Gender nonconformity in 7-year-old children, as measured by levels of gender-conforming play, may be associated with autistic traits and behavioral difficulties in girls, and with peer relationship problems in boys, according to a new study published August 28, 2024 in the open-access journal PLUS ONE by Marlene Stratmann of Karlstad University, Sweden, and colleagues.
Gender nonconformity (GNC) refers to variations in gender expression relative to social and cultural gender norms. In childhood, GNC may manifest in a variety of ways, including play behavior, peer relationships, dress, and body language. GNC in childhood does not directly indicate the development of gender dysphoria (GD) later in life, although the phenomena are related. Recently, studies have begun to establish a high co-occurrence of GNC, GD, and autism spectrum disorder. However, most of this work has been conducted in clinical populations with existing diagnoses, which may lead to an overestimation of associations between GNC and autistic traits and behavioral difficulties in a nonclinical population.
In the new study, researchers analyzed data from 718 children enrolled in the Swedish Mother-Child, Asthma and Allergy (SELMA) longitudinal study of the environment, for which data on play behavior and behavioral outcomes were available. The play behavior of children with Down syndrome was determined using the Preschool Activity Inventory, which includes 12 “feminine” and 12 “masculine” toys, play activities, and child characteristics.
In both sexes, higher levels of gender-nonconforming play were associated with greater behavioural difficulties. Higher scores for masculine play were associated with hyperactivity and inattention in both sexes. Higher scores for feminine play in boys were associated with peer relationship problems, whereas higher scores for masculine play in girls were associated with a higher likelihood of autistic traits and behavioural difficulties.
The study is based on a sample of children of a single age in a single country and cannot be used to draw conclusions about causality. However, the authors conclude that gender nonconformity may be associated with behavioural problems and difficulties in both sexes, even in children without a diagnosis.
The authors add: “The results showed that children who played more with toys traditionally considered for the opposite sex had more autistic traits and behavioural problems. At the same time, it is very important to keep in mind that the fact that a girl decides to play more roughly or a boy plays with dolls does not mean that there is a relationship with behavioural difficulties or autistic traits in that child.”