Transgender and autism spectrum disorder

Autism spectrum disorder (ASD) is characterized by difficulties in social communication and interaction, repetitive behaviour and specific interests. In transgender care, it has become evident that individuals with ASD are more likely to report transgender feelings than might be expected by chance. Prenatal exposure to testosterone, rigid thinking typical of ASD that leaves little room for being a female boy or a tomboyish girl, and an inherent feeling of being different that might be experienced as gender dysphoria, are among the hypotheses brought forward to explain this frequent cooccurrence. To date, no evidence supports any one of these hypotheses. Clinically, it is clear that a diagnosis of ASD does not rule out transgender feelings. Although eligibility assessment for gender affirming medical treatment might take more time and can be complex, individuals in the autistic spectrum should have access to this type of health care.