Is There A Link?

Or is it because the dysphoria mimics many of the symptoms of ADHD or Autism? It is because therapists only look for the oblivious and don’t probe deeper?

A Disproportionate Number of Autistic Youth Are Transgender. Why?
Slate
By Evan Urquhart
March 21, 2018

Gender specialists first noticed decades ago that a large number of people who seek treatment for gender dysphoria also seemed to have autistic traits. Research on this phenomenon goes back to at least the 1990s, when the first case study of an autistic child with gender dysphoria (then called gender identity disorder) was published. As studies investigating the co-occurrence (or correlation) between gender dysphoria and autism spectrum disorder (ASD) have trickled in, there is a growing consensus in the medical community that the two do co-occur at disproportionate rates. This consensus is based on numerous studies reporting that gender-dysphoric youth are more likely to be autistic than would be expected based on autism rates in the general population. (This may also hold true for adults, although the research on adults is sparser.) This co-occurrence has implications for the treatment of both gender dysphoria and autism in young people, and hints at a connection between the biological causes of both transgender identity and ASD.

“We have enough evidence, across multiple studies internationally, to say that autism is more common in gender-diverse youth than in the general population,” said John Strang, a neuropsychologist and founder of the Gender and Autism Program at Children’s National Health System in Washington. Strang authored a 2014 analysis that found that more than 5 percent of autistic youth sampled for his study also displayed some level of desire to be the other gender, according to parental reports. (He cautioned that it’s too soon to say what the exact percentage in the overall population may be.) Another widely referenced study found that 7.8 percent of young people being treated for gender dysphoria at a clinic in Amsterdam had a confirmed diagnosis of ASD.

These studies seem to support the hypothesis that transgender identities are rooted in biology, especially when combined with other studies pointing to a strong heritable component of transgender identity. A biological basis for transgender identity is still highly contested, although the science has been pointing toward that explanation for several years. Researchers believe that autism itself is highly heritable, so a link between autism and gender identity could even provide some direction for researchers hunting for genes associated with transgender identity.

Two things, first we cannot get hung up on a biological component of gender dysphoria, there might be many other reason for GD besides biological causes. Also we cannot say that the two are linked; there are many autistic children who are not trans.

On the other hand, it’s possible that autism is overrepresented among trans youth because autistic people are less concerned with social norms and less likely to bow to social pressures that keep other trans people from coming out. Our ability to study gender dysphoria and diversity is limited by the fact that there are such strong social pressures, starting in early childhood, to conform to gendered expectations. There’s no way of knowing how many people hide their transgender identity, so we can’t know for sure whether studies of openly transgender people are representing the full picture at this time.

It can be as simple as asking questions about their gender identity.

One practical outcome of this research is that clinicians are recommending that autistic youth should be screened for gender dysphoria—and that clinics that work with gender-dysphoric youth should screen clients for autism as well. Young people who are found to have both need individualized, compassionate care, and they and their families also need to know that they are not alone. Strang cautioned that ASD should not be viewed as a negative for transgender people, because the ability to ignore social pressure can be very freeing for this group: “Autistic people may be more bold and individualistic, less swayed by social expectations. Some of the front-line leaders of the trans rights movement have been trans and autistic—and there’s a beautiful focus, for many of them, on being themselves and not bending to social expectations of what others expect them to be.”

The other thing we have to be aware of comorbidity.

We cannot block a child’s transition just because they’re autistic or if they have any other medical or mental illness. The governing factor should be can they make an informed consent to transition.

Update: 7:55 PM
The TransAdvocte reports that this article if flawed... Tomorrow post will look at her reserach.