Michael Craig at Tavi: Are autism and gender dysphoria linked?

[RethinkingLife]

Thoughtful piece.

For six months during the Covid lockdown, Professor Michael Craig sat in remotely on sessions with patients at the Tavistock gender clinic in London. They were children who were being seen for gender dysphoria, the term used to describe a sense of distress caused by somebody feeling that their biological sex does not match their gender identity. But as Craig watched them pass through he says he was “perturbed” by how many also seemed to have another condition: autism.
“There were certainly some days where I was fairly convinced 40-50 per cent of the patients I was seeing were autistic,” he said. Overall, he estimates about 20 per cent might have qualified for an autism diagnosis.
“I was trying to find out what it is that might explain this overlap, but it’s a difficult area to research for all sorts of reasons.”
…
That the two conditions often seem to occur together was highlighted in a review by Dr Hilary Cass this month, on the state of NHS services for children identifying as trans. One of its recommendations is that children presenting at gender clinics should be screened for neurological conditions, especially autism. “Clinicians report seeing teenage girls who have good cognitive ability and are articulate, but are struggling with gender identity, suicidal ideation and self-harm,” Cass explained. “In some of these young people the common denominator is undiagnosed autism, which is often missed in adolescent girls.”

https://www.thetimes.co.uk/article/autism-transgender-professor-michael-craig-cass-review-2s9tkn8qz

https://archive.ph/P4WfQ

@VitoCorleoneOfMNMafia I was responding to your post stating That was my point. We feel as much compulsion if not more to comply with social norms. which I can see might ring true for many highly verbal female autistics but isn’t universally felt throughout the population. I think you agreed with me?

I've been writing this post for a bit and have now seen AstonsDataThief's post on the same subject. And much more succinctly put! Below is my personal experience.

Wrt ”Nothing about us without us”

I am seeing more educational trainers who are themselves autistic or have adhd, coming into schools to deliver training.

Which in some respects is useful. It can be useful to hear someone describe very accurately how an individual with autism or adhd may feel in certain situations. But can also pose some issues too. There's an excellent trainer locally who's work I find really useful but he's not coming from the perspective of a child with autism AND learning difficulties or cognitive delays.

He's coming from the perspective of someone who's very academically clever and able to communicate his concepts very well, but clearly struggled at mainstream school and in life when he was younger.

A lot of his suggestions though aren't possible with many of the children in the SEND setting I teach in due to their communication and comprehension levels.

When I've discussed this with local SALT advisors they said it's about recognising there's ages and stages and context also needs to be considered.

Previously that particular trainer was very good on sexism in autism but has since been captured by TRAs.

There's another person who is marketing himself into local schools who was diagnosed late with autism who is simply not appropriate at all. But some schools and (even whole LAs) buy him in on that basis. Has been mentioned in Reduxx.

WarriorN I see that too. The Scottish Government’s proposed LDAN bill (predictably with a ‘lived experience expert panel’) even goes so far as to say ”lived experience trainers should be able to access appropriate support for training delivery as well as appropriate payments for training work undertaken.” No qualifications required (or, presumably, PVG check) and this is for training across the public sector. Just random individuals with ‘lived experience’ for all ‘neurodiversities’.

Much as I would like to agree, you only need to look at Rape Crisis Scotland, Engender, Fawcett, Women’s Aid etc or for LGB, Stonewall, to see that complete and thorough capture exists in these attributes too.

Yes. I realised after my post that I had made my comments very clumsily. I was actually looking forward to someone pulling it apart 😁

What I was trying to say, albeit badly, is that "nothing about us without us" should be simpler where the boundaries are clear e.g. the delineation of men/women etc. In other words women shouldn't be subject to rules set by men without any women's voices included (so in that respect, I think the sentiment is positive). However, those boundaries are clearly compromised... which is kind of the point of this board... 🙃 and arguably the other examples I gave have the same issue.
Rendering my... word salad.. pointless. Ah well. You live and learn 😁

Have only read the first post, but no
shit Sherlock!

Autistic women have been saying this for years, in great detail.

BonfireLady I agree. It is one of those things which has made me very cynical. Something that sounds good is actually not.

People with autism feel less compulsion to conform to societal norms, he says — an idea also mentioned by Baron-Cohen in his study. “This frees us up to connect more readily with our true gender,” Lawson said.

That is such a weird interpretation and conflates normal variations in personality traits with some esoteric gender essence or soul that inhabits a body. It's so bizarre to have supposed scientific professionals subscribe to such notions.

I would say neurotypicals are better at subconsciously picking up unspoken rules and social cues on what is viewed as 'appropriate' behaviour and interests for men and women. They might moderate or change their preferences to fit in better with those around them.

Autistic people, on the other hand, are a bit 'blind' to these rules around societal norms and will pursue hobbies and interests, or wear what feels comfortable without much thought as to what might be expected of them. And probably don't realise unless it's pointed out to them. Or when they realise it's hard to make friends of the same sex since the majority don't seem to share your interests. I don't think there's any conscious decision to go against societal norms.

There's no 'connecting with our true gender', whatever that means. We are just expressing our personality with less filters.

I do think it was a bad idea to lump all autistic people together without any differentiation. Severely autistic people that are non-verbal or have learning disabilities are a different cohort to those autistic people who don't have to deal with such issues. It would be interesting to study the two groups separately and investigate which one is more likely to turn to gender ideology.

Yes, we are in agreement.

The quoted article generalised from "high functioning" autistic males to the whole of autistic people, ignoring the differing socialisation of women, which is what I posted about initially, and ignoring the extent to which an autistic person with comorbid severe learning difficulties can absorb or act on social conditioning.

As you have said, autistic people without LD can't speak for those with LD. I add that autistic men cannot speak for autistic women.

I think people have different insights and understanding and definitely don’t think it’s up to one section of a group to feel they represent the whole. There is very little understanding of some presentations of autism and I would say that is particularly evident in how people use LD and non-verbal interchangeably, their understanding of savant skills etc. There is very little compassion or empathy shown to the more vulnerable parts of the ASD population and some frankly revolting bullying of carers who try to voice their concerns.

That's a really important distinction @TomeTome, thank you.

Also, a great explanation @TheColourOutOfSpace.

The Cass report noted that there’s a high proportion of children with ND including autism presenting to gender clinics, and made particular note of the dramatic increase in early teens girls with complex additional issues (ie the very group who are likely to have undiagnosed autism).

I was a teenage girl who had additional issues including autism that resulted in me presenting as “male”. I hear the same story from lots of autistic women who had similar experiences. Yes I agree this experience is specific to some females with high functioning autism. But from what Cass is saying it sounds like such girls form a high proportion of the “dramatic increase” at gender clinics.

increase in early teens girls with complex additional issues (ie the very group who are likely to have undiagnosed autism)

Very important consideration to highlight

Also teen girls who'd experienced trauma and abuse. Blackpool had the highest rates of referrals and this has been linked to the social service team there.

Julie Bindel article- quite shocking look at Blackpool and the reasons behind the high GIDS referrals there. www.mumsnet.com/Talk/womens_rights/4711357-julie-bindel-article-quite-shocking-look-at-blackpool-and-the-reasons-behind-the-high-gids-referrals-there

Thank you and to all women on this thread sharing their experiences of going through puberty whilst also autistic (mostly undiagnosed I assume.)

Well said. Thank you from me too. It's such a help to read your perspectives.

I think the fact that teen girls with difficulties beyond gender dysphoria were presenting suddenly and in such numbers points to a problem in practice and pathway rather than a true link between a neurological difference and any gender fluidity.

i wonder if a similar set of children were goths, or emos, or punks in previous generations?

As a late informally diagnosed AuDHD (by the clin pscyh team assessing my kids, not TikTok), it is only in retrospect that I understand how it impacted my teens. I was deeply awkward, nerdy, isolated… and a was a punk/Goth - a Souixie/Cure clone and even play electric guitar.

It was all a facade, though, as I played baroque recorder/flute, the lute, sang Suzanne Vega/Tracey Chapman; read classic literature; was top of the class in everything and was bullied unmercifully. The ‘costume’ earned me a pass and was able to fade into the background, or at least seem too scary/angry for boys to sexualise and harass me (I was a Dcup at 12 🤦🏽‍♀️). I found puberty frightening and had no support from my mum, went to a rough mixed secondary, so thought I was mitigating this for my kids by sending them to a small local private school.

I think it was because of this, thinking what I’d gone through was to some extent the normal teen experience (think, The Breakfast Club), that I missed the early signs for both my kids. Once I realised, got their diagnoses, I’d hoped that being able to explain that I truly understood what my DD was going through and why this informed my belief that she was not trans would help. Doh!!

This

some frankly revolting bullying of carers who try to voice their concerns.

and this

As a late informally diagnosed AuDHD (by the clin pscyh team assessing my kids, not TikTok)
I think it was because of this, thinking what I’d gone through was to some extent the normal teen experience (think, The Breakfast Club), that I missed the early signs for both my kids.

Undiagnosed autistic parents can often miss autism in their children because their behaviours are ‘normal’ to them. Their child do what they do. So it is ironic when activist autism groups then bully them for what are often actually autistic behaviours in their reaction to their child’s diagnosis.

Exactly this. Current ideologies actively suggest that gender non-conformity means these kids are trans. Actually, they are just gender non-conforming. Whilst some people with autism feel less pressure to conform, a significant number feel very disconnected and out of place, which again makes them vulnerable to trans ideology.

I'm very much the same, but older than you. As a child I wanted to be a boy because my brothers toys & games appealed to me more than my sisters. I hated girly clothes like tights & skirts, and hated the sudden attention that the appearance of my boobs brought. I masked like a creature possessed, wore the clothes I was told I should wear, wore make up even though I hated the feel of it on my skin, etc etc. Luckily no one considered me to be trans because it wasn't a thing in the 80s & 90s, and I learnt to cope with the attention, found the confidence to wear what I was comfortable in and am a deeply content gender non-conforming autistic woman.

I'm completely done with seeing men mansplaining what womanhood and femininity is, as they get boob-jobs and grow their hair, put on make up and paint their nails. Get fucked.