Gender: A Wider Lens
Gender: A Wider Lens
17 - Autism and Gender Dysphoria

17 - Autism and Gender Dysphoria

The startling links between ASD and Gender Dysphoria are raising plenty of questions as clinicians wonder why children on the spectrum tend to struggle with gender. Also, which comes first: ASD or gender nonconformity? In this episode, we explore how autistic traits may cause youth to question their gender and become attached to identity labels. And we wonder if this has implications for the trans movement.


Far From the Tree: Parents, Children and the Search for Identity, by Andrew Solomon

NeuroTribes: The Legacy of Autism and the Future of Neurodiversity, by Steve Silberman… 

Scientific American Article: “Autism — It’s Different in Girls” 

13 YO girl with social struggles:


Thrower, E., Bretherton, I., Pang, K. C., Zajac, J. D., & Cheung, A. S. (2019). Prevalence of Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder Amongst Individuals with Gender Dysphoria: A Systematic Review. Journal of Autism and Developmental Disorders, 50(3), 695–706. 

Hisle-Gorman, E., Landis, C. A., Susi, A., Schvey, N. A., Gorman, G. H., Nylund, C. M., & Klein, D. A. (2019). Gender Dysphoria in Children with Autism Spectrum Disorder. LGBT Health, 6(3), 95-100. doi:10.1089/lgbt.2018.0252 

Butler G, De Graaf N, Wren B, et al 

Assessment and support of children and adolescents with gender dysphoria 

Archives of Disease in Childhood 2018;103:631-636. 

Extended Notes

  • Sasha worked with autistic children early in her career and it really shaped a lot of her training today.

  • How do you define autism?

  • Stella thinks girls who have autism are getting missed at a younger age compared to boys.

  • How are gender and autism related?

  • Some children are just getting misdiagnosed as children and it’s showing up as anxiety or depression, instead of being on the spectrum.

  • Can’t figure out why a child might not be making progress? They’re on the wrong meds.

  • Autistic kids in general don’t really conform to gender norms.

  • Parents spend so much time with their autistic children just so they can live somewhat of a normal life. It’s painful and heartbreaking.

  • It’s cute when you’re five when it comes to not picking up on the gender roles, but as you get older, it can be difficult to integrate into a normal life.

  • Are there more autistic people now than there were before?

  • Technology and being overly glued to it can accelerate the social deficit traits.

  • Are you comfortable in your own body? A lot of times the answer is no.

  • One of the signs of autism is sensory issues. Both Sasha and Stella have noticed with their gender dysphoric children that they have an overfixation on the new changes their body is giving them during puberty, and how they hate it.

  • You don’t want to deny that children on the spectrum do have legitimate challenges, but there is a balance between blaming it on their autism vs. not enough real-life training.

  • “If you’re not supporting me, you must be transphobic.”

  • Should you assess your kid for autism?

  • Tread carefully when it comes to testing your teen. Your teen is going to take it as you trying to fix what’s “not fixable.”

This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:

Learn more about our show:

Gender: A Wider Lens
Gender: A Wider Lens
Therapists Stella O’Malley and Sasha Ayad explore diverse perspectives through a psychological lens, fostering open dialogue on gender identity, transition, and the transgender umbrella. Their work with gender dysphoric clients and unique experiences yield an informed outlook delving into gender's psychological nuances. Interviews with clinicians, academics, transgender individuals, parents, detransitioners, and others touched by gender provide varied insights and intimate inquiry into the taboo yet relevant topic.