'Conflict versus Congruence': A Qualitative Study Exploring the Experience of Gender Dysphoria for Adults with Autism Spectrum Disorder.
Rachel S Coleman-Smith, Richard Smith, Elizabeth Milne and 1 others
PMID 32170540WHAT IT FOUND
Ten autistic adults with gender dysphoria described autism as both a barrier to accessing support and a protector against societal judgment.
They reported that structured, predictable clinical environments and peer connections were essential for reducing distress and enabling transition.
Key findings
01Participants described autism as a barrier to interpersonal exploration of gender and accessing clinical care, but also as a protector that allowed some to ignore negative perceptions and live authentically.
02Supportive relationships, particularly with transgender peers, were instrumental in enabling gender exploration and transition, though autism-related social communication difficulties and sensory sensitivities made accessing these communities challenging.
03Clinical care was experienced as distressing due to lack of transparency and predictability, while clinicians who allowed time for discussion and implemented stepped changes were perceived as helpful.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was small (n=10) and consisted of Caucasian individuals who had accessed NHS services in the UK, limiting transferability to other cultural contexts or healthcare systems. Participants were able to provide verbal accounts, suggesting they fit the profile of 'high-functioning' autism or Asperger's syndrome. Findings may not apply to individuals with greater functional or communication challenges. The study did not include autistic children or adolescents. Data saturation was not achieved, particularly regarding physical transition, as few participants had completed surgery. The study relied on self-report and did not include observational data or third-party perspectives.
The easy way to misread this
Do not generalise these findings to all autistic people with gender dysphoria. The participants were verbal adults who accessed UK NHS services, so the experiences of non-verbal individuals, those in different healthcare systems, or children are not represented.