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In the first large scale study of its kind, researchers at VU University Medical Center Gender Identity Clinic in Amsterdam assessed over 200 children and adolescents between April 2004 and October 2007 in order to provide evidence for world-wide anecdotal reports of a high degree of co-occurrence of two rare childhood conditions: Autism Spectrum Disorders and Gender Identity Disorders. Autism Spectrum Disorders (ASD) are characterized by impaired social interactions and poor interpersonal communication skills. Impaired social interaction may include a lack of interest in social relatedness and a lack of innate understanding of the non-verbal aspects of social exchange. Impaired interpersonal communication includes difficulty with many aspects of language from grammar to pitch to concrete thinking. Those with ASD also have repetitive and idiosyncratic interests, activities and behaviors. Gender Identity Disorders (GID) are typified by strong and persistent cross-gender identification, discomfort about one’s assigned sex or a sense of inappropriateness in the gender role of that sex. Like those with ASD, those with GID may suffer from social isolation and ostracization, but unlike those with ASD, those with GID generally do not lack the skills needed to have social interactions. Prevalence The prevalence of ASD are reported to be between 60 to 100 in 10,000; the reported prevalence of GID are one in 10,000 to 50,000. Research found the rate of ASD among the children and adolescents with GID was 7.8% — ten times higher than the frequency found in the general population. Differential or Dual Diagnosis This research which supports the claim that these disorders can and do co-exist highlights the need for accurate diagnosis. Some of the signs and symptoms of each of the disorders may be misinterpreted as indicative of the other disorder. A cursory review of the diagnostic criteria for ASD and GID reveals in both the frequent use of words such as: repeated, insistent, persistent, preoccupation and stereotyped. Both disorders typically become evident in childhood. It has been well documented that there is a high frequency of non-normative sexual behaviors among those with ASD, and individuals with ASD as well as those with GID may experience a profound sense of being different. For those with GID, however, the sexual behavior and identification as “different” pertains specifically to their core sense of their gender identity. Likewise, members of both diagnostic groups may display an attraction to specific types of garments; however, for those with ASD, the interest will be more sensory or tactile and less about identification. Gender Spectrum Conference Over Labor Day weekend 2010 I attended the Gender Spectrum Family Conference in Berkeley California where I lead a workshop: Gender Incongruence in Children and Adolescents on the Autism Spectrum. There I met other professionals and families who have interest in and experience with these youngsters in engaged in discussions about the co-occurrence of ASD and GID. By studying this unique group, I believe I will further hone my skills in working with those with ASD and those with GID, as well as those individuals who have both diagnoses. Reference: de Vries, A. L. C., Noens, I. L. J., Cohen-Kettenis, P. T., van Berkelaer-Onnes, I. A., Doreleijers, T. A. (2010). Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents. Journal of Autism and Developmental Disorders 40 (8). |
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