Transgender kids might just be autistic: doctor

PSYCHOLOGIST’S THEORY DRAWING IRE OF LGBT COMMUNITY

Many children who are diagnosed as transgender may actually be autistic, whose “fixation” with the opposite gender may be as fleeting as a toddler’s obsession with trains or trucks, according to a new theory that is already drawing ire.

Doctors working in gender disorder clinics are seeing a higher-than-expected number of children with autism, while recent studies have found young people with autism were nearly eight times more likely to exhibit “gender variance” — the wish to be the opposite sex — than normally developing children.

Now, a prominent but controversial Canadian psychologist claims autistic traits of “fixating” on issues could convince children they are the wrong sex.

In a new BBC documentary, Dr. Kenneth Zucker, hastily dismissed two years ago from his 30-year directorship of the gender-identity clinic at Toronto’s Centre for Addiction and Mental Health, said children identifying as transgender often display autistic tendencies.

“It is possible that kids who have a tendency to get obsessed or fixed on something may latch on to gender,” Zucker says in the documentary, according to The Telegraph.

“Just because kids are saying something doesn’t necessarily mean you accept it, or that it’s true, or that it could be in the best interests of the child,” he said, later adding: “A four-year-old might say that he’s a dog — do you go out and buy dog food?”

His comments are drawing outrage from the LGBT community. Some fear transgender children could become targeted for being somehow “mentally disturbed.”

Others argue the transgender movement has gone too far.

“Autistic adolescents struggling to deal with their quirky cerebral wiring do not need to be told they are ‘a girl trapped in a boy’s body’ or vice versa,” Dr. Susan Bradley, former chief of psychiatry at Toronto’s Hospital for Sick Children, writes in an opinion piece published in the National Post. Yet “many parents are buying into this completely unscientific hypothesis.”

However, several studies have suggested autism and gender dysphoria co-occur more often than by chance in adolescents. And new guidelines published in October state a diagnosis of autism “should not exclude the potential for GD (gender dysphoria) treatment,” including cross-sex hormones that can have permanent effects, even if stopped.

A pivotal study published two years ago led by Dr. John Strang, of the Children’s National Health System in Washington, D.C., found gender variance was eight times more common in children with autism spectrum disorder, and seven times more likely in children with ADHD.

It’s not clear what might be behind the overlap.

One of the most striking features of autism is what has been described as “social blindness” or disconnection. Children are less inhibited by social expectations, and therefore may have less of an impulse to avoid expressing gender behaviour that doesn’t fit stereotypical norms, Strang has argued.

“Children and adolescents with autism spectrum disorders may be less aware of the social restrictions against expressions of gender variance and therefore less likely to avoid expressing these inclinations,” he said when the study was published. “It could also be theorized that excessively rigid or ‘black and white’ thinking could result in such a child’s rigidly interpreting mild or moderate gender nonconforming inclinations as more intense or absolute.”

Zucker posits that autistic traits of “fixating” on issues could convince children they are the wrong sex, according to the Telegraph.

Once an academic star, Zucker left CAMH after an external review concluded not all his practices were “in step with the latest thinking.” His published research suggests 80 per cent of children treated for gender dysphoria no longer identify as the opposite sex by high school. They grow to accept the gender they were “assigned” at birth.

In the documentary, he rejects claims he practised socalled “conversion therapy,” saying instead his approach was “developmentally informed therapy,” according to the Guardian.

Dr. Stephen Feder, codirector of the Children’s Hospital of Eastern Ontario’s gender diversity clinic in Ottawa, said children on the autism spectrum are overrepresented in his clinic.

“Our approach is still affirmative. But we perhaps take a bit more time to make sure that we get to know the kid as well as we possibly can,” Feder said. “It doesn’t change the overall approach,” he said. “I think we’re just even more vigilant about making sure we’re responding to the appropriate needs of the kid.”

The issue of obsessiveness “certainly comes up,” Feder said.

THIS IS NOT ABOUT INTERESTS. IT’S ABOUT HOW THEY SEE THEMSELVES.

But he said adolescents, when asked to compare their feeling of gender with obsessions of the past, “they really identify it as quite different,” Feder said. “This is not about interests. It’s about how they see themselves.

“At the end of the day, we feel it’s inappropriate to turn around and say, well if you’re autistic, that probably explains your gender,” he said.

“The risk is that people will say, aha, that explains it. And I think we want to move away from that,” Feder added.

Eating disorders, for example, are also more prevalent among those with gender identity issues, he noted.