Exploring the Experiences of Autistic Transgender and Non-Binary Adults in Seeking Gender Identity Health Care.
Harley Bruce, Katie Munday, Steven K Kapp
PMID 37346990WHAT IT FOUND
Autistic transgender and non-binary adults reported being denied or delayed gender healthcare due to providers misinterpreting autism as mental illness or incompetence.
Participants described hiding their autistic identity to avoid gatekeeping and highlighted the need for sensory-friendly environments and clear, written communication.
Key findings
01Participants reported that providers often lacked knowledge of autism, leading to infantilization, gatekeeping, and denial of care.
02Autistic gender-diverse adults frequently concealed their autism or non-binary identity during assessments to prevent being denied treatment.
03Physical environments and communication methods were major barriers, with participants citing overstimulating clinics and a lack of alternative contact options like email.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was small (17 participants) and recruited online, leading to a lack of racial and ethnic diversity (mostly white participants from Western countries). Participants included both formally diagnosed and self-diagnosed autistic individuals, but the study did not distinguish between these groups in analysis, which may affect experiences of care. Researchers had not personally accessed GIH, which may limit insight into the specific patient experience of the system. Non-speaking autistic individuals and those with learning disabilities were not included.
Declared interests
The study was inspired by one author's experience supporting a transgender autistic person denied care. One author was an autistic transgender community researcher. No financial conflicts were declared.
The easy way to misread this
Do not interpret these findings as evidence that autism causes poor outcomes in gender care; the barriers described are systemic and provider-related. The study highlights that autistic people are often gatekept out of care they need, rather than being unsuitable for it.