BackgroundGender clinic and single‐item questionnaire‐based data report increased co‐occurrence of gender diversity and neurodevelopmental conditions. The nuances of these associations are under‐studied. We used a transdiagnostic approach, combining categorical and dimensional characterization of neurodiversity, to further the understanding of its associations with gender diversity in identity and expression in children.MethodsData from 291 children (Autism N = 104, ADHD N = 104, Autism + ADHD N = 17, neurotypical N = 66) aged 4–12 years enrolled in the Province of Ontario Neurodevelopmental Network were analyzed. Gender diversity was measured multi‐dimensionally using a well‐validated parent‐report instrument, the Gender Identity Questionnaire for Children (GIQC). We used gamma regression models to determine the significant correlates of gender diversity among age, puberty, sex‐assigned‐at‐birth, categorical neurodevelopmental diagnoses, and dimensional neurodivergent traits (using the Social Communication Questionnaire and the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scales). Internalizing and externalizing problems were included as covariates.ResultsNeither a categorical diagnosis of autism nor ADHD significantly correlated with current GIQC‐derived scores. Instead, higher early‐childhood dimensional autistic social‐communication traits correlated with higher current overall gender incongruence (as defined by GIQC‐14 score). This correlation was potentially moderated by sex‐assigned‐at‐birth: greater early‐childhood autistic social‐communication traits were associated with higher current overall gender incongruence in assigned‐males‐at‐birth, but not assigned‐females‐at‐birth. For fine‐grained gender diversity domains, greater autistic restricted‐repetitive behavior traits were associated with greater diversity in gender identity across sexes‐assigned‐at‐birth; greater autistic social‐communication traits were associated with lower stereotypical male expression across sexes‐assigned‐at‐birth.ConclusionsDimensional autistic traits, rather than ADHD traits or categorical neurodevelopmental diagnoses, were associated with gender diversity domains across neurodivergent and neurotypical children. The association between early‐childhood autistic social‐communication traits and overall current gender diversity was most evident in assigned‐males‐at‐birth. Nuanced interrelationships between neurodivergence and gender diversity should be better understood to clarify developmental links and to offer tailored support for neurodivergent and gender‐diverse populations.

中文翻译：

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性别多样性与维度神经分歧特征相关，但与儿童的分类神经发育诊断无关

背景性别诊所和基于单项问卷的数据报告增加了性别多样性和神经发育状况的同时出现。这些关联的细微差别尚未得到充分研究。我们使用跨诊断方法，结合神经多样性的分类和维度表征，以进一步了解其与儿童身份和表达性别多样性的关联。方法数据来自 291 名儿童（自闭症）氮= 104，多动症氮= 104，自闭症 + 多动症氮= 17，神经典型氮= 66) 对加入安大略省神经发育网络的 4-12 岁儿童进行了分析。使用经过充分验证的家长报告工具——儿童性别认同问卷（GIQC），对性别多样性进行多维度测量。我们使用伽玛回归模型来确定年龄、青春期、出生时性别分配、分类神经发育诊断和维度神经发散特征之间性别多样性的显着相关性（使用社交沟通问卷以及多动症症状和正常的优缺点）行为评定量表）。内化和外化问题作为协变量包括在内。结果无论是自闭症的分类诊断还是 ADHD 都与当前 GIQC 得出的评分显着相关。相反，较高的幼儿期自闭症社交沟通特征与较高的当前总体性别不一致（如 GIQC-14 评分所定义）相关。这种相关性可能受到出生时性别分配的调节：在出生时分配的男性中，较大的幼儿期自闭症社会沟通特征与当前较高的总体性别不一致相关，但在出生时分配的女性中则不然。对于细粒度的性别多样性领域，更大的自闭症限制性重复行为特征与出生时分配的性别之间更大的性别认同多样性相关。较高的自闭症社交沟通特征与出生时性别中较低的刻板男性表达相关。结论：维度自闭症特征，而不是 ADHD 特征或分类神经发育诊断，与神经分歧和神经典型儿童的性别多样性领域相关。儿童早期自闭症社会沟通特征与当前总体性别多样性之间的关联在出生时指定的男性中最为明显。应更好地理解神经分歧和性别多样性之间微妙的相互关系，以澄清发展联系，并为神经分歧和性别多样化人群提供量身定制的支持。