Autistic Consultant & British Psychologist, Wenn, leading by example to empower autistic individuals and promote quality co-produced research

The Autism Spectrum and Gender Dysphoria

Being on the autism spectrum (AS) influence's individual's lives in a variety of ways; this is one reason we think of autism as a spectrum. Gender and sexuality also lie along and across a spectrum of varying experience. There is minimal research to date on the connections between autism, sexuality and gender variance, but, this is a growing area of concern and one that needs attention. AS Individuals are 7 times more likely to live with conflicting gender and sexuality issues (Cassidy, 2015; Strang et al, 2014); 20% will experience gender dysphoria (compared to 1% of the typical population) and, in the US '...a staggering 41 percent of transgender people have attempted to commit suicide...'. Learning how to recognize gender variance in autism is vital. It's also vitally important to tell if the issues an individual is living with are of a permanent nature and what the best ways to educate, support and tap into resources for that AS individual are.

Research over time has demonstrated that autism and gender are biological dispositions and some argue the higher statistical analogy between autism and gender variance might be strongly correlated due to a shared biological disposition: See (http://science.sciencemag.org/content/310/5749/819) or (Baron-Cohen, Knickmeyer & Belmonte, 2005).

But other research points out it's only autistic females who seem to show an increase in 'systemising' or a tendency towards having 'an extreme male brain disposition' (Lai et al 2013), not autistic males; however, this idea is still under debate.

Then, some other research suggests being XX chromosome (female) reduces the 'risk' of autism (Skuse, 2000) while others state:

'...Taken together, our results suggest that women with ASD have elevated serum testosterone levels and that, in several aspects, they display more masculine traits than women without ASD, and men with ASD display more feminine characteristics than men without ASD. Rather than being a disorder characterised by masculinisation in both genders, ASD thus seems to be a gender defiant disorder. Our results strongly suggest that gender incoherence in individuals with ASD is to be expected and should be regarded as one reflection of the wide autism phenotype. The prevalence of ASD appears to be rising and so does gender identity disorder. The comorbidity between these two disorders is striking..'' (Bejerot, et al 2012 p.122).

For some gender identity fits with the usual societal expectations and there is very little needed to help such an individual fit in or belong. When autism is in the mix though, social understanding will need teaching, often via the individual's 'interest' so, turn taking, sexual etiquette and so on, can be learned as young people naturally interact with each other.

Working to raise awareness of autism and gender dysphoria is a good thing. It will help inform the wider community that autism and gender non-conformity/variance exists. However, awareness in and of itself isn't the same as action.

All the time we have 'his' and 'hers' when it comes to public conveniences, clubs, Bars, shopping areas, school uniform, and so on, we are keeping the community set on the idea that gender is binary and there are no differences to this concept. Those differences one encounters will be viewed as 'rare,' 'odd' and/or deviant. If we changed how we name things, for example we now commonly have 'unisex' hair salons… why not have something similar for public conveniences. When a person with a disability needs to use a toilet for the disabled, there isn't usually a 'his' and 'hers' public convenience! A young trans autistic youth, aged thirteen, was told to use the disability toilets at school. He felt upset with this option because, he argued, he didn't have a disability.

One of the reasons I enjoy Sci-Fi films and literature is because there is room for that which is different, such as 'the mutants' in Mutant Ninja Turtles or The X-Men. Being autistic I felt like an alien much of the time. It was only when I found my 'tribe' that I knew I could belong (Lawson, 2000). For autistic individuals who are non-binary or non-conforming in their gender identity, or are living as trans men and women (boys and girls) where the gender they identify with is not that assigned them at birth, finding their tribe is doubly difficult.

It's also hard to access the kind of medical treatment you believe you need, access community understanding and acceptance, find appropriate support among one's peers and be considered for suitable education and employment, once you disclose you are a trans gender person.

Below are some more resources on this topic you may be interested in

http://www.theatlantic.com/health/archive/2016/11/the-link-between-autism-and-trans-identity/507509/

http://www.sbs.com.au/topics/sexuality/agenda/article/2016/11/17/link-between-autism-and-trans-identity

http://spectrumnews.org/features/deep-dive/living-between-genders/

So, there is much debate concerning whether autistic individuals are more likely to have a 'male' brain and whether this pre-disposes them towards gender issues. See: https://www.ncbi.nlm.nih.gov/pubmed/25744543

But, we must remember, the theory of autism and having a male brain is only a theory and is highly debated. See: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3754459/

So, even if it seems a bit far-fetched to think of working towards changing the world we live in, even the bit closest to us, by aiming at a gender inclusive society (uni-sex toys for example that any child can play with; equality in sport where females play football too; uni-sex bathrooms, clothing and gender free expectations on shared domestic chores and/or parenting) we will be helping to remove barriers for autistic non-binary individuals, trans persons, those who are inter sexed and so on.

See Video 1 and Video 2

It's not about whether one agrees with what some people are saying it's more about being open and willing to have the discussion.

If we are accepting of our own gender we are part the way there for acceptance of others. If we are to assist young people to accept difference, perhaps they are cis-gender, gender non-conforming, non-binary or trans in their gender identity, we need to begin with acceptance of the human condition.

REFERENCES

Baron-Cohen,. Knickmeyer, R.C. & Belmonte, M. (2005) Sex Differences in the Brain: Implications for Explaining Autism. Science Vol. 310, Issue 5749, pp. 819-823

Bejerot, S,. Eriksson, J,. Bonde, S., Carlström, K. Humble, M. B. and Eriksson, E. (2012) The extreme male brain revisited: gender coherence in adults with autism spectrum disorder. The British Journal of Psychiatry Aug 2012, 201 (2) 116-123 DOI: 10.1192/bjp.bp.111.097899

Cassidy, S. (2015) Suicidality in Autism: Risk and Prevention. Atypical Development Theme Lead Organisation: Centre for Research in Psychology Behaviour and Achievement, Coventry University.

Lai, Meng-Chuan, Lombardo, M.V., Suckling, J., Ruigrok, A.N.V., Chakrabarti, B., Ecker, C., Deoni, S.C.L., Craig, M.C., Murphy, D.G.M., Bullmore, E.T. and Baron-Cohen, S. (Aug. 2013) Biological sex affects the neurobiology of autism. Brain

Lawson, W. (2000) Life behind glass. JKP: London

Skuse, D.H. (2000) Imprinting, the X-Chromosome, and the Male Brain: Explaining Sex Differences in the Liability to Autism, Pediatric Research, 47. 9-9

Strang, J.F., Kenworthy, L., Dominska, A., Sokoloff, J., Kenealy, L.E., Berl, M., Walsh, K., Menvielle, E., Slesaransky-Poe, G., Kim, K.E., Luong-Tran, C., Meagher, H &Wallace, G.L. (2014) Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Archives of Sexual Behaviour 43(8) 1525-33