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. 2023 May 24;33(11):6633-6647.
doi: 10.1093/cercor/bhac530.

The autism spectrum among transgender youth: default mode functional connectivity

John F Strang  1   2   3 , Lucy S McClellan  3 , Sufang Li  4 , Allison E Jack  5 , Gregory L Wallace  6 , Goldie A McQuaid  5 , Lauren Kenworthy  2   3 , Laura G Anthony  7 , Meng-Chuan Lai  8   9 , Kevin A Pelphrey  10 , Alexandra E Thalberg  11 , Eric E Nelson  12 , Jenny M Phan  3 , Eleonora Sadikova  13 , Abigail L Fischbach  3 , John Thomas  14 , Chandan J Vaidya  4
Affiliations

The autism spectrum among transgender youth: default mode functional connectivity

John F Strang et al. Cereb Cortex. .

Abstract

The common intersection of autism and transgender identities has been described in clinical and community contexts. This study investigates autism-related neurophenotypes among transgender youth. Forty-five transgender youth, evenly balanced across non-autistic, slightly subclinically autistic, and full-criteria autistic subgroupings, completed resting-state functional magnetic resonance imaging to examine functional connectivity. Results confirmed hypothesized default mode network (DMN) hub hyperconnectivity with visual and motor networks in autism, partially replicating previous studies comparing cisgender autistic and non-autistic adolescents. The slightly subclinically autistic group differed from both non-autistic and full-criteria autistic groups in DMN hub connectivity to ventral attention and sensorimotor networks, falling between non-autistic and full-criteria autistic groups. Autism traits showed a similar pattern to autism-related group analytics, and also related to hyperconnectivity between DMN hub and dorsal attention network. Internalizing, gender dysphoria, and gender minority-related stigma did not show connectivity differences. Connectivity differences within DMN followed previously reported patterns by designated sex at birth (i.e. female birth designation showing greater within-DMN connectivity). Overall, findings suggest behavioral diagnostics and autism traits in transgender youth correspond to observable differences in DMN hub connectivity. Further, this study reveals novel neurophenotypic characteristics associated with slightly subthreshold autism, highlighting the importance of research attention to this group.

Keywords: Autistic; Gender diverse; Resting state.

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Figures

Fig. 1
Fig. 1
Significance of between-group functional connectivity differences.
Fig. 2
Fig. 2
Functional connectivity differences by autism-related grouping. Note. Circle represents seed region. Heat map represents t values.
Fig. 3
Fig. 3
Autism trait level by autistic grouping. Note. Tukey’s post hocs indicated by brackets, *P < 0.001.
Fig. 4
Fig. 4
Autism trait level-based findings (higher autism trait level > lower autism trait level). Note. Circles represent seed regions. Heat map represents t values.
Fig. 5
Fig. 5
Overlap between group-based and composite autism trait score-based findings.
Fig. 6
Fig. 6
Gender-based findings (trans young men > trans young women). Note. Circles represent seed regions. Heat map represents t values.
See this image and copyright information in PMC

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