年轻自闭症成年人希望成为异性的心理健康相关因素和潜在儿童预测因素

作者：

Chang, JC (Chang, Jung-Chi) [; Lai, MC (Lai, Meng-Chuan) ; Tai, YM (Tai, Yueh-Ming)  ; Gau, SSF (Gau, Susan Shur-Fen)

摘要：

Cross-sectional research has demonstrated the overrepresentation of gender dysphoria in children and adults with autism spectrum disorder. However, the predictors and underlying mechanisms of this co-occurrence remain unclear. This follow-up study aimed to explore baseline (childhood/adolescence) predictors for the follow-up (adulthood) self-reported wish to be of the opposite sex and to investigate its mental health correlates in a sample of 88 autistic individuals as compared with 42 typically developing controls. An item on the Adult Self-Report Inventory-4, “I wish I was the opposite sex,” was used. We compared mental health symptoms between adults with and without this item endorsement. We used prediction models to explore family and autism-related predictors in childhood/adolescence to endorse this item in adulthood. There were more adults endorsing the item in the autism spectrum disorder group compared with the typically developing group. Autistic adults who endorsed the item experienced more mental health challenges, more bullying victimization, more suicidal ideations, and worse quality of life. Lower parent-reported family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. It is necessary to raise more attention to gender development and related mental health impact in autistic individuals. Lay abstract Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item “I wish I was the opposite sex” was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.

横断面研究表明，自闭症谱系障碍的儿童和成年人中存在着性别认同问题的过度表现。然而，这种共同发生的预测因素和潜在机制尚不清楚。本跟踪研究旨在探索基线（童年/青少年）对于随后（成年）自报希望成为异性的预测因素，并在一个由88名自闭症个体和42名典型发展对照组成的样本中研究其心理健康相关性。使用了《成人自我报告清单-4》上的一项：“我希望成为异性。”我们比较了有无此项声明的成年人之间的心理健康症状。我们使用预测模型探讨了儿童/青少年时期家庭和与自闭症相关的预测因素与成年时是否声明这一项之间的关系。自闭症谱系障碍组中有更多的成年人承认了这一项，与典型发展对照组相比。承认了这一项的自闭症成年人经历了更多的心理健康挑战、更多的欺凌受害、更多的自杀意念和更差的生活质量。在自闭症个体中，儿童/青少年时期较低的家长报告的家庭支持和更多的刻板/重复行为预测了成年时报告希望成为异性的愿望。有必要更加关注自闭症个体的性别发展及其相关的心理健康影响。