by Dr Wesley Turner, Clinical Psychologist at Minds & Hearts
Helping adolescents with gender identity and autism is both important and challenging. The development of self-identity and gender identity can be a confusing time for most adolescents. This can be especially true for adolescents on the Autism Spectrum, as they are typically slower to develop self-concept than their neurotypical peers.
Psychologists helping clients with ASD explore their self-identity and gender may wish to be guided by some initial clinical guidelines. These guidelines have been developed for co-occurring Autism Spectrum Disorder and Gender Dysphoria in adolescents.
Briefly, the early-stage recommended steps include:
– Addressing and assessing the intensity of gender feelings/urgency throughout treatment;
– Determining whether Gender Dysphoria/Identity Issues are clear, pervasive and persistent over time;
– Determining whether Gender Dysphoria/Identity Issues increase or decrease with intervention;
– Providing psychoeducation about and exploring the possibility of a range of gender outcomes;
– Providing structure, as necessary, for gender exploration, and supporting the adolescent’s ability to explore gender transition; and
– Developing cognitive flexibility, social and self-awareness, executive function flexibility and big picture thinking skills, and communication skills.
Guiding and validating the adolescent’s gender exploration should allow for them to feel supported and free to explore their identity, whilst also affording psychologists and parents the opportunity to help develop the adolescent’s:
– Cognitive flexibility;
– Social awareness;
– Big picture thinking skills; and
– Communication skills.
Providing adolescents with ASD a supportive environment for self-identity and gender exploration should afford them the opportunity to slowly explore their identity in a way that minimises any potential risks to their mental and physical health. Non-judgementalism, compassion, understanding and education should greatly help adolescents develop into healthy adults, irrespective of identity.
Some example questions to help guide exploration in the area of gender identity and autism are provided below:
– One of the things I enjoy most about being a male/female is…
– My friends would say that I am…
– I act powerfully when…
– I define masculinity as…
– I define femininity as…
– What does it mean to be a man?
– What does it mean to be a woman?
– If I were a member of the opposite sex I would probably enjoy…
– As a male/female, I strongly challenge the expectation that I should…
– One of the most important things in my life is…
– What similarities and differences were there across your responses?
(Adapted from ‘Exploring Gender Identity’, NSW Department of Education. Sourced via https://cpb-ap-se2.wpmucdn.com/learning.schools.nsw.edu.au/dist/c/2/files/2014/11/Final-Exploring-gender-identity-1u322sd.pdf)
At Minds & Hearts we encourage individuals and parents to seek further, specific information and advice about gender identity and autism, by speaking to an appropriately trained professional. Strang, J. F., Meagher, H., Kenworthy, L., de Vries, Annelou L. C, Menvielle, E., Leibowitz, S., . . . Anthony, L. G. (2018). Initial clinical guidelines for co-occurring Autism Spectrum Disorder and Gender Dysphoria or incongruence in adolescents. Journal of Clinical Child & Adolescent Psychology, 47(1), 105-115. doi:10.1080/15374416.2016.1228462