TY  - JOUR
PY  - 2021//
TI  - In addition to stigma: cognitive and autism-related predictors of mental health in transgender adolescents
JO  - Journal of clinical child and adolescent psychology
A1  - Strang, John F.
A1  - Anthony, Laura G.
A1  - Song, Amber
A1  - Lai, Meng-Chuan
A1  - Knauss, Megan
A1  - Sadikova, Eleonora
A1  - Graham, Elizabeth
A1  - Zaks, Zosia
A1  - Wimms, Harriette
A1  - Willing, Laura
A1  - Call, David
A1  - Mancilla, Michael
A1  - Shakin, Sara
A1  - Vilain, Eric
A1  - Kim, Da-Young
A1  - Maisashvili, Tekla
A1  - Khawaja, Ayesha
A1  - Kenworthy, Lauren
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: Autism spectrum disorder (ASD) is significantly over-represented among transgender adolescents. Independently, ASD and gender diversity are associated with increased mental health risks. Yet, mental health in autistic-transgender adolescents is poorly understood. This study investigates mental health in the largest matched sample to date of autistic-transgender, non-autistic (allistic) transgender, and autistic-cisgender adolescents diagnosed using gold-standard ASD diagnostic procedures. In accordance with advancing understanding of sex/gender-related autism phenotypes, slightly subthreshold autistic diagnostic presentations (common in autistic girls/women) are modeled.<br><br>METHOD: This study includes 93 adolescents aged 13-21, evenly divided between autistic-transgender, autistic-cisgender, and allistic-transgender groups; 13 transgender adolescents were at the margin of ASD diagnosis and included within a larger "broad-ASD" grouping. Psychological and neuropsychological evaluation included assessment of mental health, IQ, LGBT stigma, ASD-related social symptoms, executive functioning (EF), and EF-related barriers to achieving gender-related needs.<br><br>RESULTS: Autistic-transgender adolescents experienced significantly greater internalizing symptoms compared to allistic-transgender and autistic-cisgender groups. In addition to stigma-related associations with mental health, ASD-related cognitive/neurodevelopmental factors (i.e., poorer EF and greater social symptoms) were associated with worse mental health: specifically, social symptoms and EF gender barriers with greater internalizing and EF problems and EF gender barriers with greater suicidality. Comparing across all ASD and gender-related groups, female gender identity was associated with greater suicidality.<br><br>CONCLUSIONS: Parsing the heterogeneity of mental health risks among transgender youth is critical for developing targeted assessments and interventions. This study identifies ASD diagnosis, ASD phenotypic characteristics, and EF-related gender barriers as potential risks for poorer mental health in transgender adolescents.<p />  <p>Language: en</p>
LA  - en
SN  - 1537-4416
UR  - http://dx.doi.org/10.1080/15374416.2021.1916940
ID  - ref1
ER  -