There are quite a few other conditions and life experiences that commonly co-occur with autism spectrum disorders. In this blog, I’m going to look at one of them: being transgender (or ‘trans’). Trans people have become more represented in the media recently, but unfortunately, coverage is not necessarily positive or accurate.
I will, therefore, explain that the word ‘trans’ simply describes a person who’s experienced gender is different from the one they were assigned at birth. Some trans people may undergo medical treatment such as hormones or surgery, but others will not. If you’re not trans, you may be described as cisgender (or ‘cis’).
If you’re reading this as a parent of an autistic child, it’s possible that your child has, or will in the future, display(ed) gender non-conforming behaviour. Maybe your child is, or might come out in the future as, trans. If so, I’d like to reassure you that this isn’t something to worry about.
Evidence shows that the best thing you can do for a trans child is simply to support them and allow them to express their gender. Just as you may have experienced negative attitudes towards autism, you may also see people who are prejudiced towards trans people. It’s important that you make sure your child knows that you are on their side, in both cases.
Now that we understand what it means if someone is trans, we will look at what the research says about autistic trans people. It seems that more autistic people are trans, compared to allistic (non-autistic) people, and also that more trans people are autistic, compared to cis people. So why is this?
No-one knows for certain, but there are some psychological and sociological theories that try to explain it. Firstly, it has been suggested that autism is inherently a gender defiant disorder- which means that autistic men tend to display more typically ‘female’ traits, and autistic women tend to show more traditionally ‘male’ traits. If this is true, it would mean that we should expect more autistic people to be trans than allistic people.
Secondly, some researchers think that it’s not necessarily true that autistic people are more likely to be trans- but actually, that autistic people are more likely than allistic people to realise that they are trans, or to come out as trans.
This may be related to reduced cognitive empathy- autistic people can struggle with understanding others’ thoughts and emotions, and therefore might be less affected by them. This means that they may be differently affected by social prejudices like transphobia, and thus may be more likely to come out and to transition, regardless of others’ thoughts about it.
Additionally, a theory called the ‘flattened priors hypothesis’ suggests that, in contrast to how allistic people respond to things based on the context of their previous experiences, autistic people’s reactions are more based on only the information from that specific situation.
When applied to gender, this means that allistic people tend to immediately assume a single binary gender for others and for themselves, because that’s what they’ve generally learned from their previous experiences.
However, autistic people are less likely to expect this binary and may be more open to perceiving people based on new information. They may also be more likely to perceive gender variance in themselves. So we’ve been looking at the potential reasons why people might be both autistic and trans- but why is this important?
Firstly, it might not be the most helpful question to be asking. Many trans and autistic people are concerned about the motivation behind this focus on explaining why their experiences exist. Some people think that trying to find out the causes contributes to the unnecessary medicalisation of being trans or autistic.
Trans autistic people have also had problems with some medical professionals using one diagnosis to try to invalidate the other one. For example, even though there is no evidence for it, some doctors may think that autistic people are less able to know whether they are trans or not. However, we can use the knowledge that autism and being trans commonly co-occur to help autistic trans people.
For example, autistic people might benefit from appropriate adjustments to the diagnostic tests for gender dysphoria (a medical term used for trans people’s experience of feeling like their physical body, or how they are perceived by others, doesn’t match their true gender).
Gender clinic doctors may need extra training on how to best support autistic people. Also, autism services could improve by being more knowledgeable about, and inclusive of, trans and other LGBT+ people.
Overall, we don’t really know for certain why autism and being trans often happen together. However, regardless of the actual cause, it is important that our main focus is on how we can best support autistic trans people to live happy and healthy lives. The main way we can do this is simply to support them in however they feel most comfortable expressing themselves, and to allow them access to any medical treatment they need.
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Bejerot, S., & Eriksson, J.M. (2014). Sexuality and gender role in autism spectrum disorder: A case-control study. PLoS One, 9, 1.Brooks, E. (2015, October 19). Focus on autism must broaden to include non-binary genders.
Spectrum News. Retrieved from: https://spectrumnews.org/opinion/focus-on-autism-must-broaden-to-include-non-binary-genders/
Glidden, D., Bouman, W.P., Jones, B.A., & Arcelus, J. (2016). Gender dysphoria and autism spectrum disorder: A systematic review of the literature. Sexual Medicine Reviews, 4(1), 3-14.
Kristensen, Z.E., & Broome, M.R. (2015). Autistic traits in an internet sample of gender variant UK adults. International Journal of Transgenderism, 16(4), 234-245.
Rudacille, D. (2016, April 13). Living between genders. Spectrum News. Retrieved from:https://spectrumnews.org/features/deep-dive/living-between-genders/
Strang, J.F. et al. (2014). Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Archives of Sexual Behaviour, 43(8), 1525-1533.
Strang, J.F. et al. (2018). Initial clinical guidelines for co-occurring autism spectrum disorder and gender dysphoria or incongruence in adolescents. Journal of Clinical Child & Adolescent Psychology, 47(1), 105-115.
Walsh, R., Begeer, S., & Krabbendam, L. (2017, April 7). Autistic gender identity differences- Resisting the social schema? Presented at the 2nd EPATH conference, Belgrade, Serbia, 6-8 April 2017.
[https://programme.exordo.com/epath2017/delegates/presentation/54/]
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