Intersections of childhood sexual abuse, autistic traits, and gender-related distress in forensic psychiatric evaluation

This study investigated the intersection of neurodevelopmental and gender-related vulnerabilities among adolescents and young adults with verified histories of childhood sexual abuse (CSA) referred for forensic psychiatric evaluation. The sample comprised 186 individuals aged 15–25 years (89.3% female), all with CSA histories confirmed through official forensic and court records. Participants completed the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA) and the 50-item Autism Spectrum Quotient (AQ-50). Regression analyses controlling for age and education revealed that higher AQ-Communication scores and the presence of psychiatric comorbidity were independently associated with greater gender-related distress. These findings highlight overlapping developmental mechanisms linking early sexual trauma, neurodevelopmental traits, and identity formation. They underscore the importance of trauma-informed, sexuality-sensitive, and neurodiversity-aware approaches in forensic psychiatric assessment of CSA-exposed youth.