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.
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.
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
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.