Department of Organismal Biology, Uppsala University, Uppsala, Sweden.
Centre for Women's Mental Health during the Reproductive Lifespan-Womher, Uppsala University, Uppsala, Sweden.
PLoS One. 2024 Aug 28;19(8):e0308605. doi: 10.1371/journal.pone.0308605. eCollection 2024.
Childhood gender nonconformity is related to psychological distress and behavioral difficulties. Similarly, there is evidence for a link between gender nonconformity, or gender dysphoria in some studies, and autism spectrum disorder and related traits. Our knowledge on those associations mostly originates from clinical populations, which might lead to overestimation. Thus, this study aimed to assess associations between gender nonconformity and behavioral difficulties in a population-based study.
In the Swedish Environmental Longitudinal, Mother and Child, Asthma and Allergy (SELMA) study, cross-sectional associations between gender-specific play behavior and behavioral outcomes and autistic traits were investigated among 718 children at 7-years of age. Play behavior was measured using the Preschool Activities Inventory; behavioral outcomes and autistic traits were measured with the Strengths and Difficulties Questionnaire and the Social Responsiveness Scale, respectively. Linear and logistic regression analyses were performed.
Higher composite play behavior scores (indicating either increased masculine or decreased feminine play behavior) were associated with increased autistic trait scores in girls (β = 0.13; 95% confidence interval [CI] = 0.00, 0.26). Furthermore, higher composite scores were shown to be associated with behavioral difficulties in both girls (β = 0.11; 95% CI = 0.04, 0.18) and boys (β = 0.10; 95% CI = 0.02, 0.19). Additionally, higher feminine scores were related with increased problems in peer relationships in boys (β = 0.04; 95% CI = 0.00, 0.07).
This study suggests a link between gender nonconforming play behavior and autistic traits as well as behavioral difficulties among children in a non-clinical population, which calls attention to the necessity of supporting children with gender nonconformity from early ages.
儿童时期的性别非一致性与心理困扰和行为困难有关。同样，有证据表明，在一些研究中，性别非一致性或性别焦虑与自闭症谱系障碍和相关特征之间存在联系。我们对这些关联的认识主要来自临床人群，这可能导致高估。因此，本研究旨在评估基于人群的研究中性别非一致性与行为困难之间的关联。
在瑞典环境纵向、母婴、哮喘和过敏（SELMA）研究中，在 718 名 7 岁儿童中，调查了性别特异性游戏行为与行为结果和自闭症特征之间的横断面关联。使用学前活动量表测量游戏行为；使用优点和困难问卷和社交反应量表分别测量行为结果和自闭症特征。进行线性和逻辑回归分析。
较高的综合游戏行为得分（表示男性化或女性化行为增加）与女孩的自闭症特征得分增加相关（β=0.13；95%置信区间[CI]：0.00，0.26）。此外，较高的综合得分与女孩（β=0.11；95%CI：0.04，0.18）和男孩（β=0.10；95%CI：0.02，0.19）的行为困难有关。此外，较高的女性化得分与男孩同伴关系问题增加有关（β=0.04；95%CI：0.00，0.07）。
本研究表明，非临床人群中，性别非一致性游戏行为与自闭症特征以及行为困难之间存在关联，这引起了人们对从早期开始支持性别非一致性儿童的必要性的关注。
