Implicit and explicit gender identification in autistic and nonautistic gender clinic-referred youth, and their caregivers

Gender diversity in autistic youth is sometimes assumed to stem from autism, leading to questions about the authenticity of their gender diverse feelings and experiences. If this were the case, different patterns of gender identity presentation would be expected between autistic and nonautistic gender diverse youth. This hypothesis was examined across two studies. In Study 1, we used an explicit measure together with an Implicit Association Test, for the first time, to examine gender identity in autistic and nonautistic gender-referred and cisgender youth, aged 7–16 years. Gender-referred participants, regardless of autism status, implicitly identified with the binary sex opposite to that assigned at birth and explicitly identified with their experienced gender to a similar degree as their cisgender peers. Autistic cisgender youth also demonstrated implicit and explicit gender identities comparable in strength to their nonautistic peers. In Study 2, we used similar measures to assess gender identification in caregivers. Caregivers of gender-referred youth, regardless of autism status, reported weaker explicit gender-group identification, while implicit identification remained unaffected. Overall, the findings challenge the idea that gender diversity in autism is qualitatively distinct and have important clinical implications for improving support pathways for autistic gender diverse youth.