Autism and gender dysphoria - whack-a-mole?

[AmaryllisNightAndDay]

Came upon this:

Fortunato A, Giovanardi G, Innocenzi E, Mirabella M, Caviglia G, Lingiardi V, Speranza AM. Is It Autism? A Critical Commentary on the Co-Occurrence of Gender Dysphoria and Autism Spectrum Disorder. J Homosex. 2022 Jun 7;69(7):1204-1221. doi: 10.1080/00918369.2021.1905385. Epub 2021 Apr 14. PMID: 33852376.

From the abstract:
"We hypothesize that the traits often classified as autistic could be more accurately related to the distress and discomfort evoked by GD."

The journal doesn't look like a journal of psychatry or autism. I can only see the abstract from here pubmed.ncbi.nlm.nih.gov/33852376/ but I think that this bit "to provide, through the description of a clinical case, our reading and a possible interpretation of the correlation of these two conditions" means that they are talking about just one patient.

@GCautist

Rather than these ridiculous and outrageous pseudo-scientific claims maybe if wider society were more accepting of difference, and quirks and weirdness and we didn’t teach girls to oust those that do not fit certain ideas of normal maybe fewer autistic girls would consider transition a “cure”.

👏

@GCautist I agree - and maybe fewer autistic boys too.

This kind of crap really annoys me.
You cannot cure autism. Not yet at any rate.

The «symptoms» are a result of structural differences in the brain ( like Haudrosaurus said) caused by multiple cluster-mutations in various genes. I think that is how you say it. But there are so many different cluster-mutations that gives autistic symptoms.
I haven’t read that anyone has singled out just a few as the cause of autism. We are talking over 100 different ones,

lately there have been people whining (yes, whining) that no NT people should be involved in the care and education of autistic children; they should be looked after solely by other autistic people. The ND people doing this whining are highly articulate and demand that the world must adapt to them.
(sounds familiar?)
Good luck with that. I am well aware that the care of autistic people have been lacking and often cruel at different times. But it seems with constructive criticism and proper studies we are going more in the right direction.
What I do wonder though is
where the fuck are these ambulating teams of autistic people educating/caring for their younger «siblings»?

hot on the heels of that gold-nugget came an article that pitted NT people against people with «ancient» genes aka autistic people. These ancient genes were the reason autistic people mustn’t eat milk or gluten.

If you have a food intolerance (or even allergy) it will help with stomach pain and sluggishness if you stop eating those foods.

It will not cure autism though.

My autistic boy loves bright colours, especially pink, purple and yellow.

Perhaps I should’ve transed the autism away before he was old enough to object?

Obviously I’m not serious.
My boy is great the way he is.

I can't add more than the highly intelligent people on this thread.

That paper is fucking horrific. Eugenics.

It's also more common for young autistic people, especially girls, to have anorexia.

More common for boys to have severe mental health difficulties and substance abuse (both sexes can obviously be very vulnerable to mental health difficulties) - Tony Atwood missed his son's own autism and his son ended up in jail due to drugs.

What an idiotic paper. We've discussed the placebo effect of transition many times. How people waving pom-poms and glitter for you helps your mental health.

The issue for these kids is regressive gender stereotypes. Why are academics so fucking sexist these days?

Slight tangent: Did anyone see the Charity Commission stuff re: various autism charities? I just read it mentioned over on the Mermaids thread at the farms…

www.thirdsector.co.uk/charity-commission-opens-compliance-case-autism-charity-social-media-use/governance/article/1752698

www.gov.uk/government/news/regulator-opens-inquiry-into-cornish-charity-over-safeguarding-concerns

www.thirdsector.co.uk/charity-investigated-teacher-sword-child-eating-dead-rat/governance/article/1799962

www.thirdsector.co.uk/academies-trust-run-major-charity-breached-law-review-finds/governance/article/1800103

wtf is going on in our charity sector?

@TheClogLady Mermaids are trying to make themselves look less bad. Yes, many charities have safeguarding concerns of one kind or another in some parts of the services they run.

But Mermaids are in a class of their own. I mean imagine if NAS was giving tons of advice and training and being consulted as "the experts" on autism by governments and health authorities and schools - which they are! - and it turned out they were directing people to chelation websites and telling parents to not to get their kids vaccinated and advising doctors and hospitals and schools the same thing. Oh, and imagine their CEO had taken their child abroad for chelation.

Mermaids isn't just one safeguarding fail in one place. Their whole approach to children with gender issues is (a) unevidenced and (b) dangerous.

(PS I am not accusing NAS of doing any of those things - it's just an analogy!)

NAS is far from perfect but two wrongs don’t make a right. My main issue with NAS is how little they’ve done to protect our autistic kids from mermaids!

I have to tell my autistic child that many people they should be able to trust are confused about what makes a man or woman. That’s a really difficult thing because autistic children are already so vulnerable. I don’t want to undermine trust in a way that makes them vulnerable to conspiracy theories later (I.e nothing anyone says is fact can be trusted) but also I do need to explain that no matter what anyone says people are biologically male or female. It’s very hard tightrope to walk. Not to mention most support groups are entirely captured.

I know of a local one that's incredibly dodgy. Many different people have complained to various places and yet he still gets more grants.

Same here.

I am GC. Sex is binary, and gender is a social construct.

I am autistic. I did struggle a lot when I was young with being a girl. I didn't think I was literally a boy, but I felt something was 'off' about me being a girl. I didn't fit in with other girls. I found lots of 'girly' things very boring and I didn't like the double standards and constraints on me because of my sex. I had zero interest in having children and this has never changed for me even now as I am nearly forty. My mum was always disappointed in me for 'not being like other girls'. I suspected my father would have liked a son.

I did feel like I was from another planet. A different kind of human being. Never fitting in anywhere.
The idea of being a man trapped in a woman's body did appeal to me as it was the only way to crudely describe my experiences and sense of isolation and disconnection from other women.
I was mostly a loner and spent a lot of time online talking to strangers and playing games. I was very depressed and suicidal.

I think if I was growing up today I would easily be spending lots of time on sites like Tumblr, Reddit etc and might have ended up really believing that I was actually a man because I found it hard to fit in with my female peers. And I haven't even touched on my body and self image issues. I really wish social media was banned for anyone under 18. It seems to wreck havoc on young minds.

@Queuesarasarah Oh yes I absolutely agree that NAS shouldn't be signposting Mermaids.

And agree that their own web page on "autism and gender identity" is weak in itself. www.autism.org.uk/advice-and-guidance/what-is-autism/autism-and-gender-identity It's one sided and imprecise and some of the content and highlighted links are really for adults and researchers. It doesn't really consider the different ways an autistic teen or young person might interpret what it says.

From what I can tell, the NAS has had some pieces written by a particular individual down in Brighton (I think they were, now seems to be Nottingham) who is exceptionally into trans ideology, a Joe Butler. twitter.com/sendsupportuk?s=21&t=7qgtDokajid73JT9fvLntA

I'm not sure whether they've been approached by them. In particular that emphasised not seeing gendered likes and clothing sensory interests as "special interests" or just "sensory need."

NAS since had an Australian trans man write a big piece, riddled with sexism etc.

For me after teaching autistic children within an MLD school for a long time, I find it striking that gender confusion or identity stuff doesn't happen at all with children who are much less interested in fitting in with peers and have less interest as well as ability to socially interact / communicate. Some of our pupils have very limited ability to communicate as they also have significant learning difficulties.

They wear what they wear. What their parents put them in and what they are comfortable in. They do what they like to do.

The bollocks about gender identity makes zero sense and is not in existence with children like this. Therefore it's an entirely socially and culturally manufactured idea/ trend.

It also is far more welcomed and celebrated than autism.

Eg

I might contact NAS about their web page. It's good to know who put it together @WarriorN Quite apart from the Mermaids link, the content and research links are not appropriate. I am familiar with academically able but non-savvy young people who have autism. The content is poorly worded and it's not balanced at all. And some of those young people could even read the academic papers without realising that they are not written for a general audience and they are not intended to show the whole picture.

I think it pays to read the abstract carefully.

We hypothesize that the traits often classified as autistic could be more accurately related to the distress and discomfort evoked by GD.

I think the paper is saying that individual cases of ASD may in fact be gender dysphoria. It's not saying that all cases of ASD are really cases of gender dysphoria and therefore ASD is curable. Anyone who knows anything about low-functioning autism (and presumably the authors do know) would realise such a proposition would be untenable.

@TomPinch I did read the abstract and indeed the whole paper carefully and it still makes me queasy.

We hypothesize that the traits often classified as autistic could be more accurately related to the distress and discomfort evoked by GD.

That's still an extreme statement based on one case that is still evolving. "Exacerbated", yes fine. But "more accurately related"?

The story is reminiscent of The Horse Boy, a lovely humourous documentary film about a young boy whose autism is ameliorated by a trip on horseback to visit shamans in Mongolia. (Yes really!) Some of his worst problems are relieved, he makes a friend and plays imaginary games with him, and he has a much brighter future ahead. No-one says his autism has gone away or was misdiagnosed.

It's dodgy to let a patient go away believing that all their autism has been fixed and gone away for good. Things are going nicely now but they could be in for disappointment later in life. Telling them they deifinitely don't have autism has shut down a pathway they might need later. Just where does this eagerness not be labelled autistic come from? Therapists like to feel that they have been successful but it might have been better to explain the effects of lowered stress and about traits that don't go away which the patient may always need to manage when life throws difficulties in their path.

The same weaknesses in the ADOS that the authors discuss and lead the authors to claim the patient was misdiagnosed with autism in the first place, might lead to a misdiagnosis the other way round when the patient is feeling relaxed and confident and has found ways to communicate. I'd be interested to know how consistent ADOS results are over time.

It's especially risky to give a patient the impression that transition fixed their condition. A lot has gone on in this young person's life. They've grown up and matured, presumably they've been given ways to manage the disconnect from their parents, and they have been getting years of lovely individual therapeutic support. They have friends now in an accepting group as @GCautist says. If the group falls away, if social problems and unhappiness resurface then how tempting will it be to go further along the route to transition? Having professionally confirmed to the patient that none of this is related to autism?

From the paper, stated approvingly:

In particular, we are currently witnessing the process of depathologization of transgender conditions, reflected by the new ICD diagnosis of gender incongruence (WHO, 2018).

Fantastic. We depathologise and at the same time we medicalise and we cut bits off.

I don't know if it's wholly that person AmaryllisNightAndDay, I remember seeing their initial piece a few years ago on there. Probably around 2018/19.

There seems to have been more guest pieces since.

The thing is that if the main charity isn't sure they'll ask / invite / or be approached by those keen to insert their ideas/ opinions.

Over a decade ago the Tavistock were doing the opposite. We had a pupil referred who'd previously been diagnosed with moderate learning difficulties. They said he should be referred for autism and was simply gender non conforming. He had no issues with his body.

A very significant aspect of daily life for many autistic people is anxiety and sometimes a deep interest in things that completely preoccupy thinking.

Obviously if the idea of being in the wrong body is that idea, being able to have that completely embraced by others is going to alleviate a lot of anxiety in the short term - plus the attention it garners.

@AmaryllisNightAndDay

I do not have access to the entire article. I take it that the abstract is accurate, however.

That's still an extreme statement based on one case that is still evolving. "Exacerbated", yes fine. But "more accurately related"?

The language is academic wibble and not very clear. But I think the point is that diagnoses of high-functioning autism are (in my experience) based on observations of behaviour, just as they are (I'd imagine) with gender dysphoria. At the outer edge of things, the behaviour could be interpreted all manner of ways. One of my DCs has an HFA diagnosis and, to be honest, the supports put in place are so personal to her that the sole advantage of the diagnosis (a big one I admit) is getting the attention from people who can help.

I accept your concerns about the article. It is typical that people with ASD present in their own way, which may or may not be gender-conforming, and there is no reason in heaven or hell why that should be pathologised.

Thinking back to ADOS - seeing this as an observer I am confused how transitioning made a difference. It was about play mostly and not gendered play. Things like using an object to to represent something else, response to toys, looking through a book. I suppose an obsession with Transideology might partially 'drown out' some responses. If you engage more with the people in the book because your special interest involves people? If you look at the play items in relation to your special interest of trans? If you don't consider trans as an obsession then you might put down any responses which should properly be link to this as a special interest but rather say it is evidence of gender dysphoria?

Were the people who carried out both aDOS tests independent of each other and the research? Blinded to what the study purpose was?

Are they using the exact same paperwork both times?

Only it turned out that the famous Amsterdam study that validated paediatric transition and set the whole western world off in this direction turned out to be using two different sets of paperwork, one for pre and one for post transition (they switched them over so the second time natal boys were assessed using the paperwork for natal girls and vice versa. This means the ‘gold standard’ of child transition research is … potentially a big pile of guff).