Intense/obsessional interests in children with gender dysphoria: a cross-validation study using the Teacher’s Report Form

Kenneth J. Zucker, A. Natisha Nabbijohn, Alanna Santarossa, Hayley Wood, Susan J. Bradley, Joanna Matthews, Doug P. VanderLaan

This study assessed whether children clinically referred for gender dysphoria (GD) show symptoms that overlap with Autism Spectrum Disorder (ASD). Circumscribed preoccupations/intense interests and repetitive behaviors were considered as overlapping symptoms expressed in both GD and ASD. To assess these constructs, we examined Items 9 and 66 on the Teacher's Report Form (TRF), which measure obsessions and compulsions, respectively. For Item 9, gender-referred children (n = 386) were significantly elevated compared to the referred (n = 965) and non-referred children (n = 965) from the TRF standardization sample. For Item 66, gender-referred children were elevated in comparison to the non-referred children, but not the referred children. These findings provided cross-validation of a previous study in which the same patterns were found using the Child Behavior Checklist (Vanderlaan et al. in J Sex Res 52:213-19, 2015). We discuss possible developmental pathways between GD and ASD, including a consideration of the principle of equifinality.