Executive function (EF) underlies broad health and adaptive outcomes. For transgender youth, navigating gender discernment and gender affirmation demand EF. Yet, factors associated with transgender youth EF are unknown. We investigate hypothesized predictors of EF: over-represented conditions among transgender youth (anxiety and depression symptoms, autism spectrum disorder [ASD]) and gender-affirming care. One-hundred twenty-four transgender 11−21-year-olds participated. Parents/caregivers completed EF and mental health report measures. ASD diagnostics and gender-affirming medication histories were collected. 21 % of non-autistic and 69 % of autistic transgender youth had clinically elevated EF problems. Membership in the gender-affirming hormone treatment group was associated with better EF. ASD, anxiety symptoms, and membership in the long-duration pubertal suppression group were associated with poorer EF. Given the importance of EF skills for multiple outcomes, and the unique and additional EF demands specific to transgender youths’ experiences, EF skill monitoring—and when appropriate, supports—should be considered for transgender youth.

执行功能 (EF) 是广泛健康和适应性结果的基础。对于跨性别青年，驾驭性别辨别力和性别肯定需要 EF。然而，与跨性别青年 EF 相关的因素尚不清楚。我们调查了 EF 的假设预测因素：跨性别青年（焦虑和抑郁症状、自闭症谱系障碍 [ASD]）和性别肯定护理中过度表现的情况。一百二十四名 11-21 岁的变性人参加了。父母/看护人完成了 EF 和心理健康报告措施。收集了 ASD 诊断和性别肯定用药史。21% 的非自闭症青少年和 69% 的自闭症跨性别青少年有临床上升高的 EF 问题。性别肯定激素治疗组的成员与更好的 EF 相关。自闭症，焦虑症状，和长期青春期抑制组的成员与较差的 EF 相关。鉴于 EF 技能对多种结果的重要性，以及特定于跨性别青年经历的独特和额外的 EF 要求，EF 技能监测——以及适当时的支持——应该考虑用于跨性别青年。