Autism and (trans)gender: dysphoria, ambivalence, and gender fluidity in ASD
People who feel significant gender distress because their gender identity differs from their birth sex have higher than expected rates of autism. This is a growing topic of study and discussion as our acceptance for those with gender dysphoria grows.
What is gender dysphoria?
Gender dysphoria (GD), also known as gender identity disorder (GID) is the condition of distress (or dysphoria) that an individual feels when they do not identify with their birth sex. Many of these individuals go on to become transgender, some adopt the clothing and lifestyle of the opposite sex while maintaining their own gender, and some simply struggle to conform despite their distress.
The effect of high functioning autism on gender orientation
The Autism Europe conference in Edinburgh had research presentations on the topic of gender dysphoria and its connection to high functioning ASD. Dr. Mark Stokes from from La Trobe University in Melbourne Australia spoke about his recent study examining this topic. The results from the international study found a higher percentage of those with ASD have gender distress, ambivalence and/or neutrality.
When compared to controls, individuals with ASD demonstrated significantly higher sexual diversity, reported gender-identities incongruent with their biological sex, and higher gender-dysphoric symptomatology.
The ASD group reported higher rates of asexuality; decreased heterosexual attraction and contact; increased homosexual attraction; ASD females reported higher homosexual contact; and were not concerned with the gender of their romantic partner. ASD individuals who were gender non-conforming reported better relationships with their opposite-sex peers during their schooling years than their gender-conforming peers did. The ASD group reported poorer mental health than controls and belonging to a sexual or gender-diverse group worsened this effect.
Conclusions: Increased non-heterosexuality in ASD may particularly fit predictions from the Extreme Male Brain theory of autism. An androgynous self-concept, gender ambivalence and dissatisfaction with culturally-dictated sex-roles emerged as major themes, which together may permit more fluid sexual-identities.
What is the Extreme Male Brain theory?
The “extreme male brain theory” is a somewhat contentious theory put out by Simon Baron-Cohen, a prominent autism researcher at Cambridge University. Dr. Baron-Cohen proposed the extreme male brain theory of autism, which attempts to explain the remarkable similarities between traits generally associated with human “maleness” and traits associated with the autism spectrum. These traits are listed as the predominance of strength in the areas of maths and spatial reasoning, and detail-oriented processing. The theory also highlights the lack of strengths in what it considers traditionally “female” traits like communication and empathy. One of the contentious areas of this study is that it also relies heavily on the idea that there is a predominance of males with ASD; an idea that has been heavily scrutinized and questioned in the past few years.
Living in the space between the sexes
The connection between ASD and gender dysmorphia has gone relatively unnoticed up until now. In a very good article from Spectrum Magazine that talks about what it feels like to have GD, they found that:
“Between 8 and 10 percent of children and adolescents seen at gender clinics around the world meet the diagnostic criteria for autism, according to studies carried out over the past five years, while roughly 20 percent have autism traits such as impaired social and communication skills or intense focus and attention to detail. Some seek treatment for their gender dysphoria already knowing or suspecting they have autism, but the majority of people in these studies had never sought nor received an autism diagnosis.”
The more awareness we have on this topic the sooner we can offer appropriate testing and support for individuals with ASD, and those who do not identify with the bodies in which they were born.
Resources ( Both of these books can be special ordered through our book store):
Sex, Sexuality and the Autism Spectrum by Wendy Lawson (This book can be special ordered through our bookstore.)
Love, Sex and Long-Term Relationships by Sarah Hendrickx
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Hello. My son is currently wanting to transition. He has often said how he thinks he could have autism due to the social anxiety he has plus the trouble he has communicating with others, as well as other symptoms . My question is do you know of any cases where someone newly diagnosed with ASD has found that their gender dysphoria was related to that, and decided to quit transitioning?
Linda, this is a question I am not able to answer. I would suggest reading some of Wenn Lawson’s writings and watch some of his YouTube videos. http://www.buildsomethingpositive.com/wenn/gender.html He transitioned back in 2015 and speaks and writes widely on this topic. https://www.youtube.com/watch?v=_uT5ISydIrQ
Hi there, I hope you’re still replying in 2021 (Happy new year btw)
I have a sister, (or sibling, now that I’m learning more about gender identity) whom is apart of the low-functioning spectrum of autism, along with ADHD. Growing up, they have expressed dislike of their body changes like wanting their chest to be smaller. For a while they have talked about wanting to shrink and become a child again (they will be 13 this year). I don’t want to assume anything, but I want to know if this is a gender dysphoria issue or just a child trapped in a growing teen’s body. I wish I could ask them about it.
Yes, I am still replying every day to questions. Gender dysphoria has more to do with identifying with the opposite sex that you are born with. Gender dysphoria is the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics. Here is some more information on this topic – https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/symptoms-causes/syc-20475255 Sometimes people with autism don’t feel at ease with natural body changes because it is a change from what they are used to. Has puberty been explained to your sister? If not, you may want to start here as sometimes this topic is not discussed with people with autism. Here is a good article on the subject – https://raisingchildren.net.au/autism/development/physical-development/preparing-for-puberty-asd
I first heard in a YouTube comment that the non binary percentage in people with autism is higher.
I started thinking that I might be autistic weeks ago and I am really sure by now, I just don’t think my parents will get it. They never supported me getting therapy, not even when I had strong depression and couldn’t go to school most of the time for more than a year. I thought about getting a diagnosis before talking to my parents about it, just so they can’t shut me off. But I have heard that getting a diagnosis as an adult can be problematic.
Well, I am Trans and this is just interesting that these often appear together. The human brain is weird.
Nathan, I recently wrote an article about how to seek a diagnosis as an adult that you may find helpful – https://autismawarenesscentre.com/am-i-autistic-a-guide-to-diagnosis-for-adults/ You may also find some of Wenn Lawson’s writings helpful – http://www.buildsomethingpositive.com/wenn/ and this You Tube lecture https://www.youtube.com/watch?v=_uT5ISydIrQ
Hi, I hope you can help?
Is there a support group you are aware of , or any advice available for parents who suspect their child (who is now an adult) has undiagnosed high functioning ASD and is transgender?
I am not sure where you are located, but I don’t know of any support groups around this topic. There is this article from Autism Speaks which does list some resources at the end of it – https://www.autismspeaks.org/expert-opinion/gender-identity-and-autism . Have a look at this article as well – https://slate.com/human-interest/2018/03/why-are-a-disproportionate-number-of-autistic-youth-transgender.html I would also recommend reading Wenn Lawson’s writing (used to be Wendy Lawson, but is now a man – Wenn Lawson) http://www.buildsomethingpositive.com/wenn/gender.html .
For support groups, you would either have to contact your local autism society or maybe find a group that is for transgendered people. You will more than likely meet other parents who have a child on the spectrum there.
Hello I have Aspergers and have never felt male at all and I am trying to start transitioning but Arkansas medicaid doesn’t cover it do u have any idea on how I can start
James, this is out my area of expertise. You need to speak with your doctor to ask for assistance and resources. You may find this list of resources helpful – https://locallytrans.com/loc/fayetteville-ar/ or this – http://www.artranscoalition.org/health/
Hey, saw your comment and as a trans guy who’s looking into whether or not I have ASD, I definitely think that trauma can be a cause for gender dysphoria. I know that after some of my past trauma I started to feel more and more dysphoric. So I think so. I’m no medical expert and this may only be in my case and not anyone else’s.
Thank you for the informative article. I have also read that Gender Dysphoria can have childhood trauma (drug babies, etc.) as a contributing factor. I’m also curious to know if brain trauma/concussion could be a contributing factor.
I have no idea if brain trauma can be a contributing factor. That would be a question for a researcher in this area. Thank you for commenting.
Good article, Maureen
Thanks Pauline! I heard the research presented at the Autism Europe conference in the fall.