Autism and LGBTQ identities#autigender

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File:Autistic Pride Flag - Pride is a Protest.jpg

Current research indicates that autistic people have higher rates of LGBTQ identities and feelings than the general population.{{Citation |last1=Bertelli |first1=Marco O. |title=Autism Spectrum Disorder |date=2022 |url=https://books.google.com/books?id=4mtvEAAAQBAJ&pg=PA391 |work=Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder |pages=391 |editor-last=Bertelli |editor-first=Marco O. |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-319-95720-3_16 |isbn=978-3-319-95720-3 |quote=Persons with [autism spectrum disorder] and/or other neurodevelopmental problems are more likely than the general population to have transgender identity, non-heterosexual sexual orientation, and other gender non-conformities. |access-date=2022-06-08 |last2=Azeem |first2=Muhammad Waqar |last3=Underwood |first3=Lisa |last4=Scattoni |first4=Maria Luisa |last5=Persico |first5=Antonio M. |last6=Ricciardello |first6=Arianna |last7=Sappok |first7=Tanja |last8=Bergmann |first8=Thomas |last9=Keller |first9=Roberto |editor2-last=Deb |editor2-first=Shoumitro (Shoumi) |editor3-last=Munir |editor3-first=Kerim |editor4-last=Hassiotis |editor4-first=Angela|url-access=subscription }}{{Cite journal |last1=Lord |first1=Catherine |last2=Charman |first2=Tony |last3=Havdahl |first3=Alexandra |last4=Carbone |first4=Paul |last5=Anagnostou |first5=Evdokia |last6=Boyd |first6=Brian |last7=Carr |first7=Themba |last8=de Vries |first8=Petrus J |last9=Dissanayake |first9=Cheryl |author-link9=Cheryl Dissanayake |last10=Divan |first10=Gauri |last11=Freitag |first11=Christine M |display-authors=10 |date=2022 |title=The Lancet Commission on the future of care and clinical research in autism |url=https://fhi.brage.unit.no/fhi-xmlui/bitstream/handle/11250/2975811/Lancet+Commission.pdf?sequence=1 |journal=The Lancet |volume=399 |issue=10321 |pages=299–300 |doi=10.1016/s0140-6736(21)01541-5 |pmid=34883054 |s2cid=244917920 |via=Norwegian Institute of Public Health |hdl=11250/2975811}}{{Cite journal |last1=Graham Holmes |first1=Laura |last2=Ames |first2=Jennifer L. |last3=Massolo |first3=Maria L. |last4=Nunez |first4=Denise M. |last5=Croen |first5=Lisa A. |date=2022-04-01 |title=Improving the Sexual and Reproductive Health and Health Care of Autistic People |journal=Pediatrics |publisher=American Academy of Pediatrics |volume=149 |issue=Supplement 4 |pages=e2020049437J |doi=10.1542/peds.2020-049437J |pmid=35363286 |issn=0031-4005 |quote=A substantial proportion of autistic adolescents and adults are LGBTQIA+. Autistic people are more likely to be transgender or gender nonconforming compared with non-autistic people, and findings from a recent autism registry study suggest that among autistic people able to self-report on a survey, up to 18% of men and 43% of women may be sexual minorities. |doi-access=}} A variety of explanations for the increased prevalence of LGBTQ identities have been proposed, such as prenatal hormonal exposure, which has been linked with sexual orientation, gender dysphoria and autism. Alternatively, autistic people may be less reliant on social norms and thus are more open about their orientation or gender identity. A narrative review published in 2016 stated that while various hypotheses have been proposed for an association between autism and gender dysphoria, they lack strong evidence. In a special issue of Autism in Adulthood, editors note that research support for autistic sexual minority studies is lacking.{{Cite journal |last=Strang |first=John F. |last2=Fischbach |first2=Abigail L. |date=June 2023 |title=A Special Issue of Autism in Adulthood Dedicated to the Intersection of Autism and the Broad LGBTQ+ |url=https://www.liebertpub.com/doi/abs/10.1089/aut.2023.0056.editorial?journalCode=aut |journal=Autism in Adulthood |volume=5 |issue=2 |pages=109–111 |doi=10.1089/aut.2023.0056.editorial |issn=2573-9581|pmc=10280169 }}

Autism and sexual orientation

=General interest in sexuality=

Early claims that autistic people lack a sex drive or desire for sexuality have been regarded as an inaccurate stereotype.{{cite journal |last1=Sullivan |first1=Amanda |last2=Caterino |first2=Linda C. |title=Addressing the Sexuality and Sex Education of Individuals with Autism Spectrum Disorders |journal=Education and Treatment of Children |date=2008 |volume=31 |issue=3 |pages=381–394 |doi=10.1353/etc.0.0001 |jstor=42899984 |s2cid=143957507 |url=https://www.jstor.org/stable/42899984 |issn=0748-8491|url-access=subscription }}{{cite journal |last1=Schöttle |first1=Daniel |last2=Briken |first2=Peer |last3=Tüscher |first3=Oliver |last4=Turner |first4=Daniel |title=Sexuality in autism: hypersexual and paraphilic behavior in women and men with high-functioning autism spectrum disorder |journal=Dialogues in Clinical Neuroscience |date=December 2017 |volume=19 |issue=4 |pages=381–393|doi=10.31887/DCNS.2017.19.4/dschoettle |pmid=29398933 |pmc=5789215 }}{{Cite journal|last1=Sala|first1=Giorgia|last2=Pecora|first2=Laura|last3=Hooley|first3=Merrilyn|last4=Stokes|first4=Mark A.|date=2020-06-01|title=As Diverse as the Spectrum Itself: Trends in Sexuality, Gender and Autism|url=https://link.springer.com/article/10.1007/s40474-020-00190-1|journal=Current Developmental Disorders Reports|language=en|volume=7|issue=2|pages=59–68|doi=10.1007/s40474-020-00190-1|s2cid=214606609|issn=2196-2987|url-access=subscription}} These claims were a result of methodological problems. More recent evidence indicates that most autistic people express an interest in both romance and sexuality.

=Sexual orientation of autistic people=

Autistic people are less likely to identify as heterosexual than their non-autistic counterparts.{{Cite journal|last1=Sala|first1=Giorgia|last2=Hooley|first2=Merrilyn|last3=Attwood|first3=Tony|last4=Mesibov|first4=Gary B.|last5=Stokes|first5=Mark A.|date=2019-09-01|title=Autism and Intellectual Disability: A Systematic Review of Sexuality and Relationship Education|url=https://link.springer.com/article/10.1007%2Fs11195-019-09577-4|journal=Sexuality and Disability|language=en|volume=37|issue=3|pages=353–382|doi=10.1007/s11195-019-09577-4|s2cid=189875576|issn=1573-6717|url-access=subscription}}{{Citation |last1=Gilmour |first1=Laura |title=Sexuality and ASD: Current State of Research |date=2014 |url=https://link.springer.com/referenceworkentry/10.1007/978-1-4614-4788-7_27 |work=Comprehensive Guide to Autism |pages=569–584 |editor-last=Patel |editor-first=Vinood B. |place=New York, NY |publisher=Springer |language=en |doi=10.1007/978-1-4614-4788-7_27 |isbn=978-1-4614-4788-7 |access-date=2022-06-09 |last2=Smith |first2=Veronica |last3=Schalomon |first3=Melike |editor2-last=Preedy |editor2-first=Victor R. |editor3-last=Martin |editor3-first=Colin R.|url-access=subscription }} Some attempt to explain this as part of an association between autism, prenatal hormones, and sexual orientation.{{Cite journal |last1=Pecora |first1=Laura A. |last2=Hancock |first2=Grace I. |last3=Hooley |first3=Merrilyn |last4=Demmer |first4=David H. |last5=Attwood |first5=Tony |author-link5=Tony Attwood |last6=Mesibov |first6=Gary B. |last7=Stokes |first7=Mark A. |date=2020 |title=Gender identity, sexual orientation and adverse sexual experiences in autistic females |journal=Molecular Autism |volume=11 |issue=1 |pages=57 |doi=10.1186/s13229-020-00363-0 |issn=2040-2392 |pmc=7353794 |pmid=32653016 |doi-access=free }}{{Cite journal |last1=Attanasio |first1=Margherita |last2=Masedu |first2=Francesco |last3=Quattrini |first3=Fabrizio |last4=Pino |first4=Maria Chiara |last5=Vagnetti |first5=Roberto |last6=Valenti |first6=Marco |last7=Mazza |first7=Monica |date=2021-11-15 |title=Are Autism Spectrum Disorder and Asexuality Connected? |url=https://link.springer.com/content/pdf/10.1007/s10508-021-02177-4.pdf |journal=Archives of Sexual Behavior |volume=51 |issue=4 |pages=2091–2115 |language=en |doi=10.1007/s10508-021-02177-4 |issn=1573-2800 |pmid=34779982 |s2cid=244115396}} That is not the only proposed explanation, however. While there is a broad consensus that autistic people are more likely to have an LGBTQ identity, there is great variation in estimates of the size of these effects,{{Cite news |last=Sarris |first=Marina |date=June 22, 2020 |title=Autistic People More Likely to Identify as LGBTQ |work=Simons Foundation Powering Autism Research for Knowledge (SPARK) |publisher=Simons Foundation Autism Research Initiative (SFARI) |url=https://sparkforautism.org/discover_article/autism-lgbtq-identity/ |access-date=December 13, 2021}} and most research suggests that the majority of autistic people are heterosexual.{{Cite journal |last1=Sala |first1=Giorgia |last2=Pecora |first2=Laura |last3=Hooley |first3=Merrilyn |last4=Stokes |first4=Mark A. |date=2020-06-01 |title=As Diverse as the Spectrum Itself: Trends in Sexuality, Gender and Autism |url=https://doi.org/10.1007/s40474-020-00190-1 |journal=Current Developmental Disorders Reports |language=en |volume=7 |issue=2 |pages=59–68 |doi=10.1007/s40474-020-00190-1 |s2cid=214606609 |issn=2196-2987|url-access=subscription }} Studies on sexual orientation and autism suggest that more autistic people have homosexual and bisexual feelings compared to the general population.{{cite journal |last1=Byers |first1=E.S. |last2=Nichols |first2=S. |last3=Voyer |first3=S.D. |title=Challenging stereotypes: Sexual functioning of single adults with high functioning autism spectrum disorder |journal=Journal of Autism and Developmental Disorders |date=2013 |volume=43 |issue=11 |pages=2617–2627 |doi=10.1007/s10803-013-1813-z |pmid=23526036 |s2cid=41857222 |url=https://www.researchgate.net/publication/236077894}} Studies have indicated higher incidence of asexuality among autistic people, though a 2019 review article stated that this "should be interpreted with caution, bearing in mind the difficulty of establishing social relations in persons with ASD".{{Cite journal |last=Parchomiuk |first=Monika |date=2019-06-01 |title=Sexuality of Persons with Autistic Spectrum Disorders (ASD) |url=https://link.springer.com/article/10.1007/s11195-018-9534-z |journal=Sexuality and Disability |language=en |volume=37 |issue=2 |pages=259–274 |doi=10.1007/s11195-018-9534-z |s2cid=150360611 |issn=1573-6717|url-access=subscription }} Similarly, a survey of asexual individuals found that about 7% to 8% of respondents had acquired an autism diagnosis, approximately 4 times larger than the American population estimate.{{Cite journal |last1=Alison |first1=Rowan |last2=Verardi |first2=James H. |date=2021 |title=Including Asexual People in Services |url=https://www.equality-network.org/wp-content/uploads/2021/06/Asexual-booklet-final-web.pdf |journal=Equality Network |pages=17}}{{Cite web |last=CDC |date=2022-03-02 |title=Data and Statistics on Autism Spectrum Disorder {{!}} CDC |url=https://www.cdc.gov/ncbddd/autism/data.html |access-date=2022-10-08 |website=Centers for Disease Control and Prevention |language=en-us}}{{Cite web |last=CDC |date=2020-04-27 |title=CDC Releases First Estimates of the Number of Adults Living with ASD |url=https://www.cdc.gov/ncbddd/autism/features/adults-living-with-autism-spectrum-disorder.html |access-date=2022-10-08 |website=Centers for Disease Control and Prevention |language=en-us}}{{Cite web |title=National Population by Characteristics: 2020-2021 |url=https://www.census.gov/data/datasets/time-series/demo/popest/2020s-national-detail.html |access-date=October 1, 2024 |website=United States Census Bureau |archive-url=https://web.archive.org/web/20220414183930/https://www.census.gov/data/datasets/time-series/demo/popest/2020s-national-detail.html |archive-date=April 14, 2022}}

The decreased incidence of heterosexuality in the autistic population is present when measuring for self-reported sexual orientations, behaviors, and interests alike.

=Gender differences in sexual orientation=

{{See also|Sex and gender differences in autism}}

Some studies have indicated that autistic women have lower rates of heterosexual orientation than autistic men do.{{Cite journal|last1=Dewinter|first1=J.|last2=De Graaf|first2=H.|last3=Begeer|first3=S.|date=2017|title=Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder|journal=Journal of Autism and Developmental Disorders|volume=47|issue=9|pages=2927–2934|doi=10.1007/s10803-017-3199-9|issn=0162-3257|pmc=5570786|pmid=28597143}}{{Cite journal|last1=Pecora|first1=Laura A.|last2=Hooley|first2=Merrilyn|last3=Sperry|first3=Laurie|last4=Mesibov|first4=Gary B.|last5=Stokes|first5=Mark A.|date=2021-03-01|title=Sexuality and Gender Issues in Individuals with Autism Spectrum Disorder|url=https://www.sciencedirect.com/science/article/pii/S0193953X20300812|journal=Psychiatric Clinics of North America|series=Autism Spectrum Disorder Across the Lifespan Part II|language=en|volume=44|issue=1|pages=111–124|doi=10.1016/j.psc.2020.11.009|pmid=33526233|s2cid=231760483|issn=0193-953X|url-access=subscription}} This was also corroborated by an online survey conducted by the University of Cambridge and published in Autism Research. That survey suggested that autistic women had a wider range of sexual identification than both non-autistic women and autistic men. Younger respondents had a higher likelihood for reporting themselves as homosexual than did older respondents.{{Cite journal|last1=Weir|first1=Elizabeth|last2=Allison|first2=Carrie|last3=Baron-Cohen|first3=Simon|date=2021|title=The sexual health, orientation, and activity of autistic adolescents and adults|journal=Autism Research|language=en|volume=14|issue=11|pages=2342–2354|doi=10.1002/aur.2604|pmid=34536071|s2cid=237557123|issn=1939-3806|doi-access=free}} According to a 2021 review, some studies indicated that autistic women were about three to four times as likely to be bisexual when compared to non-autistic women.

Autism and gender identity

{{Primary sources|date=December 2024}}

=Gender identity of autistic people=

Autistic people are more likely to exhibit diverse gender identities or gender variance (also known as gender non-conformity) than the general population.{{Rp|page=515}} The size of the difference varies significantly based on the methodology of studies and so cannot be said conclusively.

In 2016, researchers published a study that examined gender variance in a sample of 492 children and adolescents that had been diagnosed with an autism spectrum disorder at the New York University's Child Study Center between 2011 and 2015. They analyzed the parents' responses to the Child Behavior Checklist (CBCL) that was administered as part of the initial evaluation of all children at the center. The study, which was reported on in the popular press,{{cite web |last=Laurye |first=Sharon |date=March 6, 2016 |title=Study: Autistic kids more likely to be gender non-conforming |url=https://www.phillyvoice.com/study-autistic-kids-more-likely-be-gender-non-conforming/ |access-date=2023-06-05 |website=Philly Voice}} concluded that autistic children were seven times more likely to exhibit gender variance than their non-autistic peers.{{cite journal |last1=Janssen |first1=A. |last2=Huang |first2=H. |last3=Duncan |first3=C. |date=2016 |title=Gender Variance Among Youth with Autism Spectrum Disorders: A Retrospective Chart Review |journal=Transgender Health |volume=1 |issue=1 |pages=63–68 |doi=10.1089/trgh.2015.0007 |pmc=5367474 |pmid=28861527}}

A study on the gender identity of autistic people (mostly adults) without intellectual disability published in 2018 found that this group, and especially those assigned female at birth, had lower identification with their assigned gender, and lower self-esteem about that gender, than non-autistic controls. In discussing the limitations of their study, the researchers noted that they observed an unusually high occurrence of gender and sexual orientation diversity as well as mental health problems across all participants, which they attribute to a selection bias due to the recruitment of participants through various only channels.{{Cite journal |last1=Cooper |first1=Kate |last2=Smith |first2=Laura G. E. |last3=Russell |first3=Ailsa J. |title=Gender Identity in Autism: Sex Differences in Social Affiliation with Gender Groups |journal=Journal of Autism and Developmental Disorders |volume=48 |issue=12 |pages=3995–4006 |date=18 April 2018 |pmc=6223803 |pmid=29705922 |doi=10.1007/s10803-018-3590-1}} A comparable study published in 2020 focused on autistic people (mostly adults) assigned female at birth concluded that these were more likely to identify as transgender compared to a non-autistic control group. Similar to the 2018 study, the researchers cautioned that their recruitment methods likely led to a selection bias, as they observed an unusually high occurrence of non-heterosexual orientations among the non-autistic participants. Further, the number of transgender people in the sample was relatively small.

= Autigender =

{{anchor|autigender}}

Some people feel that autism causes them to have a very different understanding of their gender than is expected of them.{{Cite book |last1=M.D |first1=Eric Hollander |url=https://books.google.com/books?id=d0pkEAAAQBAJ&pg=PA93 |title=Textbook of Autism Spectrum Disorders, Second Edition |last2=M.D |first2=Randi Hagerman |last3=M.S |first3=Casara Ferretti |date=2022-03-15 |publisher=American Psychiatric Pub |isbn=978-1-61537-304-8 |pages=93 |language=en}}{{Cite book |last1=Hartman |first1=Davida |url=https://books.google.com/books?id=5hCZEAAAQBAJ&pg=PA171 |title=The Adult Autism Assessment Handbook: A Neurodiversity Affirmative Approach |last2=O'Donnell-Killen |first2=Tara |last3=Doyle |first3=Jessica K. |last4=Kavanagh |first4=Dr Maeve |last5=Day |first5=Dr Anna |last6=Azevedo |first6=Dr Juliana |date=2023-02-21 |publisher=Jessica Kingsley Publishers |isbn=978-1-83997-167-9 |pages=171 |language=en}} Some autistic individuals use the term "autigender" to describe the unique experience they have with their sense of gender.{{cite web |url=https://www.shoretherapycenter.com/blog/autigender-autism-gender-identity |title=What is autigender?: exploring the relatioship between neurodiversity and gender identity |last=Goldberg |first=Corrie |date=March 9, 2023 |website=Shore Therapy Center for Wellness |access-date=October 1, 2024 |archive-url=https://web.archive.org/web/20230710183920/https://www.shoretherapycenter.com/blog/autigender-autism-gender-identity |archive-date=July 10, 2023}} Autigender is often incorrectly interpreted as saying that "autism" is one's gender.

The use of "autigender" has been controversial in both the autistic and non-binary communities.

=Gender dysphoria in autistic children=

Gender dysphoria is a diagnosis in the fifth edition of the Diagnostic and Statistical Manual of Mental Disoders (DSM-5, since 2013, revised 2022) given to people who experience discomfort related to their gender identity.{{Cite book |last=American Psychiatric Association |title=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision |publisher=American Psychiatric Association |year=2022 |isbn=978-0-89042-575-6 |location=Washington, DC |doi=10.1176/appi.books.9780890425787|s2cid=249488050 }}{{Rp|pages=511–514}} The 11th edition of the International Classification of Diseases (ICD-11, since 2022) maintained by World Health Organization describes a similar condition under the term gender incongruence.{{Cite web |date=2023 |title=Gender incongruence |url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/411470068 |access-date=2023-06-05 |website=ICD-11 for Mortality and Morbidity Statistics |publisher=World Health Organization}}

Among people diagnosed with gender dysphoria, autism spectrum traits are observed more often than in the general population.{{Rp|page=515}}{{cite journal |last1=Kallitsounaki |first1=Aimilia |last2=Williams |first2=David M. |date=20 May 2022 |title=Autism Spectrum Disorder and Gender Dysphoria/Incongruence. A systematic Literature Review and Meta-Analysis |journal=Journal of Autism and Developmental Disorders |volume=53 |issue=8 |pages=3103–3117 |doi=10.1007/S10803-022-05517-Y |pmid=35596023 |pmc=10313553 |doi-access=free}} A 2022 meta analysis concluded that there is a high prevalence of gender dysphoria in people diagnosed with an autism spectrum disorder. The authors conclude that the data suggests a link between autism and gender dysphoria, but the nature and scope of the link requires further investigation.

According to the DSM-5-TR, gender dysphoria can be difficult to diagnose in autistic people, as these might think concretely and rigidly around gender roles and/or have difficulties understanding their social context.{{Rp|pages=519–520}} In 2018, a first proposal for clinical guidelines for co-occurring gender dysphoria and autism was published by a team of psychiatrists from across the US.{{Cite journal |last1=Strang |first1=John F. |last2=Meagher |first2=Haley |last3=Kenworthy |first3=Lauren |last4=de Vries |first4=Annelou L. C. |last5=Menvielle |first5=Edgardo |last6=Leibowitz |first6=Scott |last7=Janssen |first7=Aron |last8=Cohen-Kettenis |first8=Peggy |last9=Shumer |first9=Daniel E. |last10=Edwards-Leeper |first10=Laura |last11=Pleak |first11=Richard R. |last12=Spack |first12=Norman |last13=Karasic |first13=Dan H. |last14=Schreier |first14=Herbert |last15=Balleur |first15=Anouk |date=2018 |title=Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents |journal=Journal of Clinical Child & Adolescent Psychology |language=en |volume=47 |issue=1 |pages=105–115 |doi=10.1080/15374416.2016.1228462 |pmid=27775428|s2cid=2393051 |doi-access=free }}

While numerous case studies of gender dysphoria in autistic people were reported in the scientific literature, the first study to assess the convergence of gender dysphoria and autism was not published until 2010,{{cite web |last=Urquhart |first=Evan |date=March 21, 2018 |title=A Disproportionate Number of Autistic Youth Are Transgender. Why? |url=https://slate.com/human-interest/2018/03/why-are-a-disproportionate-number-of-autistic-youth-transgender.html |access-date=2023-06-05 |website=Slate}}{{cite web |last=White |first=Bryony |date=November 15, 2016 |title=The Link Between Autism and Trans Identity |url=https://www.theatlantic.com/health/archive/2016/11/the-link-between-autism-and-trans-identity/507509/ |access-date=2023-06-02 |website=The Atlantic}} when researchers in the Netherlands examined 129 children and adolescents who were diagnosed with gender identity disorder (the precursor to gender dysphoria defined in the DSM-IV) at a gender identity clinic, finding that 6 individuals (4.7%) were also diagnosed as autistic.{{cite journal |last1=Vries |first1=A.L.C. |last2=Noens |first2=I.L.J. |last3=Cohen-Kettenis |first3=P.T. |last4=Berckelaer-Onnes |first4=I.A.V. |last5=Doreleijers |first5=T.A. |date=22 January 2010 |title=Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents |journal=Journal of Autism and Developmental Disorders |volume=40 |issue=8 |pages=930–936 |doi=10.1007/s10803-010-0935-9 |pmc=2904453 |pmid=20094764}} A 2016 review of the available literature concluded that the prevalence of autism spectrum conditions among children and adolescents diagnosed with gender dysphoria was higher than in the general population.{{cite journal |last1=Glidden |first1=Derek |last2=Bouman |first2=Walter Pierre |last3=Jones |first3=Bethany A. |last4=Arcelus |first4=Jon |year=2016 |title=Gender Dysphoria and Autism Spectrum Disorder: A Systemic Review of the Literature |url=http://irep.ntu.ac.uk/id/eprint/35588/1/13151_Jones.pdf |journal=Sexual Medicine Reviews |volume=4 |issue=1 |pages=3–14 |doi=10.1016/j.sxmr.2015.10.003 |pmid=27872002 |s2cid=3454600}} A narrative review published in 2016 concluded that hypotheses regarding the underlying causes lacked evidence.{{Cite journal |last1=Miesen |first1=Anna I. R. Van Der |last2=Hurley |first2=Hannah |last3=Vries |first3=Annelou L. C. De |date=2016 |title=Gender dysphoria and autism spectrum disorder: A narrative review |journal=International Review of Psychiatry |volume=28 |issue=1 |pages=70–80 |doi=10.3109/09540261.2015.1111199 |pmid=26753812 |s2cid=20918937 |doi-access=free}}

=Autistic traits in gender non-conforming and transgender people=

A 2022 meta analysis concluded that there is a relationship between autistic traits and feelings of gender dysphoria. However, the researchers noted that little is known about autistic traits in those that are non-autistic.

Some studies have noted an overlap between those with autism and those who are transgender. British researchers in 2011 concluded that trans men had more autistic traits than trans women.{{cite journal |last1=Jones |first1=R.M. |last2=Wheelwright |first2=S. |last3=Farrell |first3=K. |last4=Martin |first4=E. |last5=Green |first5=R. |last6=Di Ceglie |first6=D. |last7=Baron-Cohen |first7=S. |title=Brief report: female-to-male transsexual people and autistic traits |journal=Journal of Autism and Developmental Disorders |date=30 March 2011 |volume=42 |issue=2 |pages=301–6 |doi=10.1007/s10803-011-1227-8 |pmid=21448752 |s2cid=17812230 |url=https://link.springer.com/article/10.1007%2Fs10803-011-1227-8|url-access=subscription }} However, a study by British researchers in 2013 concluded that there was "no significant difference" between trans men and trans women in autistic traits observed.{{cite journal |last1=Pasterski |first1=V. |last2=Gilligan |first2=L. |last3=Curtis |first3=R. |title=Traits of autism spectrum disorders in adults with gender dysphoria |journal=Archives of Sexual Behavior |date=18 July 2013 |volume=43 |issue=2 |pages=301–6 |doi=10.1007/s10508-013-0154-5 |pmid=23864402 |s2cid=20078504 |url=https://link.springer.com/article/10.1007%2Fs10508-013-0154-5|url-access=subscription }} Steven Stagg and Jaime Vincent of Anglia Ruskin University concluded in September 2019 that some of those seeking advice and help for their gender identity may be autistic, whether diagnosed or not, with these abilities impeding possible support, and urged clinicians treating individuals who are transgender or non-binary, especially those assigned female at birth, to consider whether they have undiagnosed ASD.{{cite journal |last1=Stagg |first1=S. |last2=Vincent |first2=J. |title=Autistic traits in individuals self-defining as transgender or nonbinary |journal=European Psychiatry |date=September 2019 |volume=61 |issue= |pages=17–22 |doi=10.1016/j.eurpsy.2019.06.003 |pmid=31260907 |s2cid=195770805 |url=https://www.sciencedirect.com/science/article/abs/pii/S0924933819301014}} Four researchers in January 2020 suggested "overlap between autism and transgender identity", possibly more in trans men than trans women, and stated that anxiety and depression were the highest in autistic individuals who were transgender.{{cite journal |last1=Murphy |first1=J. |last2=Prentice |first2=F. |last3=Walsh |first3=R. |last4=Catmur |first4=C. |last5=Bird |first5=G. |date=2020 |title=Autism and transgender identity: Implications for depression and anxiety |journal=Research in Autism Spectrum Disorders |volume=69 |page=101466 |doi=10.1016/j.rasd.2019.101466 |s2cid=210571788 |doi-access=free |number=101466|url=https://kclpure.kcl.ac.uk/ws/files/122537020/1_s2.0_S1750946719301540_main.pdf }} Scientists with the Autism Research Centre at University of Cambridge, using data from 600,000 adults in the UK, concluded in August 2020 that adults who were transgender or gender diverse were three to six times more likely to have an autistic diagnosis than those who were cisgender, and suggested that between 3.5 and 6.5% of transgender and gender diverse adults in the UK are autistic.{{cite press release |date=7 August 2020 |title=Transgender and gender-diverse individuals are more likely to be autistic and report higher autistic traits |url=https://www.cam.ac.uk/research/news/transgender-and-gender-diverse-individuals-are-more-likely-to-be-autistic-and-report-higher-autistic |location=Cambridge, UK |publisher=University of Cambridge |access-date=2021-09-11 |archive-url=https://web.archive.org/web/20210422223526/https://www.cam.ac.uk/research/news/transgender-and-gender-diverse-individuals-are-more-likely-to-be-autistic-and-report-higher-autistic |archive-date=22 April 2021 |url-status=live}}{{cite journal |last1=Warrier |first1=V. |last2=Greenberg |first2=D.M. |last3=Weir |first3=E. |last4=Buckingham |first4=C. |last5=Smith |first5=Paula |last6=Lai |first6=M.C. |last7=Allison |first7=C. |last8=Baron-Cohen |first8=S. |title=Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals |journal=Nature Communications |date=7 August 2020 |volume=11 |number=3959 |page=3959 |doi=10.1038/s41467-020-17794-1 |pmid=32770077 |pmc=7415151 |bibcode=2020NatCo..11.3959W }}

Other researchers have noted the prevalence of autistic traits among those who identify as non-binary or genderqueer. Two Warwick University researchers, utilizing data from 446 UK adult respondents, concluded in January 2016 that, based on their sample, genderqueer individuals were more likely to be autistic than any other group with gender dysphoria.{{cite journal |last1=Kristensen |first1=Z.E. |last2=Broome |first2=M.R. |title=Autistic Traits in an Internet Sample of Gender Variant UK Adults |journal=International Journal of Transgenderism |date=16 January 2016 |volume=16 |issue=4 |pages=234–45 |doi=10.1080/15532739.2015.1094436 |s2cid=146875880 |url=https://www.tandfonline.com/doi/full/10.1080/15532739.2015.1094436|url-access=subscription }}

=Gender-affirming care for autistic people=

In December 2014, four researchers concluded that being on the autism spectrum does not "preclude gender transition" and suggested methods for assisting such individuals in "exploring their gender identities".{{cite journal |last1=Jacobs |first1=L. |last2=Rachlin |first2=Katherine |last3=Erickson-Schroth |first3=L. |last4=Janssen |first4=A. |title=Gender Dysphoria and Co-Occurring Autism Spectrum Disorders: Review, Case Examples, and Treatment Considerations |journal=LGBT Health |date=11 December 2014 |volume=1 |issue=4 |pages=277–82 |doi=10.1089/lgbt.2013.0045 |pmid=26789856 |url=https://www.liebertpub.com/doi/10.1089/lgbt.2013.0045|url-access=subscription }} One of the study's authors, Katherine Rachlin, said that, sometimes, being transgender can "look like the spectrum experience" to clinicians.{{cite web |last=Rudacille |first=Deborah |date=April 13, 2016 |title=Living between genders |url=https://www.spectrumnews.org/features/deep-dive/living-between-genders/ |access-date=2023-06-02 |website=Spectrum |publisher=Simons Foundation}} In March 2015, a study from researchers at the Yale School of Medicine stated that those on the autism spectrum should be treated equally to other individuals for gender dysphoria, and suggested that clinicians "broaden the social frame" and facilitate an "exploration of gender roles".{{cite journal |last1=van Schalkwyk |first1=G.I. |last2=Klingensmith |first2=K. |last3=Volkmar |first3=F.R. |title=Gender identity and autism spectrum disorders |journal=Yale Journal of Biology and Medicine |date=4 March 2015 |volume=88 |issue=1 |pages=81–3 |pmid=25744543 |pmc=4345542 }} A Finnish study in April 2015 recommended that the autism spectrum be recognized seriously in developing guidelines for treating "child and adolescent gender dysphoria".{{cite journal |last1=Kaltiala-Heino |first1=R. |last2=Sumia |first2=M. |last3=Työläjärvi |first3=M. |last4=Lindberg |first4=N. |title=Two years of gender identity service for minors: overrepresentation of natal girls with severe problems in adolescent development |journal=Child and Adolescent Psychiatry and Mental Health |date=9 April 2015 |volume=9 |number=9 |page=9 |doi=10.1186/s13034-015-0042-y |pmid=25873995 |pmc=4396787 |doi-access=free }}

A 2022 survey of gender clinic healthcare clinicians found there were often differences in communication and thinking styles between the clinicians and autistic patients.{{Cite journal |last1=Cooper |first1=Kate |last2=Mandy |first2=William |last3=Russell |first3=Ailsa |last4=Butler |first4=Catherine |title=Healthcare clinician perspectives on the intersection of autism and gender dysphoria |journal=Autism |year=2023 |volume=27 |issue=1 |pages=31–42 |orig-date=14 March 2022 |publication-date=January 2023 |pmid=35285287 |pmc=9806459 |doi=10.1177/13623613221080315}} The study concluded that adaptations should be made, including training for clinicians on working with autistic patients, and adjustments made in the clinical setting.

WPATH SOC Version 8, published in August 2022, states that there is no evidence that withholding gender-affirming care from individuals with neurodevelopmental conditions has any benefit.{{cite journal |last1=Coleman |first1=E. |last2=Radix |first2=A. E. |last3=Bouman |first3=W. P. |last4=Brown |first4=G. R. |last5=de Vries |first5=A. L. C. |last6=Deutsch |first6=M. B. |last7=Ettner |first7=R. |last8=Fraser |first8=L. |last9=Goodman |first9=M. |last10=Green |first10=J. |last11=Hancock |first11=A. B. |last12=Johnson |first12=T. W. |last13=Karasic |first13=D. H. |last14=Knudson |first14=G. A. |last15=Leibowitz |first15=S. F. |last16=Meyer-Bahlburg |first16=H. F. L. |last17=Monstrey |first17=S. J. |last18=Motmans |first18=J. |last19=Nahata |first19=L. |last20=Nieder |first20=T. O. |last21=Reisner |first21=S. L. |last22=Richards |first22=C. |last23=Schechter |first23=L. S. |last24=Tangpricha |first24=V. |last25=Tishelman |first25=A. C. |last26=Van Trotsenburg |first26=M. A. A. |last27=Winter |first27=S. |last28=Ducheny |first28=K. |last29=Adams |first29=N. J. |last30=Adrián |first30=T. M. |last31=Allen |first31=L. R. |last32=Azul |first32=D. |last33=Bagga |first33=H. |last34=Başar |first34=K. |last35=Bathory |first35=D. S. |last36=Belinky |first36=J. J. |last37=Berg |first37=D. R. |last38=Berli |first38=J. U. |last39=Bluebond-Langner |first39=R. O. |last40=Bouman |first40=M.-B. |last41=Bowers |first41=M. L. |last42=Brassard |first42=P. J. |last43=Byrne |first43=J. |last44=Capitán |first44=L. |last45=Cargill |first45=C. J. |last46=Carswell |first46=J. M. |last47=Chang |first47=S. C. |last48=Chelvakumar |first48=G. |last49=Corneil |first49=T. |last50=Dalke |first50=K. B. |last51=De Cuypere |first51=G. |last52=de Vries |first52=E. |last53=Den Heijer |first53=M. |last54=Devor |first54=A. H. |last55=Dhejne |first55=C. |last56=D'Marco |first56=A. |last57=Edmiston |first57=E. K. |last58=Edwards-Leeper |first58=L. |last59=Ehrbar |first59=R. |last60=Ehrensaft |first60=D. |last61=Eisfeld |first61=J. |last62=Elaut |first62=E. |last63=Erickson-Schroth |first63=L. |last64=Feldman |first64=J. L. |last65=Fisher |first65=A. D. |last66=Garcia |first66=M. M. |last67=Gijs |first67=L. |last68=Green |first68=S. E. |last69=Hall |first69=B. P. |last70=Hardy |first70=T. L. D. |last71=Irwig |first71=M. S. |last72=Jacobs |first72=L. A. |last73=Janssen |first73=A. C. |last74=Johnson |first74=K. |last75=Klink |first75=D. T. |last76=Kreukels |first76=B. P. C. |last77=Kuper |first77=L. E. |last78=Kvach |first78=E. J. |last79=Malouf |first79=M. A. |last80=Massey |first80=R. |last81=Mazur |first81=T. |last82=McLachlan |first82=C. |last83=Morrison |first83=S. D. |last84=Mosser |first84=S. W. |last85=Neira |first85=P. M. |last86=Nygren |first86=U. |last87=Oates |first87=J. M. |last88=Obedin-Maliver |first88=J. |last89=Pagkalos |first89=G. |last90=Patton |first90=J. |last91=Phanuphak |first91=N. |last92=Rachlin |first92=K. |last93=Reed |first93=T. |last94=Rider |first94=G. N. |last95=Ristori |first95=J. |last96=Robbins-Cherry |first96=S. |last97=Roberts |first97=S. A. |last98=Rodriguez-Wallberg |first98=K. A. |last99=Rosenthal |first99=S. M. |display-authors=1 |last100=Sabir |first100=K. |last101=Safer |first101=J. D. |last102=Scheim |first102=A. I. |last103=Seal |first103=L. J. |last104=Sehoole |first104=T. J. |last105=Spencer |first105=K. |last106=St. Amand |first106=C. |last107=Steensma |first107=T. D. |last108=Strang |first108=J. F. |last109=Taylor |first109=G. B. |last110=Tilleman |first110=K. |last111=T'Sjoen |first111=G. G. |last112=Vala |first112=L. N. |last113=Van Mello |first113=N. M. |last114=Veale |first114=J. F. |last115=Vencill |first115=J. A. |last116=Vincent |first116=B. |last117=Wesp |first117=L. M. |last118=West |first118=M. A. |last119=Arcelus |first119=J. |title=Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 |journal=International Journal of Transgender Health |date=19 August 2022 |volume=23 |issue=Suppl 1 |pages=S37,S49 |issn=2689-5269 |doi=10.1080/26895269.2022.2100644 |doi-access=free |pmid=36238954 |pmc=9553112 }} WPATH SOC 8 further recommends that healthcare professionals working with gender-diverse adolescents receive training and develop expertise in autism spectrum disorder and other neurodevelopmental presentations.

=Mental health of gender diverse autistic people=

In a 2021 study on autistic camouflaging, gender-diverse autistic adults were found to use more autistic camouflaging than cisgender autistic adults.{{Cite journal |last1=McQuaid |first1=G. A. |last2=Lee |first2=N. R. |last3=Wallace |first3=G. L. |date=2022 |title=Camouflaging in autism spectrum disorder: Examining the roles of sex, gender identity, and diagnostic timing |url=https://osf.io/frbj3/download |journal=Autism |volume=26 |issue=2 |pages=552–559 |doi=10.1177/13623613211042131|pmid=34420418 |s2cid=237268400 |url-access=subscription }}

A January 2023 study on trans and non-binary adults found that higher autistic traits and higher gender minority stress were correlated with poorer mental health outcomes.{{Cite journal |last1=Kung |first1=Karston T. F. |date=2023 |title=Autistic Traits, Gender Minority Stress, and Mental Health in Transgender and Non-Binary Adults |url=https://link.springer.com/article/10.1007/s10803-022-05875-7 |journal=Journal of Autism and Developmental Disorders |doi=10.1007/s10803-022-05875-7 |pmid=36652125|s2cid=255969392 |url-access=subscription }}

See also

References

{{reflist}}

Further reading

  • {{cite interview |last=Dale |first=Laura Kate |interviewer=Yenn Purkis |title=Interview with Author of Uncomfortable Labels, Laura Kate Dale by Yenn Purkis |work=Spectrum Women Magazine |date=July 10, 2019 |location=Australia |url=https://www.spectrumwomen.com/featured/interview-with-author-of-uncomfortable-labels-laura-kate-dale-by-yenn-purkis/ |access-date=September 12, 2021 |archive-url=https://web.archive.org/web/20210307045003/https://www.spectrumwomen.com/featured/interview-with-author-of-uncomfortable-labels-laura-kate-dale-by-yenn-purkis/ |archive-date=March 7, 2021 |url-status=live}}
  • {{cite web |last=Dodson |first=Bradley |url=https://www.heraldextra.com/news/2018/nov/11/dual-spectrums-more-people-with-autism-identify-as-lgbtq-than-general-population/ |title=Dual spectrums: More people with autism identify as LGBTQ than general population |website=Daily Herald |date=November 11, 2018 |access-date=September 12, 2021 |archive-url=https://archive.today/20210912210506/https://www.heraldextra.com/news/2018/nov/11/dual-spectrums-more-people-with-autism-identify-as-lgbtq-than-general-population/ |archive-date=September 12, 2021 |url-status=live}}
  • {{cite news |last=Fearn |first=Nicholas |url=https://www.pinknews.co.uk/2018/05/16/this-is-how-autism-impacts-the-lgbt-community/ |title=Autistic and LGBT: This is what it's like to be queer and have an autistic spectrum disorder |date=May 16, 2018 |work=PinkNews |access-date=September 12, 2021 |archive-url=https://web.archive.org/web/20210211021441/https://www.pinknews.co.uk/2018/05/16/this-is-how-autism-impacts-the-lgbt-community/ |archive-date=February 11, 2021 |url-status=live}}
  • {{cite magazine |last=Houck |first=Austin |url=https://glaad.org/growing-up-queer-with-aspergers |title=Growing up queer with Asperger's |magazine=GLAAD |date=March 30, 2020 |access-date=September 12, 2021 |archive-url=https://web.archive.org/web/20210911235932/https://www.glaad.org/amp/growing-up-queer-with-aspergers |archive-date=September 11, 2021 |url-status=live}}
  • {{cite report |author=LGBT Health Education Center |date=August 2020 |title=Neurodiversity & Gender-Diverse Youth |url=https://www.lgbtqiahealtheducation.org/wp-content/uploads/2020/08/Neurodiversity-and-Gender-Diverse-Youth_An-Affirming-Approach-to-Care_2020.pdf |publisher=Fenway Institute |access-date=September 12, 2021 |archive-url=https://web.archive.org/web/20210623212115/https://www.lgbtqiahealtheducation.org/wp-content/uploads/2020/08/Neurodiversity-and-Gender-Diverse-Youth_An-Affirming-Approach-to-Care_2020.pdf |archive-date=June 23, 2021 |url-status=live}}
  • {{cite magazine |last=Molnar |first=Luis |url=https://www.advocate.com/commentary/2017/3/10/intersectionality-autism-and-homosexuality |title=The Intersectionality of Autism and Homosexuality |magazine=The Advocate |date=March 10, 2017 |access-date=September 12, 2021 |archive-url=https://web.archive.org/web/20210408214425/https://www.advocate.com/commentary/2017/3/10/intersectionality-autism-and-homosexuality |archive-date=April 8, 2021 |url-status=live}}
  • {{cite web |last=Sarris |first=Marina |url=https://sparkforautism.org/discover_article/autism-lgbtq-identity/ |title=Autistic People More Likely to Identify as LGBTQ |website=Simons Powering Autism Research |date=June 22, 2020 |access-date=September 12, 2021 |archive-url=https://web.archive.org/web/20210616223010/https://sparkforautism.org/discover_article/autism-lgbtq-identity/ |archive-date=June 16, 2021 |url-status=live}}
  • {{Cite news |date=24 February 2020 |title=Study shows LGBTQ+ individuals with autism have greater health disparities than peers |work=The University of Kansas |url=https://news.ku.edu/2020/02/24/study-shows-lgbtq-individuals-autism-have-greater-health-disparities-peers-are-denied |access-date=8 June 2022}}
  • {{Cite journal |last=Jackson-Perry |first=David |date=23 July 2020 |title=The Autistic Art of Failure? Unknowing Imperfect Systems of Sexuality and Gender |journal=Scandinavian Journal of Disability Research |language=en |publisher=Stockholm University Press |volume=22 |issue=1 |pages=221–229 |doi=10.16993/sjdr.634 |s2cid=225485760 |issn=1745-3011|doi-access=free |url=https://pureadmin.qub.ac.uk/ws/files/214886496/634_3642_1_PB.pdf }}
  • {{Cite news |date=4 March 2020 |title=Sexual and Gender Minorities with Autism Spectrum Disorder May Face Challenges to Getting Needed Healthcare |work=National Rehabilitation Information Center |publisher=National Institute on Disability, Independent Living, and Rehabilitation Research |url=https://www.naric.com/?q=en/rif/sexual-and-gender-minorities-autism-spectrum-disorder-may-face-challenges-getting-needed |access-date=8 June 2022}}
  • {{cite report |last=Moran |first=Tom |title="As a gay autistic man, it is almost as if I have two identities." |url=https://www.autism.org.uk/advice-and-guidance/stories/celebrating-pride-month-tom-moran |publisher=National Autistic Society}}
  • {{Cite news |last=Mendes |first=Eva |date=1 October 2016 |title="Labels Do Not Describe Me" Gender Identity Among Women on the Autism Spectrum |work=Autism Spectrum News |url=https://autismspectrumnews.org/labels-do-not-describe-me-gender-identity-among-women-on-the-autism-spectrum/ |access-date=8 June 2022}}
  • {{Cite journal |last1=Herrick |first1=Samantha J. |last2=Datti |first2=Paul A. |date=2022-04-03 |others=American Association of Sexuality Educators, Counselors and Therapists |title=Autism Spectrum Disorder and Sexual Minority Identity: Sex Education Implications |url=https://www.tandfonline.com/doi/full/10.1080/15546128.2021.2002225 |journal=American Journal of Sexuality Education |volume=17 |issue=2 |pages=257–276 |doi=10.1080/15546128.2021.2002225 |s2cid=247065963 |issn=1554-6128 |url-access=subscription}}
  • Wallisch, Anna; Boyd, Brian A.; Hall, Jean P.; Kurth, Noelle K.; Streed Jr, Carl G.; Mulcahy, Abigail; McMaughan, Darcy Jones; Batza, Katie (June 2023). "Health Care Disparities Among Autistic LGBTQ+ People". Autism in Adulthood. 5 (2): 165–174. doi:10.1089/aut.2022.0006. ISSN 2573-9581. PMC 10280185. PMID 37346996.

{{Autism}}

{{LGBTQ|orientation}}

Category:LGBTQ and disability

Category:LGBTQ identities

Category:Sexual orientation and psychology

Category:Sociological and cultural aspects of autism