Gender Expression and Autism Spectrum Disorder

Introduction

Since 2010, there has been a link shown in research between the autism population and an increased rate of reported gender dysphoria or gender incongruent feelings. For instance, Researcher de Vries and colleagues found that “7.8% of children and adolescents with gender dysphoria also had an autism diagnosis” (Autism.org, n.d.). Research has also shown that about 32% of gender-diverse youth on the spectrum report being questioned about their identity due to their autism (Spectrum News, 2020). Additionally, 78% of gender diverse youth adolescents with ASD have a history of mental health issues, self-harming behaviors, or suicidal thoughts (Mahfouda et al., 2019). Considering these facts and prevalence, it is relevant to take a deeper look into why this association is showing up and how to best support individuals within this population.

Gender Incongruence and Autism Spectrum Disorder 

In a systematic literature review on the overlap between ASD and gender incongruence, researchers found that studies involving the general population indicate a correlation between parents reported ASD symptoms and gender variance in their child (Kallitsounaki et al, 2022). In one study on autism and gender identity and sexual orientation, researchers, George and Stokes, reached this conclusion even without including children diagnosed with autism (George et al., 2018). For adults, a study with non-autistic participants exhibiting mild autism traits also showed that higher self-reported ASD symptoms were linked to increased feelings of gender dysphoria (Kallitsounaki et al, 2022). In the autistic population specifically, research revealed that autistic adolescents were 2.12 times more likely to report gender dysphoria or incongruence, while autistic adults were 2.46 times more likely to express these feelings (Kallitsounaki et al, 2022). 

The Lived Experience of Autism and Gender Dysphoria

Interviews with transgender or gender non-binary individuals on the autism spectrum highlighted feelings of distress related to gender dysphoria or incongruence. Some participants felt that their autism heightened gender-related stress, while others believed certain features of autism allowed for greater freedom in gender expression (Cooper et al., 2021). However, most interviewees expressed negative emotions stemming from this disconnect, often reporting feelings of depression and, in some cases, anger related to their experiences. This mirrors findings from the broader community experiencing gender incongruence (Cooper et al., 2021).

Many participants in this study also struggled to articulate their feelings due to alexithymia, a condition characterized by difficulty identifying and expressing emotions, which can lead to misinterpretation by clinicians. Transgender individuals often face heightened discrimination and social isolation, which compounds the existing stressors for autistic individuals, such as sensory sensitivities (Cooper., 2021). The conflict between sensory needs and gender identity, as well as other mental health challenges, can escalate feelings of distress and discomfort.

This research points out that sensory experiences within the body can amplify feelings of gender dysphoria. Many individuals reported that facing multiple stressors exacerbated their symptoms. Importantly, simply belonging to either the transgender or autistic community is linked with increased mental health struggles. This study suggests that a transgender person with autism may face more social challenges than those without autism.

The Problem with Linking ASD and Gender Dysphoria/Gender Incongruence

One key issue with associating autism with gender fluidity and experiences of gender incongruence is that we still don’t fully understand the reasons behind this link. Strongly tying gender dysphoria to autism could lead to discrimination against both communities. When it comes to children, differences in reported gender incongruence might stem from autistic children feeling less societal pressure to conform to binary gender roles, whereas non-autistic children may be more likely to suppress or not report such feelings due to societal expectations. 

Conclusion

In summary, while there is some correlation between gender fluidity and the autism population, it is crucial to be cautious in making a strong connection between the two. Equally, it is important to be aware of the overlap, as it is helpful for treatment and improving patient outcomes. Improving conditions for clients is an ethical responsibility for service, but the underlying reasons for this association are still unclear, and jumping to conclusions could be harmful.

References

Autism and gender identity. (n.d.). Www.autism.org.uk. 

https://www.autism.org.uk/advice-and-guidance/what-is-autism/autism-and-gender-identity

Cooper, K., Mandy, W., Butler, C., & Russell, A. (2021). The lived experience of gender dysphoria in autistic adults: An interpretative phenomenological analysis. Autism, 26(4), 136236132110391. https://doi.org/10.1177/13623613211039113 

George, R., & Stokes, M. A. (2017). Gender identity and sexual orientation in autism spectrum disorder. Autism, 22(8), 970–982. https://doi.org/10.1177/1362361317714587 

Kallitsounaki, A., & Williams, D. M. (2022). Autism Spectrum Disorder and Gender Dysphoria/Incongruence. A systematic literature review and meta-Analysis. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-022-05517-y 

Learn How Tying Gender Dysphoria to Autism Might Be Discriminatory. (n.d.). Verywell Health. 

https://www.verywellhealth.com/gender-dysphoria-and-autism-4134405 

Spectrum News (2020) Largest study to date confirms overlap between autism and gender diversity https://www.spectrumnews.org/news/largest-study-to-date-confirms-overlap-between-autism-and-gender-diversity/