Autistic Transgender People

While transgender people make up about 1% of the general population, they make up at least 10% of the autistic population. Some studies suggest 23% or higher.

Studies also suggest that while autistic people make up around 5% of the general population, they make up 13% of the transgender population.

Autism diagnosis by gender

Autistic-Led Research

A 2018 study (linked below) shows autistic people’s responses across a range of issues, alongside responses from non-autistic people who have an autistic relative, and the responses of those who are neither autistic nor have autistic relatives (usually professionals who work with autistic people). It is not a representative study, but it is an enormous study by any research standards with over 11,000 respondents from across many different autism forums in several different countries.

Which terms do you use?

20 key findings

1. Autistic respondents preferred the term “autistic person” (52%) rather than “person with autism” (12%). “Both” was selected by 28%, and “neither” was selected by 9%. In contrast, non-autistic respondents strongly preferred “person with autism”.

2. When asked if they identified as LGBT+, 7% of non-autistic respondents answered yes, while 38% of autistic respondents answered yes. 20% of respondents who said they might be autistic answered yes.

3. When asked if they were cisgender (not transgender), 17% of non autistic respondents replied no, while 23% of autistic respondents replied no.

4. There was a major correlation between being non-binary and being autistic.

5. Autistic respondents were more likely than non-autistic respondents to disagree with the statement “I have a religious faith”, and this was especially so for non-binary autistic respondents.

6. When asked if they agreed with the statement “I identify as liberal rather than conservative”, over 42% of autistic respondents strongly agreed, and over 20% agreed..

“Many autistic advocates prefer “identity-first” language (“autistic person” instead of [“person-first” language] “person with autism”). Our disability is part of us, and we don’t want to dance around it. And please — don’t call us “high functioning” or “low functioning.” If you don’t respect our language, you don’t respect us.” – AAPD

Studies have shown that autistic people are less likely to make decisions based on “what everyone else does” and are more likely to make decisions based on pragmatism. They often have a strong sense of fairness and social justice. This may partly explain the liberal (rather than conservative) tendency, and openness to exploring their gender and attractions in non-heteronormative ways.

Autistic young people

7. 84% of autistic respondents disagreed (74% strongly disagreed) with the statement “I am concerned about a link between vaccines and autism” while 62% of non-autistic respondents disagreed (47% strongly).

8. Most autistic respondents said their school didn’t know how to provide for them.

9. Almost half of the autistic respondents who struggled in school did not have an academic learning difficulty.

10. Most autistic respondents were strongly against ABA (Applied Behavioral Analysis therapy) for children.

11. Autistic respondents strongly believed that autism awareness focused too much on children.

While we don’t have data on autistic trans students in Aotearoa, we know that 23% of trans students experience weekly (or more frequent) bullying in schools, while this is experienced by just 5% of their cisgender counterparts. We also know that this bullying is often not addressed appropriately, and not dealt with effectively. There are schools which make it difficult for trans students to attend; including not providing bathrooms, insisting on inappropriate clothing (eg. wrong gender uniforms), and not making school content relevant for them (eg. sex education teaching only about cisgender boys and girls). We also know anecdotally that bullying and accessibility issues are common for autistic young people. We believe there is crossover here.

Applied Behavioral Analysis therapy on children is considered by many to be analogous with conversion therapy. It focuses on teaching autistic people to “not act autistic” through rewards and punishment. It has been alarmingly popular with non-autistic people for a long time, but autistic adults are now speaking out against it.

“The stated end goal of ABA is an autistic child who is ‘indistinguishable from their peers’—an autistic child who can pass as neurotypical. We don’t think that’s an acceptable goal. The end goal of all services, supports, interventions, and therapies an autistic child receives should be to support them in growing up into an autistic adult who is happy, healthy, and living a self-determined life.” – Autistic Self Advocacy Network.

ABA for children

“Curing autism”

12. 72% of autistic respondents would not take a “cure for autism” if one existed, and 14% said they would. Of non-verbal and selective mute autistic respondents, 75% said they would not take a “cure”, and 12% said they would. 69% of autistic respondents with learning difficulties said they would not take the “cure”, and 16% said they would.

13. 34% of non-autistic respondents said they would not give a “cure” to an autistic relative, and 41% said they would.

14. Respondents who had a positive association with autism – as represented by those who selected “awesomeness” as a characteristic of autism – were much more likely to be anti-cure, to say “autistic person”, and to be autistic (especially if they also had an autistic relative).

15. Almost three quarters of autistic respondents struggled with employment.

16. 75% of autistic respondents felt socially isolated.

Many non-autistic people believe that it would be better if autism didn’t exist. Autistic people disagree. Autistic lives are worth living, just like trans lives are worth living. Stereotypes, prejudices, and discrimination are common, but it is these things – not autism – that autistic people would rather live without.

Conditions and effects

17. 60% of autistic respondents had an anxiety disorder, 42% had a Sensory Processing Disorder, 40% had depression, and 35% had ADHD, followed by digestive issues at 20%.

18. These conditions were consistently more common for non-binary autistic respondents (anxiety disorder 78%, depression 75%, ADHD 46%, digestive issues 40%). Non-binary autistic respondents had higher rates of Sensory Processing Disorders (56%) and Post Traumatic Stress Disorder (56%).

It is worth noting that male and female respondents were not separated by being transgender or cisgender, so it is possible that all transgender respondents had elevated rates of these conditions.

19. The most common effects of autism for non-binary autistic respondents were sensory issues (91%), anxiety (90%) and enthusiasm for special interests (90%).

Making environments accessible for autistic trans people means not only eliminating transphobia and providing appropriate bathrooms; but considering sensory needs, social stressors, and managing trauma triggers and responses.

Empathy

20. Respondents were asked about empathy, and options included intense empathy, lack of empathy, both, and neither. Excluding the ‘both’ responses, 58% of autistic respondents ticked ‘intense empathy’, while only 11% ticked ‘lack of empathy’.

Including those who selected ‘both’, 67% had selected intense empathy. Responses were similar across non-verbal autistic respondents and autistic respondents with learning difficulties. Of the non-autistic respondents with an autistic relative, only 22% ticked intense empathy, while 27% ticked lack of empathy, and 47% selected ‘neither’.

Autistic respondents who are both non-verbal and have learning difficulties selected 60% intense empathy, 15% lack of empathy, 14% both, and 11% neither (a total of 74% intense empathy), while respondents who were non-autistic relatives of a non-verbal autistic person with a learning difficulty selected 51% neither, 32% lack of empathy, 13% intense empathy, and 3% both.

Autistic people are vastly more likely to feel intense empathy than a lack of empathy. But non-autistic relatives are likely to believe that they don’t feel intense empathy, and almost a third believe they lack empathy.

What it means

Autistic transgender people face unique challenges, and high levels of stigma and discrimination. Families, communities, and healthcare providers must be culturally competent and work to unlearn bias against autistic people, and recognise where this bias may affect the ways they interact with the autistic trans people they come into contact with.

GMA has a number of autistic transgender staff, and hears from many dozens of autistic trans people every year, who are struggling to access gender affirming healthcare at a disproportionate rate, and who are struggling with a lack of accessibility and safety in their schools, workplaces, and home environments.

It is common for autistic people to be denied gender affirming healthcare as their gender expression may not be binary, or because they may struggle to express or parents/clinicians may struggle to understand the autistic person’s complex ideas and understandings of gender. They may believe the autistic person is unable to fully understand the consequences of transition – most often due to difficulty with communication, rather than understanding. It is essential that a transgender diagnosis should not be withheld on the basis of a patient being autistic.

Download our resource

Further research

Further research is needed on autistic transgender experiences. GMA advocates for more research into autistic adults’ experiences, and for this to be developed by or in collaboration with autistic researchers and autistic populations, including those who are rainbow and transgender.

Further Reading

Facebook Groups and Pages:

Autistic Spectrum New Zealand.
Autistic Not Weird.
Autistics Worldwide.
Autism Inclusivity.
Autistic Newsfeed.
The Autistic Cooperative.
Tone it Down Taupe.
Autistic Black/Indigenous/People of Color & Latinx Advocates to follow – Autistic, Typing.


Website and Articles:

Autistic Self Advocacy Network of Australia & New Zealand.
Autistic burnout, explained – Spectrum.
Reframing Autism.
Good Autistic Advocacy Organisations and Bad Autism Charities – In the Loop About Neurodiversity.
Safe Places Online for Parents of Autistic Children and Autistic People to Learn About Autism – The Autistic Advocate.
The Ableist History of the Puzzle Piece Symbol for Autism – In the Loop About Neurodiversity.
The man behind ex-gay “conversion therapy” started out trying to make autistic children “normal” – Sabastion Rubino, LGBTQ Nation.
I Self‑Diagnosed My Autism Because Nobody Else Would. Here’s Why That Needs to Change – Rakshita Shekhar.
In Silence and in Sound: Autistics Do Not Benefit From Presumptions of Deficit – Thinking Person’s Guide to Autism.
Here’s Why You Should STOP Using Functioning Labels – Planning Across The Spectrum.