On ASD, GID, and Jumping to Conclusions

May 1, 2018 by · Leave a Comment

On ASD, GID, and Jumping To Conclusions

by dannygenderphantom

            Since the first case studies conducted in the 1960s, the research confirming the correlation between the occurrence of ASD (Autism Spectrum Disorder) and gender dysphoria, previously known as Gender Identity Disorder, has been steadily increasing. The fact that the research is proving the correlation consistently is a good thing. As a trans* person on the autism spectrum, I do not see this data being put to beneficial use. The assumptions that everyone from mass media to well-established researchers are trying to pawn off on these figures are simply another way to invalidate trans* and autistic people’s self-knowledge.

Autism Spectrum Disorder is defined in the DSM-V as “persistent deficits in social communication and social interaction across multiple contexts” and “restricted, repetitive patterns of behavior, interests, or activities.” Although there are many ways in which the prior suspect behaviors can manifest in individuals with ASD, myself included, above are the two major criteria required for a diagnosis. In my experience, being autistic has gifted me with superior written communication and artistic ability, while stunting my executive function, social grace, and advanced motor planning.

The diagnosis requirements for gender dysphoria in the DSM-V are separate for adults/adolescents and children. In adults and teenagers, gender dysphoria is marked by “a difference between one’s experienced/expressed gender and assigned gender, and significant distress or problems functioning”, while in children a diagnosis is pinned down through a child’s marked preferences to be, present as, and play with other kids and toys designated as typical of their gender of choice. The behaviors and emotions involved in diagnosing gender dysphoria must persist in both adults and children for a minimum of six months. Whether a person needs to experience gender dysphoria to identify as trans* is a point of contention for many in and out of the community. I do not believe this to be the case and have not been diagnosed with dysphoria. I can, however, recall increased discomfort around other girls, uncharacteristic methods of play, and increased “male-typical” interests into adulthood.

A 2016 meta-analysis of studies pertaining to the occurrence of ASD and gender dysphoria published by the International Society for Sexual Medicine (ISSM) reviewed literature on the concurrence of ASD and gender dysphoria from 1966 to 2016 using four psychology article research databases and four full-text collections. Most of the studies that matched the ISSM’s criteria are case-control and cohort studies pertaining to children, with only 7 out of the 19 articles assessed pertaining to adults. The studies consistently find a correlation between children and adolescents who are diagnosed with gender dysphoria or ASD having concurring symptoms of the other condition when tested with approved measures for ASD or gender dysphoria. An article from Spectrum magazine notes that in a study carried out over five years at gender clinics around the globe, “between 8 and 10 percent of children seen at gender clinics” would “meet the diagnostic criteria for autism”, and “roughly 20 percent have autism traits such as impaired social and communication skills or intense focus and attention to detail”.

As a person who is both diagnosed with Autism Spectrum Disorder, specifically Asperger’s Syndrome, and who identifies as genderqueer under the trans* umbrella, I was glad that the correlation is at least consistently proving true. If there is some way that these findings can maximize the efficacy of treating the difficulties that come with being trans and autistic, in a world where no one wants to listen to the expertise of either group of people, then all the better for us, right? Except that the findings are instead being used for hacks, conservative media, and even respected researchers to come up with unproven and highly bizarre explanations for this correlation, and the public is not well-informed enough to reject them.

An emerging and frustrating theory emerging from conservative groups, a small group of researchers, and the parents of autistic children is typically some variation of the following: trans* children are simply autistic children who have fixated on gender, autistic children who don’t have the social capacity to understand that expressing themselves androgynously or as different genders is typically not accepted, autistic children will grow out of dysphoria over time, or autistic children simply believe that their “other”-ness or interests different from their peers must mean that they are not the gender corresponding to their sex. Katelyn Burns, a freelance writer and trans woman activist, summarizes my feelings on the matter best: “Claiming that trans people are really just going through a separate mental disorder that’s unrelated to gender is a convenient and purposeful way to invalidate both transness and those with ASD.” According to a Yale Biology and Medicine literature review, “it is known that an individual’s ability to distinguish one’s own gender generally occurs by age 3 in neurotypical individuals,” and “awareness of gendered toys, roles, appearances, and forms of play similarly begin between 2 and 2.5 years of age”, and that gender plasticity rigidizes with time. One of the researchers of the study that Yale is referencing, Dr. Annelou L. C. deVries, “suggest[s] that there is a need to determine whether gender dysphoria represents a general feeling of being ‘different’ or a ‘core’ cross-gender identity.”

Devoting time to differentiating from which parts of a person’s identity dysphoria emerges from could be useful, but the notion behind it is too in line with logic used in medical gatekeeping towards trans* and autistic individuals. The Yale article backtracks and says that the articles it discusses should not be used to install further walls between autistic trans* people and treatment, but that’s exactly how the information will be used. The number of hurdles that trans* people have to jump through to receive hormone therapy and/or surgery are numerous, and it all boils down to whether the person interviewing the individual believes their pleas and recommendation letters are sufficient for them to proceed. Adding on the organizational, social, and verbal communication difficulties that many autistic people experience, and the emerging understanding that their dysphoria is temporary or illegitimate, will lead to great suffering for my community.

It has always been easy for others to dismiss both the autistic and trans* community. For trans* individuals, the barriers to being believed emerge from medical gatekeeping, scholarly elitism and rejection of our claims, and anti-trans* political agendas limiting all but a few trans* voices from being heard and accepted. For the autistic community, when we can speak for ourselves, our minds tend to be discarded as too warped, to distorted from neurotypicality for even our most logical arguments in our own defense, for our own treatment, and against organizations that mean us harm.

What I’m seeing is a surgical attempt to try and sever where trans*ness ends and ASD begins, likely to ascertain whether an autistic person is trans* enough or vice versa to warrant requested treatment. These are the kinds of barriers put up in the past to ignore self-diagnosed autistic people, because they “do not have proof”, to question trans* people about painful topics for days to “make sure” that they are valid enough for surgery, or to prevent less socially impaired autistic people from seeking help because “they can talk and make friends”. I believe that concurrent trans* and autistic support is possible, and the ideal end goal towards understanding their overlaps. I hope future research can be conducted with the alternative aim of assisting us in living our best lives, as all that we are. Until I see such evidence, I will continue to express my concerns on the research.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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