Understanding Gender Dysphoria With an Autism Diagnosis
Although the field of study is relatively new, the incidence of gender dysphoria is identified at higher rates in individuals with autism Anna Laakman spectrum disorder (ASD). Gender dysphoria is a clinical term used to define the incongruence between gender identity and biological sex.
Many who experience gender dysphoria identify as transgender, non-binary, or gender nonconforming. In recent years, there has been an increased effort to understand better the co-occurrence of ASD and gender dysphoria in an attempt to increase mental health supports to reduce associated issues with depression and anxiety. Additionally, there is a stronger effort to increase awareness and provide a more inclusive environment.
An estimated 0.7 percent of youth (ages 13 to 17), or 150,000, and 1.4 million adults (ages 18 and older) identify as transgender in the US, according to a recent study by The Williams Institute. For comparison, instances of ASD generally occur in the range of 1:58, making the likelihood of both occurring simultaneously low. However, a recent study examining 204 gender-diverse adolescents found a 7.8 percent prevalence of ASD. Another study examined the reciprocal and found that individuals with ASD were 7.59 times more likely to express gender variance.
Research examining gender diversity in tandem with ASD began in the mid-1990s, but the first study to consider the convergence between gender dysphoria and ASD was published just eight years ago. Before then, studies had only measured instances of gender variance in those with ASD, rather than examining rates of ASD among those with gender dysphoria.
The scientific community is not sure what is behind the increased prevalence of gender dysphoria in ASD. Some research cites that adolescents with ASD develop a fixation with their gender identity due to the obsessive tendencies that accompany ASD. Other researchers take a biological route and claim that the prevalence rate is due to varying levels of the hormones in the fetal brain.
While the research is ongoing, there is also a need to provide community supports. There is a recognized need to provide safe spaces for individuals to talk about their experiences and feelings without stigma or judgment. Gender diverse individuals on the autism spectrum may have more difficulty talking about their feelings, as difficulty with communication is a key feature of autism. Even today, a number of health-care providers will limit medical care access to gender diverse individuals, who are told their need to transition is a result of their ASD. The desire for hormone therapy and other treatments is often dismissed as an obsessive trait associated with ASD.
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Healthcare isn’t the only area where gender-diverse individuals with ASD face barriers. They must also navigate other forms of discrimination, exacerbating an already stressful experience. Often, healthcare professionals and family members attempt to “normalize” individuals and prevent the expression of their preferred gender.
Individuals may be forced to receive inappropriate types of intervention focused on restricting their expression which can lead to increased anxiety and depression. Additionally, individuals can be met with open hostility or violence. Typical autistic traits such as impaired communication and ability to read social cues from others make it more difficult to recognize and navigate bouts of discrimination.
As this area of research gains momentum, more research will be conducted on the specifics of the relationship between gender and ASD. The Center for Autism & Neurodevelopmental Disorders is currently exploring different methods of supporting this population and realizes that the complexity of the two conditions requires in-depth research in order to better understand and support this community.
Parents, caregivers, family members, and friends can support loved ones by:
- Providing a safe place for individuals to talk about their feelings without judgment or dismissal.
- Reassuring your family member or friend that you still care for and respect them.
- Being an advocate, and standing up for a loved one against discrimination and bullying.
- Contacting your local LGBT center for more information and resources.
Anna Laakman, education and training director for The Center for Autism & Neurodevelopmental Disorders, UCI, School of Medicine, and Department of Pediatrics.
This article was featured in Issue 85 – Top Strategies for Supporting your Family