Earlier today Steven Kapp shared this at the Spring Symposium of the University of Portsmouth’s Quality of Life, Health, and Well-Being Research Group. So, I thought I’d share it here too! (Especially as our full work is about to be published!)

“You’re asking permission to be yourself”: Autistic adults’ experiences of accessing gender identity healthcare
Harley Bruce, Katie Munday, Dr Steven Kapp

Gender diversity and autism:

• Autistic people and gender diverse people experience healthcare disparities
• Gender diverse people are more likely to be autistic or have ‘high autistic traits’
• No prior study, to our knowledge, has examined autistic adults’ access to gender identity healthcare (GIH)

Aims:

• Explore autistic transgender and/or non-binary adults’ experiences in accessing, or trying to access, GIH
• What worked well when accessing GIH, and what might need improvement?

Method:

• Online recruitment of 17 participants, trans men, trans women and non-binary adults (18+) who were either formally or self-diagnosed
• Semi-structured interviews of 15-135 minutes
• Reflexive thematic analysis with an inductive approach used to analyse data

Perceived lack of knowledge of autism:

• A doctor described medication and medical procedures in-depth but “after he found out I was autistic, he treated me like a toddler.”
• Later when seeking GIH with a friend present for support, the doctor asked the participant to “not butt in when I’m talking with your guardian.”
• When questioned as to why they were not addressing the participant about their healthcare needs, the doctor replied, “You’re autistic, do you not have a guardian?”
• (Sam, transgender and non-binary; 40, Germany)

Perceived lack of knowledge of non-binary identities:

• Professionals seemed to lack understanding of GIH needs of non-binary people, meaning participants had to hide their identity or constantly advocate for it
• One participant’s GIH was denied “because I’m autistic, and because I said that I was non-binary.” (Norah, non-binary; aged 23, Norway)
• Doctors “just don’t understand how gender is expansive and how these surgeries allow people to be expansive on their bodies, even if it doesn’t look like a binary body or have binary hormones [or] they don’t understand why I would still want breasts, according to them, but want to go on hormones.” (Riley, non-binary; aged 34, Canada)

Participant recommendations:

• Increase knowledge of gender identity healthcare needs
• Offering accommodations from the beginning of the process
• Having staff with experiential expertise of gender diversity and autism
• Training for staff on both gender identity and autism (including GPs who often know very little about the process)

[The above alt text is shared across six light blue slides. The text is large calibri font in black]