In a weird case of coincidence @UtopiaPlanitia, I was returning to this thread to talk about Dr Az now that I've finished his book.
A PP had mentioned (forgive me, I can't remember who) that he's particularly good at explaining gender identity and autism in relation to boys. I would agree. I do think there are some bits missing, but it's well worth a read as it very clearly differentiates the acronym people (heterosexual, fetish) from those that are more likely to grow up as gay men if watchful waiting is applied. I would add the following to what he says (he does mention anime/gaming but as more of a footnote):
Boys
When boys are socially isolated, particularly those that are autistic, many are drawn towards a more accessible way of socialising: gaming. During adolescence, their sexuality emerges. Purely on stats, the majority will be heterosexual. Seeing sexy female avatars in games like Fortnite can be an early introduction to feeling turned on during this. Some may already have discovered anime and may already be blurring the real world and fantasy world in this way. Autism adds the layer of "baking in". If a boy uses a female avatar and feels turned on (highly likely, given how 13 and 14 year old boys are... just ask any "non-girly" teenage girl who suddenly sees their boy friends change from being adventurous buddies into a totally different persona who seem obsessed with the pretty girls), some will not be able to, or possibly not want to, separate this feeling from reality. Dr Az does talk about detransitioners who didn't know they had the acronym, who go on to have surgery, and totally lose their libido afterwards. The cruelty here is that they didn't understand that it was all about sex because of the rainbow celebration and conflation with the "born in the wrong body, would grow up to be gay" types. Obviously some of these boys would not have "bottom surgery" and are likely to become tomorrow's escalating and dangerous acronym people. Understanding the patterns and differences is essential to giving them the right approach in therapeutic treatment. The acronym/narcissist type need to be understood and managed as a risk, very much like any other paraphilia.
Interestingly, Stella did a chapter in the book and she talks about the acronym being unfairly stigmatised.... It's fair to say that what she said in the YouTube conversation is VERY different from this. It sounds like she's been on an important journey of thinking. To be fair, so have I. I haven't lost compassion for boys who would otherwise grow up gay, nor do I think that autistic boys who are caught up in the avatar/anime world are on an inevitable pathway to becoming tomorrow's acronym. Obviously none of these people belong in women's spaces, and it's not "women's problem" to solve etc. BUT many women are mums to boys who are caught up in this. Perhaps Stella was gaslighting everyone with her shifting narrative (this has been levelled at her) or perhaps she was just saving face and trying to hide her pivot from what she said in the book to what she said in the YouTube conversation about the acronym. She's a human being and she's a curious psychologist - she's following what she learns and adapting her approach as a result of this. I'm not interested in pointing fingers. I'm more interested in how this will unfold to help boys who are victims of this as well as protecting the rights of women and girls.
Girls
He talks about social contagion, autism and trauma but completely misses the traumatic impact of sensory issues, such as breast development and periods, with autistic girls during puberty and the way that this feeds in to the mix. This thread isn't about that so I'll leave it there, with a couple of links in case it's of interest to anyone:
https://twitter.com/BonfireLady/status/1697126765687099612?t=7_e-yZYZUgKG1s_WPjS4CQ&s=19
https://www.transgendertrend.com/teenage-gender-identity-crisis/
Conclusion
Perhaps it's coming in book 3 but a deeper dive in to autism and gender identity is warranted. His main clinical interest seemed to be with males who adopt a female gender identity, which is definitely helpful, particularly in understanding more about the acronym and who will/could likely go on to detransition versus those that just need management as a danger. But given the 5000% increase in girls presenting with gender dysphoria and the fact that 48% of all referrals are autistic, he's skimming over a significant number of victims in this medical scandal.