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

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.