City Research Online

Abstract

Background: Much of the literature on Autism–gender diversity (GD) relies on self-report Autism screening questionnaires (e.g. Autism-spectrum Quotient; AQ-50) that may tap constructs other than Autism.

Aims: In two studies, we tested whether links between GD traits or categorical gender modality (cisgender/transgender) and Autism traits in non-Autistic cisgender and transgender adults reflect variance shared with alexithymia/negative affect.

Methods: Study 1 (N = 285 cisgender adults) measured Autism traits (AQ-50), alexithymia, negative affect, perceived discrimination, and dimensional GD. Study 2 (N = 208; 104 transgender and 104 cisgender) measured primarily Autism traits, alexithymia, and negative affect. Hierarchical regressions tested whether dimensional GD (Study 1) and being transgender(Study 2) predicted AQ-50 scores before and after other measures were included. Additionally, (a) mediations examined the interplay between alexithymia, negative affect, and Autism traits; (b) regressions tested whether dimensional GD or being transgenderpredicted “Autism-specific” AQ-50 variance, and; (c) groups in Study 2 were matched on alexithymia and negative affect, with differences in AQ-50 tested using independent t-tests.

Results: Both dimensional GD indices (Study 1) and being transgender (Study 2) predicted higher Autism traits, but adding alexithymia and negative affect eliminated the predictive effects. Mediation analyses showed partial, bidirectional alexithymia-negative affect associations with Autism traits. Importantly, Autism-specific variance on the AQ-50 was not predicted by dimensional GD in Study 1 or transgender identity in Study 2. Moreover, the predictive effect of being transgender in Study 2 disappeared after matching groups on alexithymia and negative affect.

Discussion: In non-Autistic cisgender and transgender people, associations between dimensional GD or being transgender and self-reported Autism traits became nonsignificant after accounting for alexithymia and negative affect. These findings caution against inferring Autism-specific links from screener totals. Clinically, elevated Autism traits alone in non-Autistic transgender people should not guide decisions.

Publication Type:	Article
Additional Information:	© 2026 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Publisher Keywords:	Autism screening tools, transgender, internalizing symptoms, emotional awareness, intersection
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Psychology & Neuroscience
SWORD Depositor:	Symplectic Administrator

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