Mum waits 3 years for autism diagnosis for child - yet transgender diagnosis took a few months.

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This poor mother's at her wits end over NHS autism services failure to support her child - while the gender services took a few months to diagnose child as transgender and treat via Zoom.

Those who have children with autism might recognise the characteristics described here?

(Sorry it's from the Mainly Fail)

www.dailymail.co.uk/news/article-8523349/A-gender-clinic-agreed-help-boy-admits-change-mind.html

@LonginesPrime I had the same experience growing up. I didn’t feel like what I thought a girl should be and my mum did reinforce gender stereotypes. I think coupled with no fitting in, I could’ve swallowed the whole transgender ideology if it had been around.

I was diagnosed with borderline personality disorder but strongly suspect adhd as I’m a lot older now and I don’t have many of the traits of borderline personality plus two of my children have adhd.

I do think gender clinics should look harder at things and have a team in place.

It sounds to me like this little girl is desperate for the adults around her to take responsibility and tell her she's perfect just as she is. But instead they're all sitting back and waiting for her to decide. They've absolved themselves of all responsibility and dumped it instead on the shoulders of a vulnerable child.

Is Mienna trans?

Do we feel Tavistock etc MUST include autism expert professionals in their team and a requirement for full assessment as a key part of a young person's diagnosis and care?

I think what they need is a solid understanding of the experience of neurodivergence (especially undiagnosed neurodivergence) because IMO, that's key to realising what a young person (or anyone) is talking about when they describe their experience of feeling they're in the wrong body/the wrong gender.

However, I don't believe this would work in the context of a specialised gender identity clinic because to someone with a hammer, everything looks like a nail.

I think there should be a policy change whereby a young person has to be seen by CAMHS first and they have to screen for other possible issues before referring on. But even with this, it's really difficult for anyone to discount gender dysphoria as a feasible option while people continue to believe that 'gender' exists as an innate characteristic.

My sister took years to get a dyslexia diagnosis for her child - and almost a year for her (my sisters) terminal diagnosis.

Any psychologist/therapist worth their salt will NOT make a snap diagnosis or rush to confirm a patient/parent's pre-existing assumptions. It sounds like sympathetic counsellors/doctors/practitioners just rubber stamping.

I guess the trouble is that gender dysphoria isn't classified as an illness or disorder, so it would be viewed as tantamount to conversion therapy to suggest that the person experiencing gender dysphoria is mistaken.

And when you add to that the fact that no-one can possibly refute someone's perception of their own gender if you accept that gender is innate and an actual internal experience, there's really not much scope for a clinician to suggest an alternative explanation without worrying about their own career and what they've been told is best practice.

The other difficulty with the current thinking around gender identity from a sociological standpoint (looking at privilege, etc) is that gender identity is often viewed as something that's completely unnoticeable unless gender dysphoria is present. So the very fact that someone is "aware" of their sense of gender indicates the presence of dysphoria by definition. Bizarre that no-one thought to check with the millions of women who've felt constrained by gender expectations their whole lives, but there you go.

IMO, neurodevelopmental disorders should be ruled out as part of a gender dysphoria diagnosis, because ASD and ADHD (and any sensory/executive dysfunction) can have such a significant impact on one's perception and sense of self, along with a lack of awareness on the part of the patient.

Couldn’t agree more @LonginesPrime

I wasn’t aware of the link between autism and anorexia until recently. Some experts even say that if a girl presents with anorexia, it’s a huge red flag for undiagnosed autism, and that alone should trigger an assessment.

Gender dysphoria is the new anorexia. It’s a scandal that the medical profession are affirming these confused kids, hoping that transition will stop them feeling like that don’t fit in.

The mother comes across as loving and concerned, but incredibly passive. Does she never say "No" to her child?

It is not necessary to have a diagnosis of ASD before initiating autism-friendly strategies and methods. Many ASD support organisations accept children on the assessment pathway awaiting diagnosis.

A spokesperson for Hertfordshire Community NHS Trust said: ‘Assessments for Autism Spectrum Disorder (ASD) require close face-to-face contact between the child and the clinician. The measures necessary to prevent the transmission of Covid-19 (including the wearing of face masks where social distancing is not possible) mean that ASD assessments are currently suspended.

This is awful. Why would there be any 'close face-to-face contact between the child and the clinician' in an autism assessment? Many autistic children would not tolerate any close face-to-face contact with a stranger! Certainly wasn't at my dc's ASD assessments (well before Covid). Not only that, but dc had previously been offered assessment by video-calls with clinicians. The service was called Healios. No reason to suspend ASD assessments during Covid when Healios has been available for over a year.

Poor child.

ADOS requires close interaction (joint playing with the same toys, looking at a book together etc), ADI-R could be done via zoom or similar. So I guess it depends on the child as to which is more appropriate.

This child has been in the news before. Here's an article from 2017.

metro.co.uk/2017/09/14/mother-hits-out-at-parents-who-pulled-sons-out-of-school-because-of-transgender-pupil-6927398/

‘About two-and-a-half, that’s when I noticed that things were changing,’ she explained. ‘But I didn’t think, “he’s transgender”. I just thought he liked boy’s thing’s and boy’s clothes because they’re more comfortable. But by the age of four-and-a-half, I was sure that transgender was what he was.’

Mienna said: ‘It made sense to the kids because Dexter only ever had male friends and wore male clothes. For example, the school sometimes had a thing where it would tell the children to form two lines – one for boys and one for girls. Dexter would always go to the boys’ line. He would also refuse to use the girls’ toilets at school. He very much looked like a boy too, he’s always liked having short hair for example.’

@rogdmum

Most young children will desist by puberty and the Tavi knows this so why don’t they use watchful waiting with therapeutic support? It sounds as though this mother hasn’t been pushing it herself, that she’s been conflicted and trying to do what is best for her child as guided by the Tavi.

The disconnect between autism diagnosis and gender dysphoria diagnosis is appalling. My daughter is older (15), but as soon as her GP heard “gender issues” she refused to refer my daughter (then 14) for an autism diagnosis and instead put her straight on the waiting list for GIDS.

IT MAKES NO SENSE.

That's fucking appalling of the GP to do such a thing. Did they think that autism can be 'cured' by puberty blockers and cross sex hormones?

Ooh I do wonder whether arguments over how to handle Shiloh are entwined in that divorce

It’s a scandal that the medical profession are affirming these confused kids, hoping that transition will stop them feeling like that don’t fit in.

How do they think affirmation is going to help these children fit in? A girl who wants to be a boy will always have a girl's body. A boy who wants to be a girl will always have a boy's body. As they grow up and go through puberty they will fit in less and less. Puberty blockers won't help as the child in this article found out:

“They promise you that your breasts will disappear, that your voice will be deeper, that I would look and sound more like a boy. For me, that was the best thing that could have happened,” he said.

Only, Jacob found that wasn’t what happened at all. Far from becoming one of the lads, as he’d hoped, he felt even more alienated from them as their physiques changed and Jacob’s remained the same.

Soontobe60 I know quite a few parents who have had the same experience, but at the same time, I know others who did have their child referred for ASD assessment so it seems to very much be down to individual GPs. With DD, she had been seeing a private child psychologist in 2019 and it had been her recommendation that DD be assessed. DD(at that time 13) was initially keen but then changed her mind. At this point she was saying she was non binary. When she decided she wanted to be seen as a boy, we raised the autism referral with her again and she seemed OKish about it so I went along to the GP first to brief her on the whole history.

The GP told me to make an appointment with DD and we’d have a chat. Then at the appointment, the GP ignored me completely, didn’t ask DD anything about an autism assessment - just asked a series of leading questions about gender (including did she want to go on medication) and then said she would refer her to GIDS. I was left utterly gobsmacked and now DD won’t entertain the idea of ASD assessment (we’re not pushing it- just leaving it unless she changes her mind).

There’s a real problem with the system in that some GPs want to push children straight to GIDS but GIDS only focus on gender dysphoria and whether the medical route is suitable for that child- they aren’t looking at the full picture.

@rogdmum

It must be so difficult for you. I do hope your DD gets the appropriate support she needs.

It sounds as though this mother hasn’t been pushing it herself, that she’s been conflicted and trying to do what is best for her child as guided by the Tavi.

From the earlier article and this TV interview it seems that this has very much been pushed by the mother who doesn't seem to realise that liking superheroes, 'boys' clothes' and short hair doesn't mean that her daughter is a boy. Even if her daughter thinks that makes her a boy.

Did they think that autism can be 'cured' by puberty blockers and cross sex hormones?

Mermaids do.

(Unfortunately I cannot find the link to their statement about how transing a child relieves their autism.)

@JellySlice

Did they think that autism can be 'cured' by puberty blockers and cross sex hormones?

Mermaids do.

(Unfortunately I cannot find the link to their statement about how transing a child relieves their autism.)

Yes, they most certainly do. And parents who prefer to take the 'watchful waiting' approach are seen as putting their child at risk of suicide. Shameful.

OldCrone Yes, I hadn’t seen the earlier media coverage when I posted!

@rogdmum That must be truly difficult for your family. I feel like the whole support services and medical services needs an overhaul and needs education on how to diagnose gender dysmorphia.

@BatShite In theory it seems correct (if you ignore the side effects of course, which can be horrendous) but in practise, once kids are on them, they will go onto cross sex hormones. When you consider without blockers 80-90% of kids desist, and 0% when medicated, then surely its obviously theres a huge issue somewhere and they certainly are not as easy to stop as made out.

Would you be able to point out where the research on this please? I am primarily interested because I am in the process of constructing a letter to National Autistic Society about a q& a on their website they have with Dr Wenn Lawson on transgender issues and who spoke at their Autism, Gender and Sexuality conference in 2019.

While he makes some valid points (eg sensory issues around peeing standing up), on the question of "how can autistic people be best supported in exploring their gender identity?" he says about children:
For instance, is this an obsession with the other gender, a sensory discomfort/like, a phase or interest, or are they telling us this is who they are? Or it might be utterly paramount to act more quickly.

For example, some young people need puberty blockers to give them time to process issues related to GD. This time factor of delaying puberty actually gives everyone time to explore options. If a young person is on the way to puberty, and they are telling you they are transgender, then joining a gender clinic or being placed in a specialist setting to gain access to appropriate support is essential. Once a young person’s voice changes and they are getting taller and sprouting a beard, it’s very difficult to undo. For young trans boys, having to go through menstruation and grow breasts can be an absolute nightmare.

I am asking the NAS to take this page off their website and really review their approach to autism and transgender issues. People will be looking for support and information around transgender and this is number 2 in the search results and there are only 4 results. My main concern is that a lot of children (and adults I guess but I don't know many adults with ASC) with autism are highly suggestible (I know because one of my child has ASC) and would take this to heart. Children with autism can also get fixated on issues (special interest) and once they are hyper-focused on a topic, nothing will dissuade them until they are ready to move on themselves. Add factors such as
poverty/co-occurring conditions/csa/dv in the family/drug abuse in the family/mental health in the family/or a combination of factors to for many children and yet gender dysmorphia is the first priority? Bonkers!

www.autism.org.uk/about/stories/wenn-lawson.aspx

(I also take issue with the fact, that it's only in the article that we find out that Dr Lawson is a transman - it should be stated explicitly at the top as part of his bio. Target audience of people with autism and their families!)

It's good to get that off my chest.

I also take issue with the fact, that it's only in the article that we find out that Dr Lawson is a transman - it should be stated explicitly at the top as part of his bio.

This is a wider problem with idolising people with ‘lived experience’ as the speakers of the ultimate ‘truth’. It completely ignores their conflict of interest, the fact they cannot be impartial, or that their evidence is generally anecdotal.

When looking at trans men's faces I've often noticed that when you tune out 'balding & bearded', that is still a readably female face - due to eyes seeming larger and lips seeming fuller, due to generally smaller skull and jaw in females?

I know that trans women can have ‘feminisation’ facial surgery - brow made smaller, jawline refined, Adam’s apple removed (?). I don’t thing there’s a similar ‘masculinisation’ version is there?