Living Between Genders: Autism & Gender Dysphoria (original) (raw)
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AUTISM AND GENDER DYSPHORIA: A NARRATIVE REVIEW OF THEIR COEXISTENCE AND CLINICAL IMPLICATIONS (Atena Editora), 2024
Objective: Analyze the existing scientific literature in order to highlight and understand the coexistence of autism and gender dysphoria, as well as their clinical implications, in order to provide an updated and comprehensive overview of the topic. Methods: Narrative bibliographic review through the PubMed database using the search terms “Autistic Disorder”, “Autism Spectrum Disorder” and “Gender Dysphoria”, in association with the Boolean operators “OR” and “AND”, initially resulting in 79 articles. After evaluation based on inclusion and exclusion criteria, only 16 articles became official sources for the present study. Discussion: The studies reviewed highlight the importance of an integrated approach when examining the co-occurrence between Autism and Gender Dysphoria, in addition to exploring possible etiological connections with maternal exposure to testosterone during pregnancy. Furthermore, several social and behavioral factors, such as prejudice and cognitive inflexibility, influence the dynamics of belonging. The lack of family support and the lack of attendance at appointments emerge as some of the obstacles that hinder both the diagnosis and the promotion of mental health in affected individuals. Final considerations: Studies indicate that the coexistence between Autism and Gender Dysphoria is a significant challenge, requiring a personalized therapeutic approach. This complex interaction requires a deeper understanding to promote adequate diagnosis, treatment, mental health, well-being and emotional support.
Transgender and gender nonconforming people who fulfill diagnostic criteria for autism spectrum disorders (ASDs) often present to mental health providers with concerns that are distinct from those without ASDs. Gender Dysphoria (GD) and ASDs have been proposed to share etiologic mechanisms and there is evidence that ASDs may be more common in transgender and gender nonconforming people. Purpose: To explore the impact of ASD characteristics on individual gender identity, expression, and the process of psychotherapy. Method: The authors present two case studies of high-functioning individuals with ASD and GD diagnoses. Results: The limited ability to articulate an inner experience, deficits in Theory of Mind (ToM), along with the intolerance of ambiguity as a manifestation of the cognitive rigidity characteristic of ASDs, may present special difficulties to gender identity formation and consolidation and create challenges in psychotherapy. Conclusions: The authors suggest that ASDs do not preclude gender transition and that individuals with highfunctioning ASDs are capable of making informed decisions regarding their medical care and life choices. The authors also consider possible challenges and suggest techniques for assisting such clients in exploring their gender identities.
Autisme spectrum and gender dysphoria
A recent article published by Lemaire, Thomazeau & Bonnet-Brilhault (2014) and a letter to the editor by Tateno, Tateno & Saito (2008) has shown that in individual cases of Gender Dysphoria (GD) there are instances of Autism Spectrum Disorder (ASD) as well. In light of this information the following question arises: To what extent do gender dysphoric features relate in individuals with Autism Spectrum Disorders ? To answer this question a keyword profile search was done in the following databases: Web of Science, PsychINFO and PubMed. A search on gender dysphoria and autism did not yield enough hits, therefore there was chosen to expand the key terms with gender identity disorder and transex* was added to gender dysphoria. And Asperger was added to the search of autism. The number of hits were increased from 7 hits to approximately 22-27 hits in the respective databases. The final keyword profile was: ((“gender dysphoria” OR “gender identity disorder” OR transex*) AND (autism* OR Asperger)). It was chosen to regard the hits given in Web of Science since this database provided the most hits. From the 27 hits in Web of Science seven articles gave relevant information in order to answer the research question. Six out of seven articles give evidence as to the co-occurrence of ASD and GD or traits thereof. One article raises caution to the diagnosis of gender dysphoria in individuals with autism spectrum disorders due to the existence of transient obsessions in said individuals.
Review Journal of Autism and Developmental Disorders
While research on the prevalence of co-occurring autism spectrum conditions (ASC) and trans gender modality (TGM) is available, less is known about the underlying mechanism of this association. Insight is needed to improve treatment of trans autistic people. This review provides an overview of theories on the ASC-TGM link and the available evidence for/against them published between January 2016 and October 2020. A systematic search was performed in PubMed, PsycINFO, Web of Science, and Scopus. This resulted in 36 studies, in which 15 theories were identified. Results indicate all theories lack substantial empirical support. Unlikely and promising theories were identified. The most promising theories were those on resistance to social norms and weakened sex differences. Future directions are provided.
Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents
Journal of Autism and Developmental Disorders, 2010
Only case reports have described the co-occurrence of gender identity disorder (GID) and autism spectrum disorders (ASD). This study examined this co-occurrence using a systematic approach. Children and adolescents (115 boys and 89 girls, mean age 10.8, SD = 3.58) referred to a gender identity clinic received a standardized assessment during which a GID diagnosis was made and ASD suspected cases were identified. The Dutch version of the Diagnostic Interview for Social and Communication Disorders (10th rev., DISCO-10) was administered to ascertain ASD classifications. The incidence of ASD in this sample of children and adolescents was 7.8% (n = 16). Clinicians should be aware of co-occurring ASD and GID and the challenges it generates in clinical management.
Brief report: Female-to-male transsexual people and autistic traits
2012
The 'extreme male brain' theory suggests females with Autism Spectrum Conditions are hyper-masculinized in certain aspects of behavior. We predicted that females with Gender Identity Disorder (who are masculinized) would have elevated Autism Spectrum Quotient (AQ) scores. AQ scores from five groups were compared: (1) n = 61 transmen (female-to-male transsexual people); (2) n = 198 transwomen (male-to-female transsexual people);
Journal of Autism and Developmental Disorders, 2020
An emergent evidence base indicates a higher prevalence of autism exists amongst people attending gender identity clinics. This qualitative study explored adults’ with autism experiences of coming to understand and address their gender dysphoria (GD). Data were collected and analysed using Grounded Theory. Ten adults with autism and GD undertook semi-structured interviews. A tentative theoretical framework of common processes involved in understanding and addressing GD for individuals with autism was developed. The experience is captured in the core category—Conflict versus Congruence. A key finding was the impact of autism as a barrier but sometimes a protective factor in participants’ understanding and addressing GD. Participants appeared to achieve greater personal congruence and wellbeing upon transition. Nevertheless, conflicts remained as they navigated the social world with a continuing fear of hostility and sense of difference due to having two stigmatised identities.
Autism and Transgender identity: implications for depression and anxiety
Research in Autism Spectrum Disorders, 2019
Autistic traits are over-represented in transgender populations, and gender variance is high in autistic individuals. Furthermore, some evidence suggests that the autism/transgender overlap is limited to individuals sex assigned female. Few studies, however, have investigated the impact of this overlap on mental health. This study therefore sought to investigate whether the autism/transgender overlap confers an increased risk of depression or anxiety. An online study of 727 individuals revealed a substantial overlap between transgender identity and autism, with increased autistic traits found in trans men compared to trans women. Depression and anxiety were highest in autistic-trans individuals, but no superadditive effect was observed. The implications of these findings are discussed in relation to the wider healthcare system.
Journal of Intellectual Disability - Diagnosis and Treatment, 2023
Introduction: Higher percentages of gender dysphoria among autistic people has been recently observed. Previous studies showed that patients with autism spectrum disorders have difficulties in social communication and romantic relationships. Aim: In light of this, this manuscript aimed to study the quality of romantic relationship in autistic people and the possible role played by gender dysphoria. Methods: The search of the literature was conducted in this database: PubMed; we used these search terms: "autism spectrum disorder", "gender dysphoria", and "romantic relationship". We found a total of 74 citations. After excluding duplicates, 74 records were screened. 58 studies were excluded according to inclusion and exclusion criteria. A total of 16 studies has been finally assessed. Results: The findings of this work showed that autistic people have a difficulties in social and romantic relationships. A variety of difficulties in interpersonal and romantic relationships were detected, but to date, it is not clear how gender dysphoria could influence the possibility to initiating and maintaining romantic relationships as well as having a satisfying sexual life. Furthermore, different diagnostic instruments resulted in having been employed, and a general heterogeneity in the population under scrutiny was observed. Conclusions: Impaired social communication and interaction (SCI) and restricted, repetitive behavior (RRB) represent the two core symptom domains of ASD within the DSM-5. It is important to pay attention to these conditions, to manage the coming out about gender dysphoria in autistic people, and to develop strategies to help future social and romantic relationships. Furthermore, as different assessment tools resulted in having been used, in future research, greater attention should be paid to standardizing assessment tools and criteria for the autism spectrum, paying attention to the subjects presenting subthreshold traits as well. In general, future research should better investigate specific existential dimensions and/or difficulties met by people presenting both ASD and Gender Dysphoria.
2019
The overarching concern of this thesis is discovering what it is that autism does to gender. This thesis argues that autism has come to constitute a form of gender trouble. Thus, the central question is how people assigned female at birth who have been formally diagnosed with autism as adults understand their gendered identity pre and post diagnosis. This thesis ascertains whether the diagnosis of autism holds any significance in how autistic individuals understand, think about and produce their gender. This thesis is interested in how an autistic identity is negotiated and how an autistic subjectivity emerges. It takes as its central proposition that autism is a masculinised diagnostic category and one which is produced and knowable through a masculinised discourse. Furthermore, autism is categorised as a neurodevelopmental disorder, thus, it becomes attached to the self or the ‘I’ of the person diagnosed through contemporary understandings of neurology and the self. This thesis de...