Autism & Gender Dysphoria: No proven link

[pennydrew]

Well since the discussion that was part of another thread got removed, for some odd reason, I thought I would start a conversation on this. To clarify, when people say there is a link, they are not referring to any data or study involving diagnosed autistic people. I have checked. I have seen language like, ' autistic traits' and ' autism spectrum related issues' but nothing credible. I am very careful not to assume a genuine link exists simply because people say so. It seems to be trendy to 'identify as autistic', but that is incredibly insulting and appropriation of a poorly understood condition. My daughter gets very upset at the casual way people discuss this link as if it is real, as a way to use autism to get acceptance for something entirely different and an ideology she finds personally threatening to her own rights- both as a woman and autistic person.

As a parent of two autistic children what I will say is that autistic people are often vulnerable. Their social difficulties, lack of interest in sex (dd describes herself as asexusal) or difficulty with sexual feelings, means that if they are struggline, as all teens tend to with body image or sexuality issues then they are much more easily influenced by those who could lead them along the transgender path.

" Dr Wren also referenced other underlying factors in children and young people’s gender dysphoria. Of the overall figure who were tested at the Tavistock since the clinic began, 51% have clinical range autism traits."

www.transgendertrend.com/hot-topics-in-child-health-a-medical-political-and-ethical-debate/

I've found a few reviews (as in studies of several other papers combined) that do suggest a higher occurrence: e.g.
'GD and ASD were found to co-occur frequently - sometimes characterized by atypical presentation of GD, which makes a correct diagnosis and determination of treatment options for GD difficult.'
(Int Rev Psychiatry. 2016;28(1):70-80. doi:10.3109/09540261.2015.1111199.)

'there is evidence that ASDs may be more common in transgender and gender nonconforming people.'
(LGBT Health. 2014 Dec;1(4):277-82. doi: 10.1089/lgbt.2013.0045)

Where were you looking? I think it's at least important to ask the question.

ScreamingBird, the professionals at Tavistock are not qualified to make those statements and 'autistic traits' is not the same as 'diagnosed autistic'. Even our GP had no clue what he was talking about with regards to autism.

so this one: Int Rev Psychiatry. 2016;28(1):70-80. doi:10.3109/09540261.2015.1111199

• lacks details and relied on 'reports and articles' rather than showing clearly diagnosed autistic people and diagnosed GD people.

The second link is a case study on two people. That is not a link.

Penny, it's true that autistic traits need to be present in multiples for diagnosis, but clinical means they would be of diagnosable level.
Why would you say the doctor isn't qualified? Which doctor did the diagnosis, and what is their specialism? Do you think the Tavistock are wilfully misleading people?

It's almost impossible to get a proper, full diagnosis of autism these days, even if you ar prepred to go private.

It doesn't mean that those people with the autistic traits (triad of impairments) are not autistic, just that they have not been fortunate enough to get a diagnoses.

AlexanderHamilton I am also a parent and partner of autistic people, I spend more time around autistic people in my adulthood, than neurotypical people. I share your concern regarding their vulnerability, although that will depend on which end of the spectrum and other co-morbidity factors. I am around a lot of people with apsergers, which changes things slightly, in my experience they are less likely to be influenced or coerced by peers.

Penny my daughter was diagnosed with autism at age 19. Aged 18 she told us she is transgender. The psychiatrist who diagnosed her with autism (NHS) said that she sees many adolescents with gender identity difficulties who are either diagnosed or not yet diagnosed with autism. And she sees a similar situation with eating disorders.
Also that girls with high functioning autism are frequently missed (as my daughters GP and psychiatrist treating her anxiety and depression dismissed out of hand that she could be autistic "because she has friends and makes good eye contact"

DS1 is an adult, very probably autistic, and "feels more comfortable identifying as female in social situations". Make of that what you will.

My daughter has aspergers (my son does too but in between her being assessed and him being assessed they had changed the terminology and the term aspergers is no longer being used, at least where we live. Its now High Functioning ASD)

My son especially is incredibly vulnerable and easily led.

ScreamingBird, it is not their speciality. Autism isn't something every psychiatrist would be familiar with or have experience with, and we personally sought professionals in that field who were specifically experienced with females on the spectrum as they present quite differently. Its actually an issue within the community, girls/woman not being diagnosed or being misdiagnosed due to research and experience being male-focussed. So the fact Tavistock is somehow diagnosing so many girls, at a far higher rate than in the general population, also indicates an over or misdiagnosis issue.

My daughter gets very upset at the casual way people discuss this link as if it is real, as a way to use autism to get acceptance for something entirely different and an ideology she finds personally threatening to her own rights- both as a woman and autistic person.

I don't think that many people here would disagree with that.

I have seen here and elsewhere people with autism discussing the "trend" of self iding as autistic. (Discussions often unrelated to gender debate)

In this part of Mumsnet the discussion seems to be revolving around young females who perhaps due to failures in our system are not being diagnosed and that perhaps what is being classed as disphoria is actually issues due to undiagnosed autism.

Diagnostic rates for ASD people (especially girls) really need to improve before a proper analysis can be made.

I was sure my son would meet criteria by the time he was about 3, although he didn’t get an actual diagnoses until after he had a mental health crisis and dropped out of high school in year 8 (he was diagnosed with dyspraxia at 10 and ADHD at 12 but was almost 14 before ASD was confirmed).

When I did a course for parents with newly diagnosed ASD kids of my son’s age group, almost all the other parents had daughters.

CAMHS are so oversubscribed they are failing almost everyone, but girls are definitely getting the shit end of the stick.

My son has now aged out of the service and I’ve been asked if I would help facilitate a parents support group. I’ve not really given it much thought but this thread is making me consider it.

You can imagine how difficult it was to get dd ( a girl with extensive drama & performing arts training) diagnosed! Masking, eye contact, copying social situations in the same way as she would a playscript, the list goes on.

I thought "identifying as autistic" meant that one has a genuine diagnosis of autism, but chooses the label "autistic person" rather than "person with autism"

I personally think the link makes a lot of sense so is probably true. Most people with autism don't just blindly follow social expectations. Gender in my opinion is socially constructed and not biological, so it makes sense for more people with autism to not identify with femininity or masculinity and therefore perhaps come to the belief they must be transgender.

Starkstaring it concerns me that the person you saw spoke about 'eating disorders' that way, with regards to autism. Due to sensory sensitivities autistic people often have ritualistic eating behaviours and textures which are unacceptable, much the same way that there are hearing issues within the autism spectrum. My husband has a sensory sensitivity with hearing, too many sounds turn to white noise and become extremely painful so he wears headphones a lot. My daughter has many sensory issues but one is food, specifically texture of food and so mixing food is not accepted and some foods are completely off the table- make her vomit on sight etc It is not a simple case of 'eating disorder' as we understand them.

dolorsit thank you for that, it is what I have been suspecting. It has been common in the past for girls to be misdiagnosed with eating disorders, which were in fact traits of their autism. very interesting. Thanks.

Re gender - my son is very sure that bio sex is everything and gender is nonsensical, made up bullshit.

He just started uni this week and I worry that he will get in trouble by ‘offending’ someone. He swears that when he was asked his pronouns he replied ‘space/ranger’ (a Buzz Lightyear reference).

However, I can see how some ASD people might come down on the other side and instead take gender presentation entirely at face value - ie, wearing trousers and calling oneself a boy means they are a boy, no questions asked.

I think 'correlation' is a more accurate term than 'link'. They may or may not be causally related to each other, we don't know in which direction the cause operates, and there could be a third (or more) factor causally linked to both.

AlexanderHamilton Oh my god!! hello there! We have the same issue! Our DD has had drama and other creative arts training since 7 and yes, everything changed after a lot of training in 'gestures' (she didn't use many before ) recognising emotions, displaying emotions.... what she says to us is, ' well I know what people want to see and hear now, even if I resent it and don't understand it, or even have the feelings I am meant to be expressing' Also I read Tony Attwood saying that girls usually role play more anyway and mimic their mothers.

Penny with my daughter I genuinely think she has an identity difficulty. Having spent all her childhood and teenage years not knowing why she didn't fit in (and no one had any idea she might be autistic), managing to mask her difficulties until it became impossible and was consumed by anxiety and depression. Then along comes a suggestion that because she isn't typically "girly", her problem is that she was born with a male brain in a female body, and there's a ready-made identity to wear.

I know of another teenager with late-diagnosed HF autism who has had an awful adolescence, bounces between various inappropriate and exploitative relationships, dabbled in substance abuse, self harm etc - I think she too is struggling to form a coherent identity, but it is manifesting itself in a different way.

Ixnayonthehombre see I have had the opposite experience with autistic people!

Re eating disorders. The psychiatrist was referring to clinically diagnosed anorexics. She had been shadowing a colleague in an eating disorder clinic and said that she could have diagnosed more than half of the patients (mostly female) with autism.