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The stability of autistic traits in transgender adults following cross-sex hormone treatment

Nobili, Anna; Glazebrook, Cris; Bouman, Walter Pierre; Baron-Cohen, Simon; Arcelus, Jon


Anna Nobili

Walter Pierre Bouman

Simon Baron-Cohen

Jon Arcelus


Background: Recent research has shown that a high percentage of treatment-seeking transgender adults who were assigned female at birth (AFAB) reported scores above the clinical cutoff for autistic traits. It is unclear whether those scores reflect a stable trait or may be inflated by the high levels of anxiety typically associated with transgender people attending clinical services.
Aims: This longitudinal study aims to explore the impact of Cross-sex Hormone Treatment (CHT) on levels autistic traits, independent of changes in anxiety.

Method: Transgender adults who were assessed at a national transgender health service in the UK, who had not previously received CHT and who had completed the AQ-Short as a measure of autistic traits pre- and one-year post-CHT were included in the study (n?=?118). Anxiety was assessed at the same time points using the Hospital Anxiety and Depression Scale.

Results: AQ-Short scores remained very stable over time (ICC = 0.7; CIs 0.591-0.779) but anxiety showed little consistency (ICC = 0.386; CIs 0.219 to 0.531). Repeated measures ANOVA found a main effect of assigned sex with AFAB having higher AQ-Short scores. There was no change in AQ-Short scores and no significant interaction between assigned sex and change in AQ-Short scores.

Conclusion: This study confirmed that treatment seeking transgender AFAB people have higher levels of autistic traits at follow-up compared to AMAB transgender people and that these traits are stable following one year of CHT regardless of assigned sex. This may have clinical implications regarding the support that transgender people may require following medical transition.


Nobili, A., Glazebrook, C., Bouman, W. P., Baron-Cohen, S., & Arcelus, J. (2020). The stability of autistic traits in transgender adults following cross-sex hormone treatment. International Journal of Transgender Health, 21(4), 431-439.

Journal Article Type Article
Acceptance Date Jun 15, 2020
Online Publication Date Jul 2, 2020
Publication Date Jul 2, 2020
Deposit Date Jun 17, 2020
Publicly Available Date Jul 3, 2021
Journal International Journal of Transgender Health
Print ISSN 2689-5269
Electronic ISSN 2689-5277
Publisher Taylor & Francis
Peer Reviewed Peer Reviewed
Volume 21
Issue 4
Pages 431-439
Keywords Transgender; Gender dysphoria; Autistic traits; Autism spectrum conditions; Anxiety; Cross-sex hormone treatment
Public URL
Publisher URL 895269.2020.1783738
Additional Information This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Transgender Health on 02.07.20, available online:


The Stability Of Autistic Traits In Transgender Adults Following Cross-sex Hormone Treatment (421 Kb)

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