Autism and Gender Dysphoria, Part 1

The Basics and the Power of Social Factors – a new Genspect series by Mary Smith

Welcome to this five-part series based on “Autism and Gender Dysphoria: An Overview,” by Mary Smith, in which we will delve into the intricate and often overlooked connections between autism spectrum condition (ASC) and gender dysphoria. As discussions around neurodiversity and gender identity are becoming increasingly prominent, this series aims to provide a thoughtful, evidence-based exploration of why autistic individuals—particularly young people—may be disproportionately affected by gender-related distress.

Over the coming weeks, we’ll break down the topic systematically. This first installment sets the foundation by introducing key concepts, statistics, and the political context, before focusing on the social sphere’s role in shaping gender dysphoria among autistic youth. Subsequent parts will cover technology and sensory issues (Part 2), puberty, sexuality, and gender nonconformity (Part 3), cognitive patterns like rigidity and special interests (Part 4), and finally, ADHD overlaps, parental advice, therapy considerations, and concluding reflections (Part 5).

We hope this series will foster understanding, encourage exploratory approaches over affirmation-only models, and highlight safeguards for vulnerable young people navigating these challenges.

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Autism and Gender Dysphoria – The Basics

Photo by Markus Winkler on Unsplash

Today, most people are quite familiar with Autism Spectrum Condition (ASC), which is a complex neurodevelopmental condition affecting communication, social interaction, and behaviour, and which presents with differing degrees of severity from individual to individual. However, the potential shock of a fresh diagnosis has parents and affected individuals turning to various sources of information for greater insight, not all of which are helpful when attempting to understand the relationship between autism and gender dysphoria, and this includes major charities representing children and autistic people.

There’s a well-documented connection between autism and gender dysphoria, but the reasons for this remain largely unexplored within mainstream discourse. Although autistic people make up only between 1% and 3% of the population, according to figures from the now-decommissioned Tavistock Clinic’s Gender Identity Development Service (GIDS), 76% of referrals were girls. Of these, 48% of these had a diagnosis of autism or showed traits of autism.

The diagnosis rate for autism is four times higher in boys than in girls. One possible explanation for this disparity is that autistic girls tend to be skilled at ‘masking’, i.e. socially conforming or blending in to be more accepted in a neurotypical setting. Another possible reason why autism in girls often goes unrecognised is that they tend not to display the same sorts of challenging behaviour at school that often results in boys being referred for an autism assessment.

The relationship between autism and gender dysphoria is a heavily contested political issue. Activists suggest an organic link between autism and a trans identity. This idea is visually represented in a recent redesign of the Progress Pride flag, resulting in the addition of the neurodiversity infinity symbol to the already symbolically crowded flag. Using the language of Critical Theory, various writers and academics are producing work that celebrates the ‘intersection’ between the two spectrums of gender identity and neurodiversity, both of which use the rainbow in their logos / flags. This prismatic imagery can be highly appealing to children and young people with a sensory impairment.

Conversely, people seeking to put the brakes on the seemingly headlong rush to affirm autistic youth with a diagnosis of gender dysphoria regard the co-morbidity of the two conditions as something that should give clinicians pause. Yet the relationship between gender dysphoria and autism has not been taken seriously in the mainstream. The scandalous result is that gender dysphoric autistic children and young adults have been encouraged along a medical pathway throughout the Western world without any consideration of how their condition might affect their decision-making competency, or indeed how adopting heavily marketed trans identities might impact on their sense of self.

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Scientific, and predominantly pseudoscientific, theories abound about the relationship between autism and gender dysphoria, some of which are a bit ‘out there’, including speculation that high birth weight leads to gender dysphoria. Instead, let’s focus on the social theories contributing to the ‘perfect storm’, i.e. the conditions that might lead an autistic child to believe they are gender dysphoric in the first place. After all, it does seem that a trans identity holds great allure for autistic children and young people.

The sphere of ‘the social’

The first and perhaps most significant factor to bear in mind is the idea of the rapid onset of gender dysphoria being due to a ‘social contagion’, as presented in Lisa Littman’s seminal paper on the subject. Although autistic people generally struggle with the sphere of ‘the social’, girls, as we have seen, tend to make greater efforts to ‘fit in’, a phenomenon known as masking. Similarly, the label of ‘Asperger’s’, which once described a form of ‘high-functioning’ autism, has now been subsumed into the wider ASC ‘spectrum’ because the neurodiversity movement sought to eliminate a perceived hierarchy of ability. If this diagnosis still existed however, it is possible that many of the cohort of young women and men currently adopting a trans identity might belong to this group. A key difference between Asperger’s and other manifestations of autism is that, although the social sphere is an area where all autistic people struggle, those with Asperger’s tend to want to be sociable and regularly experience social rejection, even bullying, when they do not get the ‘fitting in’ quite right. Part of the appeal of adopting a trans identity is acquiring a readymade marginalised status. Generation Z views the cause of ‘trans rights’ as an equivalent to the civil rights movements of earlier generations. So, the emergence of an ideological movement, cloaked in the glamour of a social justice cause (most autistic people have very strong ethical beliefs), in which marginalised, socially awkward kids can easily participate, ticks every box.

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In My Brief Spell as an Activist, the author describes the passions involved in becoming a social justice warrior, in her case focusing on the ills of ableism from an autistic viewpoint:

‘… I saw a world dominated by an inescapable, sinister force that posed a threat to the very wellbeing of every disabled person, including me. As ominous as this tableau appears, it was also incredibly seductive. Who wouldn’t want to be the hero working to defeat such unthinkable evil? Living in fight mode was electrifying. Zealotry imbued my life with intensity, every moment brimming with vivid symbolism and apocalyptic meaning. I was on fire, and at the same time, I was fragile. I never would have admitted it, but I think that beneath all the slogans and bravado, I knew how precarious my worldview really was, how quickly it would collapse under scrutiny or rigorous analysis.’

This article, by Alex Lowry, an autistic young man, explores the reasons why autistic people may find social rules so difficult to comprehend.

“I am autistic, and like many other people with autism, I frequently find that I have a hard time understanding social rules. They are just extremely complicated and hard to follow. People seem to speak in this code language where they have to say certain things and are not allowed to say other things…” Read on

In the next instalment, we will see how the very difficulties with real-world social connection that we have just explored drive many autistic young people toward the apparently safer, rule-free world of online forums — and how the bright, sensory-rich, instant-validation universe of gender-identity ideology awaits them there.

Mary Smith is a UK writer, researcher, and parent, engaged in resisting gender ideology and its harms.

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This excerpt has been lightly edited for Substack.