Barriers and Facilitators to Autism Diagnosis for Transgender, Non-Binary, and Gender Diverse People

Abstract

Transgender, non-binary, and gender diverse (hereafter ‘trans’) people are eleven times more likely to be diagnosed with autism spectrum disorder (ASD) than the general population (Kallitsounaki & Williams, 2023). A study by Warrier et al. (2020) found that trans people are more likely than cisgender people to suspect that they might have undiagnosed autism. Using semi-structured interviews with five autistic and trans adults in Ontario, Canada, this exploratory study sought to identify some of the barriers and facilitators trans autistic people face in accessing an autism diagnosis. Using inductive and deductive content analysis, I identified the following themes from participant responses: masculine and feminine presentations of autism; informational and institutional erasure; masking; cost of assessment; clinician bias; hesitancy to disclose one’s trans identity; fear of being outed to one’s parents; and co-occurring diagnoses camouflaging autistic symptoms.