Tateno Masaru, Shimomura Ryotaro, Shiraishi Eri, Nanba Kotaro, Tateno Yukie
Tokiwa Child Development Center, Tokiwa Hospital, Tokiwa 3-1-6-1, Minami-ku, Sapporo 0050853, Japan.
Brain Sci. 2024 Nov 28;14(12):1202. doi: 10.3390/brainsci14121202.
The association between autism spectrum disorder (ASD) and gender dysphoria (GD) has attracted a great deal of interest among child and adolescent psychiatrists in Japan. In clinical settings, it is common to hear complaints or concerns related to GD from adolescents with ASD. In the past few years, several review articles have been published on ASD and GD. The Initial Clinical Guidelines for co-occurring ASD and GD in adolescents were published in 2018, suggesting the increasing need of intervention for these conditions worldwide. Although a large amount of evidence has been accumulated regarding the co-occurrence of ASD and GD, all review articles were based solely on case reports and articles published in English. In this article, we performed a bilingual literature review using English- and Japanese-language literature databases. We found 13 case reports in English and 11 case reports in Japanese. The Japanese literature included articles on gender-related symptoms in ASD, but not limited to ASD with comorbid GD. Wattel and her colleagues proposed 15 theories on the link between ASD and GD. We classified the reported cases into one or more of the fifteen theories proposed by Wattel. These theories seemed useful in understanding the co-occurrence of ASD and GD, especially in AMAB cases. Wattel's 15 theories are categorized into biological, psychological, and social factors, respectively. With regard to the social factors, we discussed Japanese school culture and psychological burden among gender-dysphoric students. Further studies are awaited.
自闭症谱系障碍（ASD）与性别焦虑症（GD）之间的关联在日本儿童和青少年精神科医生中引起了极大的关注。在临床环境中，经常会听到患有ASD的青少年抱怨或担忧与GD相关的问题。在过去几年中，已经发表了几篇关于ASD和GD的综述文章。2018年发布了青少年ASD和GD共病的初始临床指南，这表明全球对这些病症的干预需求日益增加。尽管已经积累了大量关于ASD和GD共病的证据，但所有综述文章都仅基于病例报告和英文发表的文章。在本文中，我们使用英文和日语文献数据库进行了双语文献综述。我们发现了13篇英文病例报告和11篇日文病例报告。日语文献包括关于ASD中与性别相关症状的文章，但不限于合并GD的ASD。瓦特尔及其同事提出了15种关于ASD和GD之间联系的理论。我们将报告的病例归类为瓦特尔提出的15种理论中的一种或多种。这些理论似乎有助于理解ASD和GD的共病情况，尤其是在出生时被指定为男性（AMAB）的病例中。瓦特尔的15种理论分别分为生物学、心理学和社会因素。关于社会因素，我们讨论了日本的学校文化和性别焦虑学生的心理负担。有待进一步研究。
