The Truth About Autism and Transgender Identity

by Evan Urquhart

The Daily Caller seized on the fact that trans people are somewhat more likely to be autistic to discredit trans experiences and further inflate fears about gender affirming care.

An article about the connection between autism and transgender identity ran in the Daily Caller yesterday, mixing a kernel of truth (trans people are somewhat more likely to be autistic, and autistic people are more likely to be gender nonconforming or trans) with buck wild falsehoods that need to be seen to be believed. What seems to lie at the heart of this is a growing appetite on the right to justify a false belief: the belief that trans youth are not just more likely to be autistic, but that all of them are.

screenshot from the Daily Caller

Note, in the screenshot above, the Daily Caller’s claim that “as many as” 97.5 percent of patients at the GIDS clinic in the Tavistock had autism. This claim links to a paywalled article in the Daily Telegraph, whose first sentence reads “97.5 per cent of children seeking sex changes had autism, depression or other problems that might have explained their unhappiness” (emphasis mine). Combined with the quote from Susan Bradley, whose Canadian clinic for gender dysphoric youth was shut down amidst concerns it was practicing conversion therapy, it’s clear the Daily Caller is trying to move from the fact that there’s a somewhat higher rate of autism among gender dysphoric youth (thought to be in the neighborhood of 8 percent), to the absurd idea that all such youth are autistic, which would imply that gender dysphoria as distinct from autism in youth doesn’t exist.

While experts believe that the increased rate of autism among gender dysphoric youth is a real phenomenon, it’s not certain that that’s the case. As an Assigned reader pointed out on Twitter, gender dysphoric youth who present for treatment are heavily screened for any other co-occurring conditions, and autism is one that clinics are particularly alert to. That may mean youth are diagnosed with autism who would otherwise not have been diagnosed. However, the CDC estimates that 2.3 percent of 8 year olds qualify for an autism diagnosis, which is lower than what clinics who treat gender dysphoria seem to report.

In addition to suggesting that all gender dysphoric youth are autistic, the Daily Caller piece describes autistic people in deeply pathologizing terms. It uses phrases like “black and white thinking” and references to difficult peer interactions to suggest that autistic youth can’t tell the difference between being gender nonconforming and being a member of another gender, and that finding acceptance from the trans community after facing rejection from their peers is the motivation autistic people have for saying they’re trans. There is no evidence for any of this.

Although autism is a lifelong neurological difference, the Daily Caller also gives readers the impression that talk therapy is a useful or appropriate treatment for autism, relying on a description of the conversion therapy attempts at Bradley’s clinic as well quotes from a detransitioned woman, Chloe Cole, who now believes that talk therapy would have helped her more than gender affirming care.

screenshot from the Daily Caller

Of course, talk therapy doesn’t cure autism any more than it cures gender dysphoria, but you’d never know either of those things from the piece. The question of how to help autistic people thrive in a social context that is often hostile to their difference is a contested topic, but many people (including autistic people) stress accommodation and understanding of difference as the foundational insight needed to help members of this population thrive.

This was a theme I encountered when I first covered the topic of autism in trans people for Slate, back in 2018. At the time I spoke with an autistic transgender man who explained that many treatments for autism in children had an element of forcing conformity to gender norms.

screenshot from Slate Magazine

Ultimately, we don’t know why more trans people are autistic than expected. There could be a genetic link between gender dysphoria and autism, but it’s very possible that autistic people’s disinterest in following arbitrary social norms could lead more of them to be willing to express gender differences that other people hide. Either way, there is no reason to believe that autistic people’s gender dysphoria is less legitimate than other trans people’s gender dysphoria, that it would be helpful to autistic people to impose gender norms on them, or that transition is less effective in helping reduce symptoms like anxiety and depression in autistic trans youth compared to other youth.

The growing belief among those who oppose trans rights that all gender dysphoric youth are autistic is a bizarre bit of motivated reasoning by those who long to explain trans people away. Even on those terms, however, it falls short. If every single trans person was also autistic there’s still no logical reason why that would make gender affirming care less effective, or an alternative treatment like talk therapy more so. Right wing thinking on autism and transgender youth is dangerously confused, unconnected to the scientific research, and closely related to the eliminationist ideas of the far right. But, of course, that’s all par for the course.