Gender dysphoria and autism spectrum disorder: A narrative review

Int Rev Psychiatry. 2016;28(1):70-80. doi: 10.3109/09540261.2015.1111199. Epub 2016 Jan 12.


The current literature shows growing evidence of a link between gender dysphoria (GD) and autism spectrum disorder (ASD). This study reviews the available clinical and empirical data. A systematic search of the literature was conducted using the following databases: PubMed, Web of Science, PsycINFO and Scopus; utilizing different combinations of the following search terms: autism, autism spectrum disorder (ASD), Asperger's disorder (AD), co-morbidity, gender dysphoria (GD), gender identity disorder (GID), transgenderism and transsexualism. In total, 25 articles and reports were selected and discussed. Information was grouped by found co-occurrence rates, underlying hypotheses and implications for diagnosis and treatment. GD and ASD were found to co-occur frequently - sometimes characterized by atypical presentation of GD, which makes a correct diagnosis and determination of treatment options for GD difficult. Despite these challenges there are several case reports describing gender affirming treatment of co-occurring GD in adolescents and adults with ASD. Various underlying hypotheses for the link between GD and ASD were suggested, but almost all of them lack evidence.

Keywords: Autism spectrum disorder; co-morbidity; co-occurrence; gender dysphoria; gender identity disorder.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Autism Spectrum Disorder / complications
  • Autism Spectrum Disorder / epidemiology
  • Autism Spectrum Disorder / psychology*
  • Comorbidity
  • Female
  • Gender Dysphoria / complications
  • Gender Dysphoria / epidemiology
  • Gender Dysphoria / psychology*
  • Humans
  • Male
  • Transsexualism / complications
  • Transsexualism / epidemiology
  • Transsexualism / psychology