Exploring the Intersection of Gender Dysphoria and Autism Spectrum Disorder

This article will explore the current understanding, research findings, and potential correlations between Gender Dysphoria and Autism Spectrum Disorder (ASD).

Autism spectrum disorder is a neurodevelopmental condition where individuals have repetitive patterns of interest and challenges with social constructs and communication. Individuals with autism spectrum disorder are at a high risk of co-occurring conditions, including depression and anxiety. There has also been documented to be a higher risk of suicide compared to the general population. More recently, researchers have explored the overlap between gender dysphoria and autism spectrum disorder.

Gender dysphoria, previously referred to as gender identity disorder, is a psychiatric disorder where individuals have incongruencies between their identified gender or assigned gender and their expressed or reported gender. This is accompanied by significant distress in Daily life, social situations, and occupational functioning. There is a high rate of co-occurring mental health conditions for adults with gender dysphoria compared to the general population. Adults with gender dysphoria are at a higher risk of self-harm and suicide.

Understanding the intersection of autism spectrum disorder and gender dysphoria incongruence is essential because both conditions have an increased risk of secondary mental health issues and suicidal ideations. This means they pose a particularly distressful mental health burden on those who experience not just one of these conditions but both.

The intersection of autism spectrum disorder and gender dysphoria has only been studied in recent years, but the debate indicates that there is a suggested overlap.

For gender dysphoria in adults, a diagnosis happens when an individual has a noticeable incongruence between their expressed or experienced gender and their assigned gender, which lasts a minimum of 6 months and has at least two of the following symptoms:

1. A noticeable incongruence between their expressed gender and primary or secondary sex characteristics.
2. A strong desire to get rid of their primary or secondary sex characteristics because of this noticeable incongruence.
3. A strong desire to have the primary or secondary sex characteristics of the other gender.
4. A strong desire to be the other gender.
5. A strong desire to be treated like the other gender.
6. A personal conviction that they have the feelings and reactions of the other gender.

A diagnosis also requires that this incongruence causes clinically significant impairment or distress in important areas of functioning, including social and occupational areas, without any better explanation for the symptoms.

For autism spectrum disorder in adults, a diagnosis happens when an individual has deficits in social communication, social interaction, restrictive and repetitive patterns of behavior, and symptoms that develop early in life. This includes:

1. Deficits in reciprocating social or emotional feelings which can include reduced sharing of interests or failure to respond to social interactions properly.
2. Nonverbal communicative deficits in social interactions include abnormal eye contact or body language, abnormal facial expressions, or poor understanding of body language.
3. Deficits in maintaining or understanding relationships.
4. Stereotyped or repetitive movements or speech like flipping objects or lining up toys.
5. Insisting on an inflexible routine with ritualized patterns and extreme distress at even small changes like having to eat the same food every day or take the same route.
6. Highly restricted and fixated interests on things that are unusual or abnormal with an equally unusual level of intensity or focus.
7. Hyperactivity or hypoactivity to sensory input. 

A diagnosis also requires that all of these symptoms cause clinically significant impairment or distress in important areas of functioning, including social and occupational areas of functioning, which are not better explained by any other condition.

Around 1% of the population worldwide struggles with autism spectrum disorder.

Between 0.005% and 0.014% of people struggle with gender dysphoria around the world. 

Studies indicate that around 11% of those with gender dysphoria are also diagnosed as having autism spectrum disorder. This presents a documented overlap.

So, is there a link between autism spectrum disorder and gender dysphoria?

One study, Gender Dysphoria and autism spectrum disorder: a narrative review, discusses the link between gender dysphoria and autism spectrum disorder. This has led many people to ask, “Gender dysphoria and autism spectrum disorder is the link real?”

There is a growing recognition among clinicians that a significant number of patients who have gender dysphoria also have autism spectrum disorder. Subsequent research reviewing 58 articles investigating gender dysphoria and autism spectrum disorder found that there was a higher prevalence of gender dysphoria among those with autism spectrum disorder compared to among those of the general population for adults only.

Some research has shown that there’s an estimated prevalence of autism spectrum disorder diagnosed in people with gender dysphoria at 11%. This means that 11% of adults with gender dysphoria also have autism spectrum disorder.

This limited research that focuses only on adults has confirmed that across several studies, there is an increasing co-occurrence between gender dysphoria and an autism spectrum disorder.

How is this important for clinicians?

The growing link between gender dysphoria and autism spectrum disorder presents diagnostic and treatment challenges as treatment now has to extend to the possibility of co-occurring disorders with treatment plans to include psychoeducation, therapy, and pharmacological interventions for both conditions concurrently.

Moreover, clinicians now have to consider diagnosing both conditions where one might be present, investigating patients who present with autism spectrum disorder for additional signs of gender dysphoria, and vice versa.

Moreover, there is a growing concern for clinicians that autism spectrum disorder traits could have a subsequent impact on gender dysphoria, leading professionals to weigh the potential impact that autism spectrum disorder symptoms might have on the development of gender dysphoria and, as such, whether treating certain autism spectrum disorder traits might have the reverse impact on gender dysphoria. 

Gender dysphoria and autism spectrum disorder is the link real? This is becoming a much more prominent question as researchers start to investigate the link between Autism Spectrum Disorder and gender dysphoria incongruence. 

The majority of research pertaining to this intersectionality has doubled in the last two years, indicating that the pace of progress will continue to increase with additional insights regarding this intersection and supporting the diagnostic challenges in the future.

Key insights and findings regarding the intersection of gender dysphoria and autism spectrum disorder state that there is an overlap between the two conditions, and in some cases, the symptoms of one might exacerbate the presence of symptoms of the other. 

Some studies indicate an average of 10% of the general population of adults with autism spectrum disorder also present with gender dysphoria. There is a need for continued research and interdisciplinary collaboration to better understand and support individuals with these complex conditions.