Revisiting the Link: A qualitative analysis of the diverse experiences of gender dysphoria as a subset of pervasive social dysphoria co-occurring with autism in Japan.
Shoko Shimoyama, Toshihiko Endo
PMID 38465656WHAT IT FOUND
Autistic transgender participants described gender distress as part of a wider burden from all social norms, not just gender incongruence.
Five had no alternative gender identity, resisting the concept of gender itself. Clinicians should validate diverse experiences rather than assuming gender incongruence is required for a diagnosis.
Key findings
01Only eight of the fifteen participants associated their gender distress with gender incongruence; five reported having no alternative gender identity.
02Participants conceptualized their distress as Pervasive Social Dysphoria, where gender distress is a subset of accumulated distress from various societal norms.
03The social expectation to live as one's birth-assigned gender caused distress even in participants who did not experience gender incongruence.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is exploratory and qualitative, so the findings cannot be generalized to all autistic transgender people. The research was conducted in Japan, a context with strict social norms, which may influence the prevalence and nature of Pervasive Social Dysphoria. The definition of gender dysphoria used in the study was broader than the DSM-5 criteria, which requires gender incongruence.
Declared interests
The authors declared no potential conflicts of interest. The work was funded by the Sasakawa Scientific Grant, JST SPRING, and The University of Tokyo.
The easy way to misread this
Do not interpret the absence of gender incongruence as a lack of genuine gender distress. The study found that some autistic transgender individuals experience distress from the imposition of gender norms themselves, rather than a mismatch between their identity and body. Assuming gender incongruence is a prerequisite for gender dysphoria may lead to denying necessary support to these individuals.