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.

Woman are you asking that NT parents of autistic DC do not engage in discussions realting to autism?

Autism is life-long though and very clearly present in people who have it. Either from observation or from them being able to self-advocate.

It's not like having a temporary crisis.

Even the way social anxiety manifests is very different.

I don't think GIDS says there is a definitive link or that one causes the other. I believe they are just wondering why kids who are on the autistic spectrum appear to be overrepresented in the referrals they receive for treatment of gender dysphoria.

For anyone interested, here is the text they have listed under their "Evidence Base" page on the subject.
gids.nhs.uk/evidence-base

There seems to be a higher prevalence of autistic spectrum conditions (ASC) in clinically referred, gender dysphoric (GD) adolescents than in the general adolescent population. Holt, Skagerberg & Dunsford (2014) found that 13.3% of referrals to the service in 2012 mentioned comorbid ASC (although this is likely to be an underestimate). This compares with 9.4% in the Dutch service; whereas in the Finnish service, 26% of adolescents were diagnosed to be on the autism spectrum (Kaltiala-Heino et al. 2015).

Why there is a higher prevalence of ASD in GD young people is still unknown. A review of the literature by Van Der Meisen et al (2016), groups underlying hypotheses into biological, social and psychological assumptions.

• Biological: Extreme Male Brain Theory - ASD as a result of Extreme Male Brain. Prenatal testosterone may not only lead to a higher disposition towards ASD but also GD as an expression of extreme male characteristics- explains why girls with ASD would be more susceptible to develop GD.
• Social: Poor understanding of social relationships, which is a characteristic of individuals with ASD, suggests that GD could develop as a consequence of difficulty in social interactions. E.G boy with ASD who had been bullied by other boys might have developed a feeling of belonging to female sex out of aversion to male gender. Parkinson (2014) described 2 birth-assigned men who had feelings of being different and interpreted these feelings as GD and therefore requested gender reassignment therapies.
• Psychological: ASD - link with GD. From the literature review, we can conclude that knowledge on the co-occurrence of GD and ASD is far from complete. More research is needed to find out which factors are important in this co-occurrence. Despite the limited current literature on GD and ASD, there is now some replicated evidence of an over-representation of co-occurring GD and ASD compared to what would be expected by chance based on the prevalence in the general population. It is plausible that not only one suggested hypothesis but multiple suggested hypotheses may play a role in the GD-ASD co-occurrence. Alternatively, of course, the two may be present without being related to each other (Ristori and Steensma 2016).

I cannot speak to the validity of each study or who specifically diagnosed the kids in these cases (the language on the website implies that children may be referred to gender clinics with a diagnosis already in hand, and I don't think it's for me to question because I believe autism is very complicated to diagnose). I don't know about the very speculative theories that some researchers present above. But it looks like GIDS is saying there is enough of a signal to warrant further investigation, although it may be turn out that these factors are unrelated. They are advocating more careful research into this subject which I think is the responsible thing to do. I have no reason to believe that GIDS haven't critically appraised the literature, or are misrepresenting the data. More like they are saying "huh, we have noticed something slightly different from the baseline of the general population about the group of patients who are getting referred to us for gender dysphoria. Is this just a coincidence, or could there be something else at play here?" (Honestly, they'd probably find it just as curious if an unusually high number of red-haired people compared to the general population were being referred for gender dysphoria because this is all still a quite poorly understood, developing field of research). But the only way you find out for sure why existing studies seem to suggest a possible co-occurence (not saying that one causes the other!) is by looking into it properly.

WomanAKAAdultHumanFemale thanks. I don't think anyone wants to give that impression. But they might know more than their young autistic child, right? So I like to think that parents of young autistic children and adult autistic people have a lot to say to each other, and it would be nice if we could start from a place of mutual respect for each unique and important perspective. Some of our children are non-verbal too, or less verbal. Really, we really are just trying our best. Some of our kids don't like to talk much, mine doesn't like repeating herself- even if to different people. So even as an almost-adult, she still asks me to speak for her an awful lot, and she won't change her support person or head of year at school because she wants to stay with the same lady (also autistic) who 'already knows about her'. So I guess I am just saying, sometimes it is habit from having to speak and fight for our children so much. We do not mean to speak over other autistic people, but also we all need to remember that not all autistic people think and feel the same way, so what might sound wrong to you will be right for that persons child.

Also... re sex yes, thats new to me! My daughter is not going to tell me but my husband has never had an issue!

That’s interesting, Redtoothbrush and on my manor, too.

Might take a look into it.

Pennydrew my post was not aimed at you. It was aimed at the attitude that autistic parents know more about autism than do those of with autism. My apologies if you were caught in the cross-fire.

woman You aimed at me but I am at a loss to understand why or where you think I have said that autistic parents know more about autism than do those of with autism. I'm genuinely baffled

*Lady
*
My apologies if you feel that I was speaking for you. I was only articulating what I perceived as your argument as I couldn't understand what the Op was disagreeing with you about.

heresyandwitchcraft thank you. Its more that people have taken their words and translated them to mean: autistic means trans. Theres a definite link etc. I am specifically referring to TRA's.

In those TRA cases though I'm sure it's more a case of self id than someone with a diagnosis of autism.

I don't think it's the same as those of us who are autistic saying 'if this ideology had been pervasive when I was young it would have sucked me in'

They're surely separate issues.

I wonder is some of the problem is not feeling like you fit into the world as autistic. I'm gay & female but I don't feel like I fit in to the category of 'women' (other than the official dictionary definition!) because I seem to have so little in common with other women. Equally though, other than wearing men's clothing because it's more comfortable, I don't feel like I'm a man either. I'm sort of stuck in the middle in no-person's land I could see some autistic young people being like that and wondering if / having it suggested to them that they may actually be trans rather than gay & autistically-different. Maybe if the whole trans thing had been around when I was younger I'd have got sucked into it - I know I was (and still to an extent am) naive and easily-influenced / pressured.
It may well be that a fair number of NT kids identifying as trans are equally not trans at all but just not feeling like they fit in and needing to find a slot?

I dont think its trendy to identify as autistic. A lot of adults are self identifying as autistic because they realise they are, but cannot access diagnosis via adult services. This doesnt mean theyre not autistic

Super- yes they are and it has not been my intention to conflate the two! I keep trying to make that clear.

Rangerider yeah I think that is what some contributing mean.

You aimed at me

Eh? I did no such thing.

I either quote a passage or a put a poster's message in bold so as to make my response clear as to what or who I am referring. I know that I did not use your name in any of my posts so unless I referenced a post - in which case I was clearly responding to the post but not the poster - you have confused me with someone else.

If you read Jeanette Purkis's autobiography you can see all the different ideaologies she was pulled into in an attempt to find a tribe.

For her it was communism and religion among other things but it could so easily be Transactivist ideas.

What many autistic people do well is take in and retain a lot of information quickly which can easily lead to becoming rapidly at the centre of a group like, for example, all sorts.

I disagree with several points Penny has made. But I hope that I have listened to her point of view and made my point of view in a polite, considered manner without resorting to insults.

Alexander indeed, you have. And some of the comments from those with autism have given me interesting things to think about. Other than reading books by autistic people, my perspective is informed by those who are around me and none are remotely easily influenced- quite the opposite. My husband, it may be because as a child his family were in a cult. His Mum died when he was 4, and his father quickly remarried inside the church. He fled as a teen but maybe the reason he is not easily influenced or even that interested in finding a tribe- at any point in his life. Our daughter may be influenced by that, and myself as a feminist.Someone else mentioned something earlier about bright girls being more likely to have eating disorders and autism. My child goes to an extremely high achieving school and the small group of autistic girls are the ones who have given me the perspective I have with regards to trans ideology and whether or not they are easily influenced by it ( as I mentioned this particular group are not). So it is interesting isn't it, that we can all have these very different thoughts and takes on it, from autistic people themselves. Which is why I emphasise the need for more care and research.

Teenager girls presenting as transgender were new to her, but her working assumption was that changing your gender, and controlling how you present to the world and how people interact with you, is another mechanism for managing anxiety.

Sort of an extreme form of stimming? Control is a big thing for me. Being able to predict how your body experiences the world. Flapping my hands, twiddling my fingers. It's comforting because you feel what you expect to feel.

FWIW I don't think I have ever even seen someone say "autism causes trans" or whatever. What I have seen is the figures from the Tavistock etc suggesting there may be a correlational link, along with autistic MNers sharing their lived experience. Then, separately, a criticism of "Lola (65) identifies as austistic" and eye rolling at it - both from the self ID autistic side and the fact that an anecdotal, correlational link has been suggested Not proven, suggested.

Most people here seem to be saying the same, so I'd suggest that there is possibly that the issue is in how you are reading things rather than how we are wording them

the small group of autistic girls are the ones who have given me the perspective I have with regards to trans ideology and whether or not they are easily influenced by it ( as I mentioned this particular group are not)
Bear in mind that they may not be easily influenced if they either hang together as a group or are friends with each other in pairs / smaller groups i.e. if you're the lone autist you're trying to fit in with all the NTs and therefore more likely to be influenced, but if you have autistic friends that need disappears. I have no autistic friends and never had.

There have been studies about people with autism and conformity using the Asch test. I think the results were that people with autism are consistent: they are consistently conformist or consistently non-conformist.

RangeRider, PM me if you want the contact details of an autistic spectrum meetup group in London. They usually meet in a pub but also organise the occasional days out.

Bran

I agree that a lot of people who self Id are doing so because of the difficulty of getting a diagnosis.

However I do think some people who self Id are doing it because it is a "buzzword" I'm sorry I'm struggling on how to express it.

I think this because I have seen it happen over the years with multiple conditions - hyperactivity, dyslexia, OCD and bi-polar are just some of the ones that come to mind.

Long term exposure to some people I know who do this has made me sceptical towards those specific people. (Although I don't bother voicing it)

In general I wouldn't have reason to doubt anyone and think they are being trendy.

consistently non-conformist

That would be me. I long ago learnt that it was ok to march to the beat of my own drummer. Now, my attitude is that if you aren't related to me, don't employ me or aren't someone I choose to spend time with, I don't care what you think of me.

Rangerider thats an intersting point, thanks. My husband was a loner all his life and is fine with it. So i think I shall keep in mind that autistic people are as diverse as NT's.