits and obsessional thoughts did not significantly predict gender dysphoria scores, suggesting these are two distinct psychological pathways to experiencing gender-related distress.
The clinical data further revealed that participants with gender dysphoria reported the highest levels of gender-related distress, followed by those with autism. Individuals with OCD did not significantly differ from the control group in their levels of gender dysphoria, despite reporting higher levels of obsessional thoughts. This suggests that while obsessional thinking may be linked to gender dysphoria, it alone may not be a sufficient factor unless accompanied by other traits, such as those related to autism.
The researchers also made efforts to differentiate between types of obsessional thinking. Prior studies had measured these thoughts using single items, often embedded within autism measures. In contrast, this study used a validated multi-item scale focused specifically on OCD-related obsessional thinking. This distinction allowed the researchers to demonstrate that obsessional thoughts tied to OCD could be associated with gender dysphoria independent of autism-related traits.
While the exact nature of these obsessional thoughts remains unclear, the study highlights the need to better understand how negative, intrusive thoughts may contribute to gender identity experiences. The authors acknowledge that the content of these thoughts was not directly measured and propose that future research should explore this area using qualitative approaches.
Although the study relied on self-reported diagnoses for the clinical samples and measured gender dysphoria at a single point in time, the authors argue that the consistency of findings across two diverse adult samples strengthens the reliability of their conclusions.
These results add nuance to the understanding of how psychological traits may influence gender identity experiences. They also suggest the importance of recognising individual differences when assessing gender dysphoria, particularly in autistic individuals or those who experience intense, unwanted thoughts.
