Common Intersection of Autism and Gender Diversity in Youth: Clinical Perspectives and Practices

John F Strang; Anna I R van der Miesen; Abigail L Fischbach; Milana Wolff; Marvel C Harris; Sascha E Klomp

doi:10.1016/j.chc.2023.06.001

Common Intersection of Autism and Gender Diversity in Youth: Clinical Perspectives and Practices

Child Adolesc Psychiatr Clin N Am. 2023 Oct;32(4):747-760. doi: 10.1016/j.chc.2023.06.001. Epub 2023 Jul 6.

Authors

John F Strang¹, Anna I R van der Miesen², Abigail L Fischbach³, Milana Wolff⁴, Marvel C Harris⁵, Sascha E Klomp⁶

Affiliations

¹ Gender and Autism Program, Division of Pediatric Neuropsychology, Children's National Hospital, 15245 Shady Grove Suite 350, Rockville, MD 20850, USA; Center for Neuroscience, Children's National Research Institute, Children's National Hospital, Washington, DC, USA; Department of Pediatrics, George Washington University School of Medicine, Washington, DC, USA; Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine, Washington, DC, USA. Electronic address: jstrang@childrensnational.org.
² Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, the Netherlands; Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
³ Gender and Autism Program, Division of Pediatric Neuropsychology, Children's National Hospital, 15245 Shady Grove Suite 350, Rockville, MD 20850, USA.
⁴ College of Engineering and Physical Sciences, University of Wyoming, Laramie, WY, USA.
⁵ Private Consultant, Hilversum, the Netherlands.
⁶ Private Consultant, Utrecht, the Netherlands.

PMID: 37739632
DOI: 10.1016/j.chc.2023.06.001

Abstract

Autism and gender diversity often intersect. Many transgender youth seeking gender-related medical interventions are autistic. Clinicians serving these youth lack an autism-specific evidence base to guide gender care decisions. At present, care decisions are based on extrapolation of care models from transgender youth samples, generally. At this point, there is no evidence to suggest that autistic youth are likely to experience shifts in gender or gender-related medical requests, although this has been insufficiently studied. In this article, cowritten by expert clinicians and autistic gender-diverse collaborators, an overview of clinical care considerations and the current evidence base is provided.

Keywords: Autism; Autistic; Gender diverse; Gender dysphoria; Gender incongruence; Neurodivergence; Nonbinary; Transgender.

Publication types

Review
Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Autistic Disorder* / epidemiology
Humans
Interpersonal Relations

Grants and funding

KL2 TR001877/TR/NCATS NIH HHS/United States