New York based psychotherapist Laura A. Jacobs, LCSW, and coauthors from New York University and private practice, conducted a study to explore the impact of autism spectrum disorders (ASD) characteristics on individual gender identity, expression, and the process of psychotherapy; as transgender and gender nonconforming people who fulfill diagnostic criteria for ASDs often present to mental health providers with concerns that are distinct from those without ASDs.
Past studies have shown that Gender Dysphoria (GD) and ASDs share etiologic mechanisms. Also, there is evidence that ASDs may be more common in transgender and gender nonconforming people.
AdvertisementThe authors presented two case studies of high-functioning individuals with diagnoses of ASD and GD diagnoses. They found that the limited ability to articulate an inner experience, deficits in Theory of Mind (ToM), along with the intolerance of ambiguity as a manifestation of the cognitive rigidity characteristic of ASDs, may present special difficulties to gender identity formation and consolidation and create challenges in providing psychotherapy to such individuals.
The authors concluded that ASDs do not preclude gender transition and that individuals with high-functioning ASDs are capable of making informed decisions regarding their medical care and life choices. The authors have also suggested possible challenges and techniques for assisting such clients in exploring their gender identities.
"While much has been written recently on the co-occurrence of GD and ASDs, few case histories or papers discussing treatment have been published to date, gaps that this article addresses," says Editor-in-Chief William Byne, MD, PhD, Icahn School of Medicine at Mount Sinai, New York, NY.