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Dean Beadle is an autistic conference speaker, writer and singer. He has delivered over 900 talks in seven countries and has sung at balls, festivals and conferences in the UK, Ireland and Denmark. He is gay and can often be found adorned in tassels and sequins.
OK, I know you must be thinking "what on earth can some bloke in his thirties tell me about being a teenager?" How can someone old enough to remember Woolworths, Wizardora and Wendy Richard tell you anything about being a teenager in 2022? And you'd be right. It has been a hot minute since I was a teenager, and I'd be the first to admit that I know precious little about growing up in today's world. BUT what I do know about is the process of making sense of your neurodivergence and your sexuality all at the same time. So, whilst we are from different generations, give me a chance, even if there's just one of the following five points that's useful in here, then it's worth giving this blog a go.
1. You are allowed to be who you are
Whether you are homosexual, heterosexual, bisexual, asexual, queer... there is no shame in whatever sexuality you are. Thankfully the world is more accepting of sexuality now than it used to be (although of course there's still lots of room for improvement). When I was growing up, we lived in a very binary world. The expectation was that you were either straight or gay (although of course being gay was still difficult due to it being a more homophobic time). Thankfully we now realise sexuality is a spectrum made up of tonnes of sexualities. However you identify is OK and you deserve to be accepted because of who you are not despite it.
2. The answers will develop over time
Us autistic folk are no fans of uncertainty. Of course you may want to have definite answers around who you are, and it can be hugely distressing to be processing questions that you don't have immediate answers to. But unfortunately sexuality and identity tends to be something we work out as we go along. It takes time to make sense of who you are. Sexuality is an ongoing process of understanding. You are allowed to evolve and grow in your own time.
3. There's no hurry
At the age of seventeen I wanted a boyfriend. Immediately. If I could have ordered one on Deliveroo I would have done, with a side order of happy ever after. And chips, of course. Always chips. At that time, I'd been having a tough time with my mental health and thought that securing myself a fella would be the magic wand that would solve everything. How wrong can you be? A relationship can be a life enhancing wonderful thing, but it was never going to magic away my mental health challenges. I was vulnerable and was at risk of rushing into something for all the wrong reasons. Dating can also be an unpredictable process. Will it work out? Will we end up in a relationship? Because of my autistic need for certainty, I'd try to skip through the process of getting to know the person and jump straight into a relationship. As a result, I ended up in short lived relationships with people who weren't the best fit for me (my record for the shortest was three days, which surely is some sort of world record??) What I am saying is, there is no hurry, you have all the time in the world to find someone should you be interested in a relationship. And when that time comes, take your time to make sure that whatever relationship you eventually get into is right for you and that you are with the right person. It's worth the wait in the long run. Equally, you may never want to be in a relationship, and that's a perfectly valid choice too.
4. S.E.X
Yep, I'm going to go there and make us all very uncomfortable for a few minutes. Sorry about that, but here comes the sex talk. There can feel like there is enormous pressure to have sex. We're often made to feel that it's compulsory part of growing up. But it's important to remember that sex is always optional. You don't ever have to have sex if you don't want to. (Oh and by the way, the 'sex' that is often depicted on adult websites does not remotely reflect what happens in real life, those are fantasy images that are heavily choreographed and scripted and do not reflect what sex is like in real life). OK, that's enough sex chat for now, I'm making myself cringe so heaven knows how you're feeling, but remember that everybody has the right to set their own boundaries around what they do and don't want to do with their bodies and have a right to have those boundaries respected.
5. Autistic Pride
As a pre-teen, I remember being obsessed with the concept of "normal". I distinctly remember comparing myself to my classmates and being sure that I was the odd one out. Over time I grew to realise that 'normal' is a harmful myth, and that all the things that made me 'stand out' were the things that made me who I am. I grew to celebrate being autistic. So, the last piece of advice I'd give you, is to say that you are fabulous because you are autistic and never despite it. There may be folk you'll encounter who will react to you negatively. Try not to internalise that. Their ignorance and lack of understanding is never your fault. That's on THEM. Over time, you'll find your people. People who understand and celebrate you because of who you are. Anyone who doesn't can get in the bin.

Being a teenager is a weird old time, but it's survivable and, it's not all bad. It's an unsettling time of change, but trust the process, have pride in who you are and surround yourself with people who value you and respect you. You're already wonderful just the way you are.

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Being an autistic teen navigating sexuality by Dean Beadle - Reachout ASC

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Dean Beadle is an autistic conference speaker, writer and singer. He has delivered over 900 talks in seven countries and has sung at balls, festivals and conferences in the UK, Ireland and Denmark. He is gay and can often be found adorned in tassels and sequins.

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Celebrating 10 years of Talk PANTS!

Pantosaurus has helped 1.5 million parents Talk PANTS and keep their children safe from sexual abuse.

Developed in consultation with children, parents, carers and teachers, Talk PANTS is here to help children understand their body belongs to them, and they should tell a safe adult they trust if anything makes them feel upset or worried.

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Our PANTS activity pack makes it easy to talk to your child about staying safe from harm. With a word search, dot-to-dot and maze game, you can help them learn without using any scary words.

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Rachel is the founder, owner, and principal animator of Blue Seat Studios. Rachel is a former researcher and an educator, having taught physiology, biology and math at both the high school and college level. She has a B.A. in Biology from Brown University and an M.Ed. in educational psychology. She is a lifelong artist who has worked in print illustration, design and graphic recording.

Through writing books and making videos, Rachel has found a way to combine her love of making art with her passion for distilling complex concepts and using humor to educate people of all ages.

She lives in Rhode Island with her children, dog, cat, snake, bunny and flock of chickens . When she's not animating, writing books, or feeding the horde, she might be kayaking out in the bay.

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Respect: Consent, Boundaries and Being in Charge of YOU

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Buy Respect: Consent, Boundaries and Being in Charge of YOU by Brian, Rachel (ISBN: 9781526362216) from Amazon's Book Store. Free UK delivery on eligible orders.

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By including chapters on gender diversity basics, neuroqueer trauma and how to support neuroqueer individuals, this book sets out strategies for creating more effective support that takes into account the unique experiences of trans people on the spectrum. Written by a therapist who identifies as neuroqueer, this book is the perfect companion for professionals who want to increase their knowledge of the experiences and needs of their trans autistic clients.

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Supporting Transgender Autistic Youth and Adults: A Guide for Professionals and Families

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Supporting Transgender Autistic Youth and Adults: A Guide for Professionals and Families eBook : Gratton, Finn V.: Amazon.co.uk: Books

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Written by an 'insider', an openly gay autistic adult, Wendy Lawson writes frankly and honestly about autism, sex and sexuality. In her new book, she draws upon her own experience to examine the implications of being autistic on relationships, sex and sexuality. Having discussed subjects such as basic sex education and autism, the author goes further to explore the wider issues of interpersonal relationships, same sex attraction, bisexuality and transgender issues. She also examines the unspoken rules that exist between people in relationships and explains why these rules can be difficult and confusing for people with autism. This book will give courage and information to adults with autism or Asperger Syndrome and provide essential insights to those living and working with them.

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Written by an 'insider', an openly gay autistic adult, Wendy Lawson writes frankly and honestly about autism, sex and sexuality. In her new book, she draws upon her own experience to examine the implications of being autistic on relationships, sex and sexuality. Having discussed subjects such as ...

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With helpful explanations, tips and activities, plus examples of famous trans and gender divergent people on the autism spectrum, this user-friendly guide will help you to navigate the world as an awesome autistic trans teen.

Covering a huge range of topics including coming out, masking, different gender identities, changing your name, common issues trans and gender divergent people face and ways to help overcome them, building a sense of pride and much, much more, it will empower you to value yourself and thrive exactly as you are.

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The Awesome Autistic Guide for Trans Teens

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The Awesome Autistic Guide for Trans Teens eBook : Purkis, Yenn, Rose, Sam, Masterman, Glynn: Amazon.co.uk: Kindle Store

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This book is going to change and save so many lives. It's a vital exploration into autism, gender and sexuality, and is easy to understand even as it tackles difficult topics. The intersectionality between autism and LGBTQIA+ identities has long been ignored, but Queerly Autistic not only bridges the gap but guides the reader through a world of new ideas and acceptance. A pleasure to read, and to be seen. One of the most important books in autistic literature. -- Poe Charlotte, author of 'How to Be Autistic'

Erin's no nonsense, clear & concise explanations of the many roads that lead us to self-discovery re: gender and sexuality is carefully crafted. For any young autistic (or otherwise) person questioning the many variables to working our where you 'sit' and how to recognise your 'fit' within queer society, this book is perfect! -- Dr. Wenn B. Lawson (PhD) CPsychol AFBPsS MAPS

Ekins has created an essential guide for autistic LGBTQIA+ teenagers, covering all aspects of identity, relationships and, crucially, safety. Informative and refreshingly honest, Queerly Autistic provides a definitive and clear framework for LGBTQIA+ autistic teens navigating the highs and lows of life. Every LGBTQIA+ autistic teen needs a copy of this on their shelf. -- - Lizzie Huxley-Jones, editor of Stim: An Autistic Anthology

"A well articulated and queerly presented book, written in an accessible way for people to enjoy and learn. Erin allows the reader to take their own path into understanding more about where their particular queerness and autism intersect. An important book, reminding us that our queer community is so wonderfully diverse and vibrant." -- - Fox Fisher, artist, author and film maker

"What a wonderful resource for people that exist on the intersection of being queer and autistic. It will undoubtedly help many people and affirm them, in a world that is constantly questioning them and their ability to make their own decisions. A brilliant book!" -- - Ugla Stefanía Kristjönudóttir Jónsdóttir (Owl), author and campaigner

As an autistic person who both got my autism diagnosis and came into my queerness later in life, it is hard to express the feeling of comfort there was in reading a book written for the confused queer autistic kid I was. It is also so important that Erin is an autistic author writing for autistic readers. This kind of knowledge exchange is so powerful and still far too rare. -- Kate Sauder, disability scholar and blogger

'Queerly Autistic - The Ultimate Guide for LGBTQIA+ Teens on the Spectrum' is such an important and much needed book. The clear, matter-of-fact way it deals with complex and sometimes difficult topics is so accessible and easy to understand, as are the suggested 'scripts', and signposting to further support. The repeated advice, using the same language for different topics, not only makes the book easy to dip into, but also makes the suggested guidance clear and easy to remember. For any LGBTQIA+ teen, and not only those who know they are autistic, this book could provide a life-line to understanding and making sense of their identity and crucially recognising they are not alone.
Erin shares her lived experiences of being 'queerly autistic' in a way that will no doubt support and resonate with so many autistic young people. She is clear that, for example, when discussing difficulties some autistic people have in identifying and describing emotions... "This doesn't mean that we aren't able to know or make decisions about our sexuality or our gender identity. Many of us simply need support and safety in order to properly understand ourselves and our feelings."
This book might be the starting point a person needs to begin to feel that support and validation. Anyone who cares for or has responsibility for teenagers, whether autistic or not, should read it and learn from it to be able to better offer further safe support and understanding.
Whether you are a queerly autistic young person, or someone who knows, loves or supports one, Erin's empowering closing words are the reason you should read this book: Be proudly autistic, be proudly queer, and be proudly you.

-- SEND Support (@SENDsupportuk) Disability Consultancy and Training --This text refers to the edition.

Erin Ekins is a queer autistic woman who runs the popular blog Queerly Autistic . She has appeared on the Victoria Derbyshire show, Radio 5 Live and the Channel 4 documentary 'Are You Autistic?' and presented at NAS conferences. She lives in Essex with her two mums, her brother and her two dogs, Thor and Odin. --This text refers to the edition.

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Queerly Autistic: The Ultimate Guide For LGBTQIA+ Teens On The Spectrum

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Queerly Autistic: The Ultimate Guide For LGBTQIA+ Teens On The Spectrum eBook : Ekins, Erin: Amazon.co.uk: Kindle Store

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Gender diversity is more common among children with autism spectrum disorders (ASD) than among their neurotypical peers, according to a new study. Previous research has shown that the rate of gender

Contemporary research on the intersection of autism, sexuality, and gender identity asserts that autistic individuals are more likely to identify as LGBTQIA+ than the neurotypical population. Similarly, the prevalence of autism is

Previous studies have shown that older adults with autism traits may experience notably increased difficulty with executive function and social cognition as they age. Learn about emerging brain

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"I think society has an expectation where you have to be male or female, or you can be somewhere in between . But they don't get that, actually, there are many genders and finding the one that is who you are can

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Abstract

Background:

This article addresses a gap in current research by considering perceptions of gender within autistic adults raised as girls.

Methods:

We report on an online focus group, in which 21 individuals who had been raised as girls discussed their gender identities. This discussion was part of a larger study, involving 43 participants from eight countries. We used an emancipatory approach wherein participants set their own agenda, thereby highlighting directly that gender identity was significant for them. The discussion was open for 2 weeks, after which the transcript was analyzed using Applied Thematic Analysis.

Results:

Participants reported not identifying with typical presentations of the female gender for a variety of reasons, linked both to autism and to sociocultural expectations. Participants described childhoods of being a tomboy or wanting to be a boy, having difficulties conforming to gender-based social expectations and powerful identifications with their personal interests.

Conclusions:

Consideration is given to the ways in which autistic individuals conform to, or resist, gendered roles, as well as the implications for identity formation within autistic individuals raised as girls. The innovative emancipatory design proved effective in giving voice to a group who have had little presence within the academic and medical communities and, through its use of online platforms, in engaging a large and internationally based participant sample. This article highlights both the importance of approaching autism from an intersectional perspective that takes greater account of context, and the unique contributions that autistic individuals can make to current understandings within autism research.

Lay Summary

Background:

This article tries to look at a new part of autism research. It reports on what autistic adults who were raised as girls say about their feelings in relation to their gender-whether they feel more like typical women, more like typical men, or feel differently to both.

Method:

The research used online discussion groups. Forty-three individuals who had been raised as girls chose to join the group and be part of the research. Participants from eight countries decided what they would talk about. This means that they chose the topic of gender identity as one that was important to them. We analyzed the comments that people made in the discussion about gender.

Results:

Most said that they did not feel like they were similar to typical women and they gave different reasons for this. Some thought it was because they were autistic and some thought it was to do with people around them putting pressure on them to be more "girly." Participants often said they had been tomboys or wanted to be a boy growing up and their personal interests were very important to them.

Conclusions:

The discussion looks at how autistic people are sometimes forced to act in certain ways to fit in, and how this can make them feel confused and depressed. The research design was led by the participants and this meant that a group who have rarely been asked their opinion were able to have a say. Because the research was all online, the participant group could be larger than usual and came from all over the world. This article shows that it is important to understand a person's environment, to really understand how autism affects them. It also shows that autistic people can give important information that helps others understand them better, and the only way to get this type of information is to ask autistic people.

Keywords: : autism, female, gender, emancipatory research

Introduction

Investment in research focusing on the autism spectrum has risen rapidly over the past two decades. However, the vast majority concentrates on early childhood.1,2 The need for more research that directly addresses the needs of autistic adults and explores their lived experience has been well identified.3,4 The existing research base also tends to focus upon males, so that support systems are, therefore, tailored toward the needs of males, despite growing evidence that the female experience is significantly different and in need of particular attention.5,6 The limited literature available suggests that autistic individuals, including autistic women, may be at higher risk of serious mental health issues and suicide7,8 and overall premature mortality rates.8,9 In addition, there is considerable evidence that within sexual minority and/or transgender groups, there is a higher incidence of suicidal behaviors.10,11 Thus, for autistic individuals experiencing atypical gender identity, there is a complex interplay of different and distinct challenges that may be compromising their mental health, but which have been largely overlooked. This article seeks to address this gap in our understanding, by reporting on a study that explored the lived experience of adults who were raised as girls and diagnosed with autism in adulthood, using an online methodology to engage them as active participants at all stages of the research. Within this article, we refer to our participants as adults raised as girls, in recognition of the diversity of gender identity represented here.

Gender expression and autistic individuals

The social presentation of the self can be a particular struggle for disabled individuals.12 For women, it has been noted that being disabled (particularly physically) can make it very difficult to identify with the desirable female image presented by the media.13 Autistic women may face similar, but also very different, kinds of struggle. Autism is often described as an "invisible" disability and has its own unique personal and social challenges.14 As Shelly15 has observed:

If gender is a social construct, then autistic people, who are less aware of social norms, are less likely to develop a typical gender identity. Autistic girls may not envisage themselves becoming wives and mothers when they grow up. If social constructs are made of symbols and representations, then autistic concreteness may lead to a less generalized, and more personal gender identity. Therefore, autism may redefine womanhood in a unique way.

Autistic gender is being discussed at length within autistic communities, which often describe atypical presentations of gender,16 whereas when discussed in academia, autistic gender expression is often pathologized and framed in traditional binary terms (masculine/feminine).17 The challenges autistic individuals face consist of a combination of a complex interplay between different aspects of their personal lives and identities.18 It is imperative, therefore, to investigate them in a meaningful way that takes this into account.

Emancipatory research

This project endeavored to follow the main principles of emancipatory research, an approach akin to participatory research, whereby participants are active stakeholders within all aspects of the research process.19 Throughout this study, participants were encouraged to be coresearchers, directing the research agenda, setting their own questions and commenting upon the analysis and findings. In this way, it was hoped that they would derive personal benefit from the research. We aimed not only to record and represent their experiences, but also through dissemination to initiate broader change for the benefit of the whole community.20 Emancipatory research has only recently and very sporadically been used in the field of autism research.21,22 The social and communication difficulties associated with autistic individuals have caused researchers to be cautious, perhaps overly so, about consulting them, despite evidence from autistic and nonautistic researchers that this can be done effectively.23,24 This relative absence of representation of autistic individuals deprives the research community of the insights of autistic people, and as Ne'eman has observed, have put autism behind other areas of disability self-advocacy.25

There are important benefits for research communities and participants alike in adopting an emancipatory research approach. Waltz26 has claimed that the accuracy of results is likely to improve by directly involving participants, because their insights can provide important information about their needs, priorities, and challenges, which may be overlooked by nondisabled researchers. Likewise, autistic researcher Milton27 has reflected on the production of knowledge in autism studies and the fact that it is largely based on interpretations from nonautistic researchers, neglecting the autistic perspective. Yet the insights of autistic participants are of the utmost importance, if research communities are to have access to their unique ways of thinking28 and reflect their priorities. An emancipatory approach was also deemed appropriate since this research was inspired by the personal experiences of the first author, who is autistic. The first author met most of the participants online, through her journey to awareness of her own challenges.

Methods

Participants

The entire study recruited 43 participants who were raised as girls from eight different countries (the United Kingdom, the United States, Canada, Norway, Germany, the Republic of South Africa, Australia, and New Zealand). Twenty-one of these participants took part in the discussion on gender identity that is the focus of this article. Ages ranged between 21 and 52 years. The first researcher originally made a post on a Facebook group for autistic women, which was dedicated to connecting autistic women with each other and discussing issues that are faced by them. The sample was self-selected and, using a snowball approach, participants could refer other appropriate contacts to the first author to be included in the research process.29 In the post made in that Facebook group, participants were asked whether they would be interested in participating in a research study exploring the experiences of autistic women that would be conducted by the first author as part of her M.Ed. dissertation. Participants were asked to join a new, "secret"* group to participate in the research. To fulfill inclusion criteria, participants had to have been raised as a girl, be over the age of 18 years, willing to participate online through Facebook, and self-identify as being autistic.

Approach

This research was conducted entirely online. Online research allows the application of different methodological approaches30 and can facilitate the anonymity and protection of the participants.31 In a study that included women of a sensitive population-surviving birth trauma32-online interviews were found to make participants feel heard and acknowledged, creating a sense of belonging through their connection with other women experiencing similar challenges and providing closure on some aspects of their past. It can provide access to populations not otherwise accessible,31 which was important in this case, where the target group is otherwise largely "hidden" and often isolated. Indeed, it enabled access to a multicultural, international, and diverse sample. It was also deemed appropriate as electronic communication is often cited by autistic adults as a preferred way to communicate,33,34 due to its relative simplicity and lack of social pressure. The study received formal ethical approval from the University where it was conducted. However, in keeping with its emancipatory philosophy, the negotiation of consent was treated as an ongoing consensual process rather than one event. Through the dialogues both during and after the data collection and analysis, participants had multiple opportunities to raise questions or concerns.

Data collection

We collected data through an online focus group discussion. The intention was to create an online environment similar to those where discussions of this type were already taking place (i.e., online groups for autistic adults), to encourage a naturalistic discussion to evolve inside this protected space. Table 1 illustrates how the data collection and analysis for the study as a whole was planned, to subvert the typical structure, whereby the researcher drives the research agenda and participants respond. Instead, the first author sought to position herself as enabler, with participants driving the agenda. After formally consenting to participate in the research, participants were invited to join an initial discussion ("stage 1") in which they were simply asked to describe the topics they would like to discuss during the research. Contributions were then analyzed and themed into five separate discussion topics ("stage 2"). In this way, discussion topics were decided upon by participants, rather than by the first author. Each discussion was open for 2 weeks, in turn, and the entire process of data collection (for the whole study) lasted ∼3 months. After the end of the research process, the participants had the opportunity to provide comments on the final draft of the dissertation ("stage 3"). In this article, we have focused only on the second discussion topic, which centered on personal identity ( Appendix 1).

Table 1.

Data task

Participant

First author

Stage 1:
Unstructured discussion on potential topics

Contributes ideas

Themes ideas into five most popular topics

Stage 2:
Five unstructured discussion topics, staggered for a 3-month period

Contributes to any or all topics by posting or "liking" posts

Analyzes data into themes and sends out to participants for comment

Stage 3:
Feedback on final dissertation

Provides commentary on final dissertation

Incorporates commentary into the final dissertation

Participation

The discussion developed freely over the agreed time period, deliberately following a relatively unstructured approach to prioritize the voice of the participants rather than the curiosity of the researcher.35 The first author took an observing role and did not participate in the discussions, other than to post the initial topic to open the discussion and to send reminders before it closed. No comments were made, and no clarification was sought. The intention throughout was to uphold emancipatory principles and not influence participants' contributions, consciously or unconsciously.

Participants could contribute in two ways: either by posting comments or by "liking" specific comments posted by others. Comments that had been "liked" were considered separately during the analysis as it seemed likely that some participants might prefer to "like" comments with which they agreed, rather than make a comment directly, and the "liking" of a comment was a reasonable indicator of support or agreement for the content. In practice, most participants chose to participate in both ways. Individuals within the group were identifiable by their comments, so participants were also given the option of sending a personal message or email to be posted anonymously by the researcher. One participant took this option on one occasion.

After analysis of the discussion data, the analysis itself was posted in the group area so that participants could read and comment ("stage 3"). Feedback was unanimously positive, and participants liked the clear and systematic presentation of the final product:

The main thing I noticed is how amazing is that you managed to get together all those statistics on how many people liked and commented and stayed silent in each thread, that just baffles my brain! (Ruth).

After the research project ended, the group continued because participants wanted to stay in touch and be informed about the progress of the project. The final draft of this publication was also shared in the same group. Participants agreed with the content and also noted their appreciation that something was coming from the project in which they had participated.

We analyzed the data using Applied Thematic Analysis, a phenomenological approach that focuses on representing participants' experiences and perceptions, as well as being systematic and transparent in its methods.36 We used NVivo 2010 for the coding process, which followed a close reading of the transcript. Data were coded freely in the first instance, before being grouped into themes according to frequency. Likes were considered separately rather than as part of core data, since these were open to misinterpretation. (Sometimes it was not clear which part of the post the "like" referred to, and sometimes was used as a means of showing support rather than necessarily agreement). Analysis was conducted primarily by the first author, with input from the study participants by the second author.

Results

During this 2-week discussion, 21 participants participated overall. Nineteen participants posted comments, of which 14 also "liked" other posts, and 2 "liked" other posts without commenting themselves. All the names included in this document are pseudonyms created to preserve the participants' anonymity.

Table 2 summarizes themes and participation relating to this discussion. These themes will now be considered in detail in two respects: first, in terms of how participants described expressing their gender as they were growing up, and second, the ways in which participants perceived their gender identity in relation to their experience of being autistic.

Table 2.

Themes

Mentioned by participants: (comments or specific likes)

Not relating to typical presentation/activities of the female gender

21

Fluid sense of gender/gender queer/identifying with both genders

9

Tomboy

8

Sense of identity revolving around interests or company

8

Enjoying both female and male activities

7

Wanting to be a boy growing up

7

Not identifying with either gender

7

Feeling more like a boy than a girl/transgender

1

Gender expression and gender identity

Notably, all participants in this discussion felt that they did not relate to the typical presentation and activities of the female gender. The majority reported having male interests or being "tomboys," "I grew up a tomboy...I played on a boy's baseball team for years, had mostly male friends, and as an adult have mostly held 'male' jobs, landscaping and construction. However, I have a more compassionate, 'feminine' temperament, and enjoy quiet activities like sewing and drawing (Liz)"

or wanting to be boys growing up,

I believed myself to be a boy and was mortified and sick when I start developing as a girl (Ruth).

A number of participants described occasionally enjoying activities that they considered to be typically female as well as activities they considered to be typically male:

I always had a pretty even split of "girl toys" and "boy toys"-baby dolls, Ninja Turtles, stuffed animals, Ghostbusters, stickers, dinosaurs, crafty stuff, Lego. (Kate).

Most participants reported having a fluid sense of gender, being gender-queer, or feeling male and female and seeing others in the same way. For example, Clare described:

Love & desire have more to do with the personality of the individual than gender does.

An absence of a sense of gender or being unsure of how their gender should "feel" was another common report:

As a child and even now, I don't 'feel' like a gender, I feel like myself and for the most part I am constantly trying to figure out what that means for me (Betty).

Many participants also described feeling agender or not identifying with a gender:

I don't feel like a particular gender I'm not even sure what a gender should feel like (Helen).

Only one participant reported themselves as being transgender:

I remember the first time I read about gender dysphoria in a psychology book I understood myself and gender. I am a man in a female body, [...] I have been a boy who has grown into a strong, gentle man (Mike).

Participants also noted that some of their experiences reflected prevalent attitudes when they were children. As Sally reflected:

Sometimes I wish I was born during today's times. Today is a different age, and so many differences are being accepted and embraced. Maybe there's much more hope in the future if things keep going that way.

Participants also described "masking" their autistic behaviors during childhood but tended to view this as something they resisted as adults.

I am even less likely to conform to anything now that I'm older. (Rachel)

These accounts, although very different, conveyed a common experience of individuals finding themselves unable to identify with the typical gender expectations within their environments, and their individual struggles to make sense of themselves against these.

The effect of being autistic on gender identity

Participants also discussed how discovering their autistic identity has helped them accepting themselves. Sally said:

Finding out that I am an individual with autism has helped me understand myself a lot. It explains why I've been so different and why I struggle with male/female roles and identity. It helps me to better accept myself. It doesn't solve the struggles, but it helps with my own personal acceptance.

Of particular note is the extent to which interests played a role in defining both gender identity and identity in general. Most participants within this study characterized their sense of identity as "fluid" and defined more from their interests:

My sense of identity is fluid, just as my sense of gender is fluid [...] The only constant identity that runs through my life as a thread is 'dancer.' This is more important to me than gender, name or any other identifying features... even more important than mother. I wouldn't admit that in the NT world as when I have, I have been corrected (after all Mother is supposed to be my primary identification, right?!) but I feel that I can admit that here. (Taylor)

Mine is Artist. Thank you, Taylor. (Jessie)

Participants also discussed ways in which the discovery of their autistic identity had helped them to accept themselves. Sally wrote: "I don't want to be male. Yet I don't share the female interests most women have. I don't fit either. I wish there was a neutral." (Sally)

Here, participants spoke passionately about areas of identification related to personal interests. Autism in this context served as an explanation for their personal outlooks, perceived to be at odds with typical nonautistic perspectives. These were accounts of more fluid identity constructions, less constrained by social expectations.

Discussion

To date, autism research has been largely male focused, understood to be a predominantly male condition. This has greatly and detrimentally affected the experiences of autistic women,37 and indeed any autistic individuals not conforming to the expected "type," such as queer† autistic people.38 Many have grown up not knowing they are autistic or have been repeatedly misdiagnosed. Within this study, we have endeavored to tackle existing gaps in the research by engaging directly with autistic adults who have been raised as girls.

Participants in this study provided powerful narratives describing feelings of alienation provoked by the pressure to conform to "gender-typical" and "neurotypical" expectations of them. Gender identity is traditionally perceived in terms of binary categories, which is not useful for those who do not conform to them.39 Recently, discourses on gender have included a wider range of gender identities that reflect more accurately the diversity of human experience, for example, agender, bigender, and transgender.40 Although mainstream acceptance of this diversity may still be problematic, there is at least a growing recognition of its existence. At the same time, societal expectations of women within Western cultures have gradually begun to allow a broader range of opportunities and interests.

Autistic individuals have described feeling pressure to "mask" their autism.14,41,42 They often do that by "performing" normative gender roles. In doing so, they are often adopting behaviors that are not instinctive to them and pretending to be someone they are not. For the participants of this project, this attempt to conform stopped as they grew older, but was a practice many of them adopted at a younger age and may have been part of the reason they were uncertain of their gender identity. This may also provide some explanation for the high occurrence of mental health problems in autistic individuals. Participants in this study articulated these challenges and their own efforts to navigate them, describing struggles that persisted over many years.

Autism is directly associated with difficulties in understanding social concepts and social rules. Much has been written about the tendency, deliberate or accidental, of autistic people to breach social conventions. Davidson and Tamas16 highlight that "doing" gender as socially expected can be incredibly draining for autistic individuals. Discovering their autistic identity might help autistic individuals process their gender identity as well.

There were also positive narratives describing "growing out" of the pressure to conform, and participants gave passionate accounts of the ways in which they identified with, and were supported by, the interests they chose to follow personally or professionally.

The connection between participants' interests and gender identity was an important and unexpected finding of this research. Participants' questioning of their gender identity often stemmed from their interests not conforming to those typically associated with femininity. According to Butler,43 "the body becomes its gender through a series of acts which are renewed, revised, and consolidated through time." In other words, participants found it difficult to see themselves as women because their acts, motivated by their interests, differed significantly from those of the majority of other women. Autistic individuals have been described as being monotropic in their pursuance of personal interests,44,45 which, in turn, can become a very important part of their identity. This is perhaps why being identified as autistic was described by the participants as helpful in understanding their difference. To return to Shelly's15 quote: "Autism may redefine womanhood in a unique way."

These findings have important implications for the sector, both for our understandings of autistic individuals and for our understandings of the barriers they face. On the one hand, the accounts here give an indication that gender identity is a significant issue for many autistic individuals as they grow up. Given the vulnerability to mental health difficulties and social exclusion for both autistic individuals and for individuals with nonbinary gender identities, we suggest that services within both sectors need to recognize this intersection. On the other hand, these accounts reinforce the importance of supporting and recognizing the personal interests of autistic individuals. Here, personal interests served not only as enjoyable pursuits and a potential means of success within employment. They also provided positive and consistent identities for the participants in this study, serving as an important anchoring point for them in their lives. Studies that have explored intersections between different marginalized identities have considered how the interplay between social identities might serve to shape a new, unique sense of identity not represented in the current discourses. The accounts in this study are significant in illustrating the ways in which autistic individuals both navigate and move beyond the constraints of their conferred identities (autistic/nonautistic; female/nonbinary) to inhabit new identities of their own making.46-48

Its findings also serve to provide an important reminder-autism does not exist in a vacuum-as a social disability, it is by definition socially situated. Attempts to understand the full range of autistic experiences need, therefore, to take account of the complex interplay of different factors within the individual, whether they relate to gender, race, culture, class, or anything else likely to influence personal identity.49 This research, in focusing upon two elements, could not avoid the neglect of others, but nevertheless has striven to provide a platform for some of the more marginalized autistic voices. More autistic-led, participatory, and emancipatory research is needed to increase our understanding of how best to break down the barriers that constrain opportunities for autistic individuals and to understand autism not as a biological deficit, but as a form of "neurological queerness."50

Within this study, we have endeavored to tackle existing gaps in the research by engaging directly with autistic adults using an emancipatory framework. However, every study contains limitations, and we recognize those inherent in the methods employed here. Our research participants were self-selected and by necessity had literacy skills and an interest in online communication. Generalizability of findings may, therefore, be limited. Nevertheless, the research represents the voices of a group who have often found themselves misrepresented and/or completely absent from academic discussions, and so, despite the limitations, it provides important new understandings and may well have broader relevance.

The data for this study were collected by the first author, endeavoring to comply with the principles of emancipatory research throughout. The initial conception of the project was influenced by the community from which the participants were recruited, and the first author was a part of the autism community before the beginning of the process. This was an important factor behind their motivation to participate and share sensitive areas of their lives, as many of them confirmed at various times.

Although the first author's personal gains from the process are undeniable, there is evidence that participants did perceive a personal benefit, as many of them disclosed to the first author that participation had been valuable for them. Participants commented that the study was an accurate and valuable representation of their voice and were enthusiastic to have its findings published. They also reported that participating in this project helped them communicate their experiences more easily to others outside of the study. Perhaps the most important message arising from the emancipatory approach is the freedom of expression it offered to its participants. Through this, notwithstanding the mentioned points, participants not only reflected upon these aspects of their identities, but also highlighted the need to go beyond them and see the "dancer" and the "artist." Just as autism research risks neglecting the experiences of autistic women, research such as this study, with its focus on "identities of disadvantage," potentially risks neglecting the individual experience. Our participants ensured that this did not happen, and instead offered empowering accounts of the development and expression of their different identities, negative and positive.

Acknowledgments

The authors of this article would like to thank the participants for being part of this study and for their valuable input on all its stages. We would also like to thank our reviewers for their very useful feedback. Finally, we would like to express our gratitude to Prof. Julie Allan for her useful comments on an earlier draft of this article.

Appendix 1

The discussions of this project were introduced as follows:

Hello all! This is the discussion timetable! I will post it here and you can also find it in the attachment! I will send this post as a link to everyone in the group, so that everybody is aware of the fact that we are starting! I will also start doing weekly alerts from next week, to remind you all of the subject we are talking about each week! So, without further ado, this is the timetable!

March 21-April 4: "Special interests and school experiences"

(comments leading up to that were: "'Power of special interests. I was such a geek at school, but it really helped when I was being bullied and such like,' 'Bullying,' 'Schooling and education, whether we coped or not and achieved or not,' 'Coordination and team sports,' 'What peoples' special interests were, might be interesting as girls and boys are supposedly different in their special interests. And were you ever able to share that interest with anyone?'")

April 4- April 18: "Personal identity (including sexual identity)"

(comments leading up to that were "Our awareness of our difference from others, the specific differences we were aware of as well as general feelings about it, how we processed that and made sense of it," "'Gender rules' and how much of androgyny with people with Asperger's might be hormonal, and how much might simply be choice of non-conformity", "Why people on the spectrum are less likely to conform to 'norms' of any kind," "A broader discussion of how often with young girls it is 'not understanding' of gender roles, and how much is conscious choice," "Development of a unique self-identity," "The effect of being autistic on self-identity," "Puberty, emerging sexuality and sexual identity," "Gender bending.")

April 23-May 7: "Misdiagnosis and co-morbids".

(comments leading up to that were "'Misdiagnosis,' 'Co-morbids (I have CAPD, prosopagnosia, and dyspraxia, for example),' 'Co- morbids, both psychological and medical,' 'At what kind of age group might we have benefited by knowing about Asperger's.'")

May 7-May 14: "Emotions, emotional regulation and sensory issues"

(comments leading up to that were "'Emotional regulation (or lack of),' Emotions," "Mental health," "Sensory issues leading to anxiety," "Childhood and stims," "Suicide," "Suicidal depression," "Blame/shame the victim," "Selective mutism," "Anxiety," "Fears as a child which ties into the anxiety," "Anxiety as a 'normal' state on the spectrum (i.e., not pathological)," "The experience of being overwhelmed-how did you experience it, were you able to explain what was going on or anticipate it?" "Communication and ability to communicate needs. That ties into emotional regulation and sensory overload.")

May 14-May 28: "Personal safety and relationships with others"

(comments leading up to that were "'Personal safety', 'The topic of personal safety is MOST important. The incidence of abuse on many different levels is likely to be prevalent,' 'Friendships and the form they took,' 'Friendships,' 'Expectations from adults (including in the eras prior to Asperger's being recognised)-including mistaken ideas as to *why* the child behaves as he/she does!'")

Those are some of the subjects suggested so far. Feel free to comment on these or add even more to each topic!

YOUR LIKES MATTER! If you don't feel comfortable posting (which of course you are all encouraged to do) please connect at the group from time to time to "like" other people's comments, because I am trying to get as much participation from you as possible! Thank you!

Footnotes

* A "secret" Facebook group is one that cannot be accessed or searched by anyone other than its members ( https://www.facebook.com/help/220336891328465?helpref=about_content).

† "Queer" is an umbrella term that is used to describe people who are not heterosexual and/or cisgender (do not identify with the gender they were assigned at birth).

Authorship Confirmation Statement

This article is based on the original Masters research of M.K., who was responsible for the research design, data collection, and analysis. As first author, she was responsible for leading the initial conceptualization and drafting of the article, plus subsequent conceptual development and editing. A.M. supervised the research and contributed to the research design and analysis. She helped to conceptualize the article, wrote some elements, and contributed to its conceptual development and editing. This article is submitted solely to this Journal and is not published, in press, or submitted elsewhere.

Author Disclosure Statement

No competing financial interests exist.

References

5. Pellicano E, Dinsmore A, Charman T. What should autism research focus upon? Community views and priorities from the United Kingdom. Autism. 2014;18(7):756-770. [[ PubMed] PMC free article] [ Google Scholar]

16. Davidson J, Tamas S. Autism and the ghost of gender. Emotion Space Soc. 2016;19:59-65. [ Google Scholar]

19. Stone E, Priestley M. Parasites, pawns and partners: Disability research and the role of non-disabled researchers. Br J Sociol. 1996:699-716. [[ PubMed] Google Scholar]

21. Milton DE, Bracher M. Autistics speak but are they heard? J BSA MedSoc Group. 2013;7:61-69. [ Google Scholar]

22. Nicolaidis C, Raymaker D, McDonald K, et al.. Collaboration strategies in non-traditional CBPR partnerships: Lessons from an academic-community partnership with autistic self-advocates. Prog Community Health Partnersh. 2011;5(2):143-150. [[ PubMed] PMC free article] [ Google Scholar]

42. Lai M-C, Lombardo MV, Ruigrok AN, et al.. Quantifying and exploring camouflaging in men and women with autism. Autism. 2017;21(6):690-702. [[ PubMed] PMC free article] [ Google Scholar]

Articles from Autism in Adulthood: Challenges and Management are provided here courtesy of Mary Ann Liebert, Inc.

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"I Don't Feel Like a Gender, I Feel Like Myself": Autistic Individuals Raised as Girls Exploring Gender Identity

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This article addresses a gap in current research by considering perceptions of gender within autistic adults raised as girls.We report on an online focus group, in which 21 individuals who had been raised as girls discussed their gender identities. This ...

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Sexuality - your sons and daughters with Intellectual Disabilities by Karin Schwier and Dave Hingsburger (written specially for parents and very readable. Whilst not referring to ASD directly most of the principles still apply)

"Me and Us" is a website dedicated to resources for teaching people with learning disabilities about sexuality with lots of onward links. It is no longer trading but a lot of information is still available through the website. www.me-and-us.co.uk

DVDs/Videos are available which provide a more visual way of presenting sex ed information:

Jason's Private World Video This video teaching pack is for use by males with learning difficulties in support of general sex-education. The video has strong emphasis on consent and how to both say 'no' and understand when someone else says 'no'. Also emphasised is the use of condoms for safer sex. Topics covered include: Growing up and the body changes from childhood to adulthood, self examination and privacy, masturbation and privacy, personal hygiene, bathing and privacy, sex, relationships, love and affection, consent, how to use condoms and where to get condoms and advice.

Kylie's Private World for females with special needs/learning disabilities to support sex-education. The DVD has strong emphasis on consent and how to say "no". First periods and sanitary protection and the use of condoms for safer sex also are explained.

You, Your Body & Sex ~ the DVD featuring all the content from Jason's Private World and Kylie's Private World with additional material arranged into easily accessible topics. Now with very clear English subtitles. lifesupportproductions.co.uk/order.php

Hand Made Love. A guide for teaching about male masturbation through video by Dave Hingsburger. Unlike many masturbation tapes, this one places the act of self pleasure in context. Steve, the narrator, discusses privacy, pleasure and the realities of sharing living spaces with others. He also talks about sex and desire. While setting the stage to demonstrate masturbation, he speaks in plain language that is fully respectful of the needs of the viewer. As the discussion becomes more private there are opportunities for the viewer to decide if they would like to continue watching or stop. The guidebook discusses masturbation from the point of health and pleasure. Dave writes about both systemic issues and the right of the individual to privacy. He uses examples to illustrate his points and suggests ways to build healthy environments for adults. The book also includes a consultation on masturbation for clinical staff. Suggestions are made as to how to use the video in teaching about such a private topic. Explicit. Aimed at adolescents and adults.

Finger Tips. Teaching women with disabilities about masturbation through video by Dave Hingsburger, Sandra Haar and a committee of 9 women. Sandra Haar, in the video, discusses the myths and misconceptions about masturbation and provides a clear "how to" demonstration. Using gentle encouragements and giving lots of opportunities for the viewer to work through the material, Sandra attempts to ensure that the viewing experience is both educational and therapeutic. The book helps place the whole subject of female masturbation into context of the lives of women with disabilities. The book challenges the reader to think about how society has dealt with female sexual pleasure. Throughout the book there are "reflection pauses" which encourage the reader to stop and think about a variety of issues that rise from the text. Liberally using humour the book is also a fun read, from the "Myth of the Mighty Sperm" to "The 12 steps of Female Arousal" the book covers a lot of ground. Explicit. Aimed at adolescents and adults.

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Autism, sexuality and relationships - Autism at Kingwood

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Sexuality - your sons and daughters with Intellectual Disabilities by Karin Schwier and Dave Hingsburger (written specially for parents and very readable. Whilst not referring to ASD directly most of the principles still apply) "Me and Us" is a website dedicated to resources for teaching people with learning disabilities about sexuality with lots of onward links.

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The Gender Unicorn | Pop'n'Olly | Olly Pike

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On Friday, Janelle Monáe came out as non-binary, retweeting a post which read: "There is absolutely nothing better than living outside the gender binary."

Monáe's tweet came after the recent announcement of Sam Smith, who recently said they felt " just as much a woman as I am man". Both celebrities joined the increasing number of young people who identify neither as male or female.

Non-binary people tend to prefer using they/them pronouns (although not exclusively - some use she and he interchangeably). If gender neutral pronouns intimidate you, you're not the only one. As someone who is new to using them (a number of my friends have recently started to identify as non-binary), I confess it can be intimidating when you want to respect someone's wishes without making any blunders.

Putting someone's dignity before my shyness about how to use a pronoun is, of course, the bare minimum. But I admit to having made mistakes - even avoiding using pronouns in the past, for fear of getting it wrong.

It really isn't that hard, however, to get it right.

Who uses they/them pronouns, and why?

More and more people are using gender-neutral pronouns. In 2015, of 4,000 students at Harvard who had submitted preferred pronouns, around 1% chose pronouns other than "he" or "she". Last year, Merriam-Webster made the singular gender-neutral use of "they" its word of the year, based on the fact that it had seen a 313% increase in searches for its definition that year.

Reasons for choosing gender neutral pronouns are complex and personal. Some people do it because they don't feel they fit into a gender. For others, it's a form of protest: they contest rigid gender expectations and would rather live without them. Being gender non-conforming, right down to their pronouns, is how they choose to identify.

So please, if you learn someone uses they/them pronouns, don't respond: "We get it OK - she's gay!" - as my friend's parents recently did.

Why they/them?

It is normal in the English language to use they/them pronouns when we don't know the gender of the person to which we're referring, or if we want our sentence to be applicable to all genders.

This isn't new - the saying "Everybody loves their own mother" has been used since around late 1300. Both Jane Austen and Geoffrey Chaucer - who died in 1400 - used pronouns that way.

But what about the plural?

While it is no longer grammatically incorrect to use they/them as singular anymore, people still get confused about it. A friend's parent recently responded to their pronouns, saying: "But if I tell Shelly you're coming round for dinner, she'll think you're bringing extra people!"

Try this: if you are using the pronoun in a scenario where there is no confusion over singular versus plural, just go ahead and use it ("You are going to meet my friend Poppy today, I hope you like them").

If you are using it in an instance where it might be misconstrued as plural, you can change the first part of the sentence to make it clear ("I may bring a friend, their name is Poppy").

If you still feel that is confusing, you can be explicit ("I asked Poppy - who uses they/them pronouns - they might come"). This also takes the onus off your non-binary friend for having to explain it themselves later.

What to avoid

Avoid assuming every person's gender. Feel free to ask people when you meet them what pronouns they use. Feel free to put your own pronouns in your email signature, or to introduce people using your pronouns (this can take the focus off non-binary people having to do all the work).

What to embrace

Embrace doing your own research on pronouns, without expecting non-binary people to educate you. Encourage open dialogue, which means being open about your own shortcomings or fears, when relevant. Ensure this is a means to steer conversation forward ("Hey, did I get that right just then?") not back ("Well actually this is pretty scary for me, so you shouldn't correct me").

What if I get pushback?

People may use your respect for another's pronouns as a means to argue with you about the broader political context around gender and/or LGBTQ rights. But you don't need to be needlessly drawn into an argument unless that's where you want to go. Briefly explain why you are doing it, and if the challenge escalates, consider shutting down the conflict ("It's my choice to respect their wishes"; or even the more direct "I don't want to argue about this").

What if I make a mistake?

When you make a mistake, apologize, be gracious, and move on. Generally people aren't out to get you. Don't get too hung up: my experience is that people know getting it wrong is part of the process and are forgiving if they feel you are trying your best.

Sometimes you can check that you said the right thing first, rather than getting caught up in your head ("Hey, when I said that, was it offensive?'). Above all, recognize mistakes happen and apologies are OK, but don't mistake them for real work. Saying sorry a handful of times might be fine, but if you're misgendering someone over and over again you might want to think about why, and do better.

You'll be OK

Exposure is key. Keep using they/them, and soon it will feel normal. That's the aim.
Topics

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So your friend came out as non-binary: here's how to use pronouns they/them

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On Friday, Janelle Monáe came out as non-binary, retweeting a post which read: "There is absolutely nothing better than living outside the gender binary." Monáe's tweet came after the recent announcement of Sam Smith, who recently said they felt " just as much a woman as I am man".

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People who do not identify with the sex they were assigned at birth are three to six times as likely to be autistic as cisgender people are, according to the largest study yet to examine the connection. Gender-diverse people are also more likely to report autism traits and to suspect they have undiagnosed autism.

Researchers often use 'gender diverse' as an umbrella term to describe people whose gender identities - such as transgender, nonbinary or gender-queer - differ from the sex they were assigned at birth. Cisgender, or cis, refers to people whose gender identity and assigned sex match.

The results come from an analysis of five unrelated databases that all include information about autism, mental health and gender.

"All these findings across different datasets tend to tell a similar story," says study investigator Varun Warrier, research associate at the University of Cambridge in the United Kingdom.

Autistic people are more likely than neurotypical people to be gender diverse, several studies show, and gender-diverse people are more likely to have autism than are cisgender people.

But most previous studies have probed the relationship among people who sought gender-related medical care - often for gender dysphoria, a condition in which the 'mismatch' between gender identity and sex assigned at birth causes significant distress. That cohort doesn't represent the full scope of gender-diverse people, says Aron Janssen, associate professor of psychiatry and behavioral sciences at Northwestern University in Chicago, Illinois, who was not involved in the work.

"It's so vital to understand this question outside of the clinical context," Janssen says. "A more naturalistic study with this many participants outside of a clinical context really does provide a lot of support for this overlap."

Gender and autism:

The five datasets together include 641,860 people, mostly adults; 30,892 have autism and 3,777 identify as gender diverse. The majority of the data - from about 514,000 people - came from an online survey conducted as part of a 2017 British television documentary about autism. ( Simon Baron-Cohen, professor of developmental psychopathology at the University of Cambridge and the new study's lead investigator, led the collection of those data.)

Three of the other datasets also used online questionnaires. The fifth came from a population study that collected information through primary care providers and included an optional online survey about autism traits. All of the studies included a question about autism diagnosis and asked for supplementary information, such as a participant's age at diagnosis. One asked for a copy of medical records to confirm the diagnosis.

The surveys also gave different options for sex and gender: One included the terms 'nonbinary' and 'other,' for example, and another used variations on sentences such as "At birth I was registered as female, but I am male."

About 30,000, or 5 percent, of the cisgender people in the study have autism, the researchers found, whereas 895, or 24 percent, of the gender-diverse people do.

Gender-diverse people also report, on average, more traits associated with autism, such as sensory difficulties, pattern-recognition skills and lower rates of empathy - or accurately understanding and responding to another person's emotional state. And they are five times as likely to suspect they have undiagnosed autism as cis people are, based on one dataset of 1,803 people whose survey included this question.

The findings were published in Nature Communications in August.

The researchers also explored the relationship between gender identity and six mental health conditions, including schizophrenia, depression and attention deficit hyperactivity disorder (ADHD). Many of these conditions co-occur with autism, and it has been unclear whether autism's association with gender diversity is unique among these conditions, Warrier says.

Gender-diverse people have higher rates of all six conditions than cisgender people do, according to the new study. The association was highest for autism and depression.

Clinical implications:

The study reinforces trends seen in smaller studies, says Jeroen Dewinter, senior researcher at Tilburg University in the Netherlands, who was not involved in the research.

"They did a really great job in confirming earlier findings in a really careful way," Dewinter says.

It also indicates a need for clinicians and educators to talk with autistic people about gender identity, Dewinter says, and to be aware of potential mental health impacts that can result from 'minority stress' - or the difficulties associated with being part of a marginalized group. Being both autistic and gender diverse can intensify such stress.

"Clinicians and practitioners in both fields - autism and gender identity - need to be aware of this association, and to factor it into how best to support the person's mental health," Baron-Cohen says.

Nearly 70 percent of autistic gender-diverse adolescents say they need medical gender-related care, according to a small 2018 study, and 32 percent say their gender identity has been questioned because of their autism diagnosis.

"It's really, really distressing to read sometimes, where you have people who have very strong gender dysphoria and want to transition, and their therapist says, 'Well, we need to first cure your autism before we transition,' which is wrong on all levels," Warrier says. "We want this study to really demonstrate that both of these things can co-occur, and just because these things co-occur does not mean that one should be denied."

The findings also suggest that researchers should investigate how autism presents in gender-diverse people, Warrier adds. Researchers have often missed autism in cisgender girls because they tend to show different traits than cisgender boys do, and the same may be true for gender-diverse people.

Further research should move beyond quantifying the relationship between autism and gender, Janssen says, and focus instead on investigating the research priorities and clinical needs of autistic gender-diverse people, as well as underlying causes of the overlap.

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Largest study to date confirms overlap between autism and gender diversity

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People who do not identify with the sex they were assigned at birth are three to six times as likely to be autistic as cisgender people are, according to the largest study yet to examine the connection. Gender-diverse people are also more likely to report autism traits and to suspect they have undiagnosed autism.

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Sexual Orientation, Gender Identity, and Autism Spectrum Disorder

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Resources and podcast aimed at autistic YP 15+ learning about puberty, sex, online safety

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Resources and podcast aimed at autistic YP 15+ learning about puberty, sex, online safety

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Welcome to Sex Ed for Self-Advocates This guide is a sexuality and sex education resource written specifically for autistic people age 15 and up. Autistic people sometimes don’t have the chance to learn about sexuality and sex in ways that work for them, so OAR created this guide as a starting point…

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Guidance on Gender pronouns updated 2019

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Gender, like autism, exists on a spectrum. In the 1990s, as growing numbers of children sought care related to their gender identity, clinicians and researchers began to notice a trend: An unexpected number of these children were autistic or had autism traits. The observation has spurred researchers to work to quantify the association.

The field is beginning to get a clear picture of the extent to which the two spectrums overlap: Gender identity and sexuality are more varied among autistic people than in the general population, and autism is more common among people who do not identify as their assigned sex than it is in the population at large - three to six times as common, according to an August study. Researchers are also making gains on how best to support autistic people who identify outside conventional genders.

Here we explain what scientists and clinicians know - and don't know - about gender and sexuality in autistic people.

What is gender identity?
Gender identity is a person's internal sense of their own gender. People who identify as the sex they were assigned at birth are called 'cisgender,' or cis, whereas those who do not may use terms such as transgender, nonbinary or gender fluid. Researchers often use the phrase 'gender diverse' as an umbrella term for different gender identities, similar to the way some people use 'neurodiverse' to describe variations in cognitive style, including autism and attention deficit hyperactivity disorder.

How common is gender diversity among autistic people?
Many studies have examined the prevalence of gender diversity among autistic people. One of the most frequently cited studies found that about 15 percent of autistic adults in the Netherlands identify as trans or nonbinary; the percentage is higher among people assigned female at birth than among people assigned male, a trend seen in other studies. By contrast, less than 5 percent of adults in the Netherlands' general population have an identity other than cisgender. And in a 2018 study in the United States, 6.5 percent of autistic adolescents and 11.4 percent of autistic adults said they wished to be the gender opposite of what they had been assigned at birth, compared with just 3 to 5 percent of the general population. This study also found that, on two measures of autism traits, higher scores were associated with a higher likelihood of gender diversity. A 2019 study found a similar association in children who are not diagnosed with autism.

Similarly, autism appears to be more prevalent among gender-diverse people than it is in the general population. A 2018 Australian survey of transgender adolescents and young adults found that 22.5 percent had been diagnosed with autism, compared with 2.5 percent of all Australians. Some experts estimate that 6 to 25.5 percent of gender-diverse people are autistic.

Sexuality also appears to be more varied among people with autism than among those who do not have the condition. Only 30 percent of autistic people in a 2018 study identified as heterosexual, compared with 70 percent of neurotypical participants. And although half of 247 autistic women in a 2020 study identified as cisgender, just 8 percent reported being exclusively heterosexual.

Why is the prevalence of gender diversity higher in autistic people than in the general populationSocial experiences are likely a main component, experts say. Compared with neurotypical people, autistic people may be less influenced by social norms and so may present their internal selves more authentically. "You could then understand the co-occurrence as perhaps a more honest expression of underlying experiences," says John Strang, director of the Gender and Autism Program at Children's National Hospital in Washington, D.C.

It's possible that autistic people may come to conclusions about their sexual identity differently than neurotypical people do, says Jeroen Dewinter, senior researcher at Tilburg University in the Netherlands. Some autistic people have told him they would be likely to identify as bisexual after one same-sex sexual experience, but neurotypical people may be less likely to adopt that terminology based on a single same-sex encounter.

Biological factors may also play a role. Exposure levels to hormones such as testosterone in the womb may be linked to autism, some research shows; increased prenatal testosterone may also lead to more typically 'male' behaviors and to less common sexualities and gender identities, although there is some evidence against that link. Regardless, prenatal testosterone does not explain why autistic people assigned male at birth might identify as more feminine, Dewinter says. But the biology of sexuality and gender in the general population is not well understood either.

Experts say it's likely that a combination of these and other factors contribute to the increased variety of gender identities and sexualities among autistic people.

What does this mean for clinicians and caregivers?
Clinicians who work in gender clinics may want to screen for autism, and those working in autism clinics may want to discuss gender identity and sexual health, researchers say. They should also be sensitive to different information processing styles, Dewinter says. Some autistic people may struggle to express their feelings regarding gender. Even when they do express these feelings, they often face doubts from clinicians because of stereotypes about autistic people, which can block their access to medical care. In a 2019 paper, one autistic and gender-diverse person wrote, "The combination is seen to be too complex for the majority of clinicians, which led to long waiting times for specialized psychiatric care".

Screening tools may also need to be updated to better identify autism among gender-diverse children, just as they need to be adjusted to spot the condition among girls. "Clinics are working to understand what autism looks like in girls and women, and we're going to have to take that same question with the gender-diverse youth," Strang says. Identifying autistic children who may need support in affirming their identity is particularly important because some may seek medical interventions, such as puberty blockers, that are time-sensitive, he says.

Clinicians should be aware that autistic people may present their gender identity differently than neurotypical people do. Some autistic people who transition from one gender to another are not aware of how they also need to change their social cues, such as how they dress, if they want to clearly communicate their gender identity to others. Clinicians can help autistic people navigate these transitions and ensure they have the same access to gender-affirming medical care that neurotypical people have, says Aron Janssen, associate professor of psychiatry and behavioral sciences at Northwestern University in Chicago, Illinois.

How do autistic people best learn about gender and sexuality?
For years, many parents and caregivers believed that autistic people, particularly those with intellectual disability, shouldn't be given information about sexuality and are less interested in relationships than neurotypical people are, Dewinter says. That belief is changing as researchers recognize that providing relationship support is important to ensure the overall well-being of neurodiverse people, just as it is for neurotypical people. Belonging to any kind of minority group makes a person more susceptible to mental health problems, because of a phenomenon known as 'minority stress.' For a person who is both neuro- and gender-diverse, belonging to several minority groups can intensify those problems.

More comprehensive and inclusive sex education can help. In ongoing surveys, Eileen Crehan, assistant professor of child study and human development at Tufts University in Medford, Massachusetts, has found that autistic people want information about sexual orientation and gender identity more than typical people do. Research has shown that lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) adolescents who have more inclusive sex education in school have better mental health. But only 19 percent of U.S. sex-education materials are LGBTQ+ inclusive, according to the advocacy group GLSEN, creating an extra barrier for autistic LGBTQ+ people. "You have two hoops to jump through to get the information that you need," Crehan says.

Where is the research going next?
Early research focused on measuring the prevalence of diverse gender identities in the autism community - and vice versa - but now researchers are increasingly turning to questions about how best to support autistic people who are gender-diverse. To do that, they're working closely with the autistic community, ensuring autistic people guide research priorities. "I really think it's incredibly important to lift up the voices in the community themselves, and I'm grateful to see that's where the field is going," Janssen says.

Cite this article: https://doi.org/10.53053/YBTA7630

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Gender and sexuality in autism, explained | Spectrum | Autism Research News

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Gender, like autism, exists on a spectrum. In the 1990s, as growing numbers of children sought care related to their gender identity, clinicians and researchers began to notice a trend: An unexpected number of these children were autistic or had autism traits. The observation has spurred researchers to work to quantify the association.

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Pronouns are the most common way that people refer to one another outside of using proper names. While you may be inclined to choose someone's pronouns for them, assuming you know how another person wants to be addressed can be a faulty proposition. It can also be a cause of unintentional harm.

Everyone has the right to decide what pronouns they go by, and it's everyone else's responsibility to use those pronouns correctly. We all want, and deserve, to feel seen. Using correct pronouns is an easy way to validate others. Let's examine what pronouns exist to ensure you're familiar with the range of them, then discuss why it's so important that everyone uses correct pronouns.

Commonly Used Third Person Pronouns

Pronouns may convey gender, but they also can be entirely separate from gender. There are some pronouns that clearly denote gender, and others that do not. Both of these pronoun types are used by other people in the third person.

Note, the first person use of pronouns includes:

The second person usage of pronouns is

Why The Word "Preferred" Doesn't Apply to Pronouns

If you've looked into the subject of pronoun use in the past, you may have encountered the word "preferred" as a prefix to pronouns, as in the question "What are your preferred pronouns?"

However, it's best that this word is avoided when discussing pronouns. Preferences tend to indicate that one is choosing something, whereas identity is not a choice. "What are your pronouns?" is the appropriate question to ask others, and, "My pronouns are..." is the safest way to share your own.

She/Her/Hers/Herself

The usage of she/her pronouns is commonly associated with women. However, a person may choose to use she/her pronouns even if their gender is not female. If a person's pronouns are she/her, you would refer to them in ways such as, "She left her book on the counter," or, "She went to her house herself."

He/Him/His/Himself

The usage of he/him pronouns is commonly associated with men. Similar to how it shouldn't be assumed that someone who uses she/her pronouns is a woman, a person may use he/him pronouns without being a man. To use he/him pronouns, sentences about that person would sound like, "He left his book on the counter," or, "He went to his house himself."

They/Them/Theirs/Themself

There's a misconception that the usage of they/them personal pronouns is new, or that it is grammatically incorrect to refer to a singular human as they. Both of these notions are false.

Historically, they/them has been used in situations where a person's gender is unknown, as in, "Someone left their hat, do you think they need it?" Usage of they/them pronouns in the personal setting would be, "They left their book on the counter," or, "They went to their house themself."

Neopronouns

Neopronouns are a category of pronoun that specifically don't connotate any gender, and that also don't have the historical plural usage of they/them. The usage of pronouns that do not denote gender is a growing movement. Some people, like this person, dedicate their social media accounts to helping others learn pronoun usage, including neopronouns.

Neopronouns include: ze/zir/zirself, ei/em/eir/eirself, and ne/nir/nemself. You would use these pronouns exactly as you would others. For example, for the pronouns ei/em, you'd say, "Ei left eir book on the counter," or, "Ei went to eir house eirself."

What Correct Pronoun Use Accomplishes

When we ask others what pronouns they use and then we honor them in conversation, we are conveying respect. We are also conveying inclusivity. For people who are not cisgender, this is particularly important.

If you are a cisgender person, you likely have not ever experienced the stress of not being perceived as the gender you are. But for anyone who is not cisgender, this is an all too common occurrence.

Often, non-cis people are victims of violence because of their genders. That means that even though pronouns aren't necessarily an important topic to cis people, to non-cis people it is a topic that heavily impacts their lives, and the usage of incorrect pronouns is yet one more act of violence against them.

We have a long way to go as a society to make non-cis people feel as safe moving through life as cis people feel. Using the correct pronouns for trans, gender nonconforming, nonbinary, and gender fluid people is the easiest first step in this direction that cis people can take. The act of using correct pronouns serves to show others that you see them for who they are, and creates safety for them.

The Harm Of Incorrect Pronoun Use

You would never choose a derogatory nickname for a person and decide to call them that instead of the name they told you was theirs. Doing that would be incredibly mean, as well as wholly outside the scope of acceptable social behavior.

You refer to people by the names they go by because everyone deserves that common decency. In that same vein, it's equally unacceptable to call someone by a different pronoun than the one(s) they use.

Pronouns are identifiers just like names. If you don't think a person's name suits them, you wouldn't say so, because it would be considered very rude.

While it may seem like a small matter to you, using the wrong pronouns for a person can be detrimental for their mental and emotional wellness. A person who has been misgendered is invalidated and alienated from others. Additionally, incorrect pronoun use can increase that person's dysphoria, further complicating and even potentially harming their relationship with their body.

What to Do If You Misgender Someone

Collaborate Consulting uses an acronym to help people remember how to respond in a situation where they have accidentally used incorrect pronouns and/or misgendered someone. If you have made a mistake about a person's pronouns, employ the A.C.M. method:

Apologize Briefly

The first step to take when you have referred to someone by the wrong pronoun is to acknowledge it. Doing so makes it clear that you understand you've made a mistake. However, once you have apologized briefly you should immediately head to the next step.

Spending time wallowing in your mistake, expressing that the correct pronoun usage is difficult for you, and/or continuing on in any way that shifts the emotional labor onto the other person isn't helpful. Your mistake is yours, so don't make anyone else have to do any work around it.

Additionally, if someone has pointed out your mistake, it's a good idea to thank them for doing that. Informing others of their mistakes is hard, especially when that mistake is about personal identity. The act of thanking someone for pointing out your error acknowledges that they put in that work for you.

Once you've acknowledged your error, immediately use the correct pronoun. This step is also very quick, and nothing further is needed other than the correction. An example of how to express it is, "Her pronouns are she/her. She went to the bank."

Lastly, but just as importantly as the previous steps, once you have apologized and corrected the situation, you can move on from it right away. There's no discussion or processing about the issue needed. Just continue with the conversation right where it left off, and let everyone digest what happened without further commentary.

How to Be Better at Using Correct Pronouns

The main complaint about pronoun usage, especially in relation to people who use they/them pronouns or neopronouns, is that it feels hard to use anything except she or he when talking about others. Most of us were taught only those pronouns when we learned English, and then weren't taught anything further on the topic.

Like any new skill, within a short amount of time you'll have made some progress. Eventually it will be second nature for you and won't feel difficult at all. Mastering correct pronoun usage is a great first step to understanding more about gender identity.

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Pronouns are the most common way that people refer to one another outside of using proper names. While you may be inclined to choose someone's pronouns for them, assuming you know how another person wants to be addressed can be a faulty proposition. It can also be a cause of unintentional harm.

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This resource provides an introduction to what misgendering looks like in practice, and how to respond when you are witness to it.

Need an introduction to pronouns first? Our introductory resource on pronouns looks at what pronouns are and how to use them, how to ask about someone's pronouns, how to share and normalise the sharing of pronouns, and why pronouns are important.

What does it mean to misgender someone?

A person 'misgenders' another when they interact with them in some way which does not respect their gender identity.

Examples of misgendering include:

Using the wrong pronouns for someone, such as referring to a trans woman with 'he', 'him', and 'his' pronouns.

Using gendered language to refer to someone which doesn't align with their gender identity, such as referring to a trans man as a woman, a 'sister' or a 'wife' (or any other female gendered noun).

Using gendered language to refer to a group of people which doesn't align with one or more of the group's gender identity, such as referring to a group as 'ladies' when a man or non-binary person is in the group.

Indicating that you do not believe that someone is the gender they say they are.

Assigning them to a gendered category which does not align with their gender identity, such as marking a non-binary person as male or female on a form, or dividing a group according to gender identity and assigning someone to a group that doesn't match their gender identity.

Not affording someone the same opportunities as others who share their gender identity, such as not advertising a women-only programme to trans women.

How does it feel to be misgendered?

For most people, their gender is an important part of their identity and sense of self. When someone misgenders you, it implies that they do not recognise your gender identity. This can be distressing, particularly when it happens regularly. It can feel as though others do not respect you, and you cannot be your whole, authentic self with others.

It places trans people in the difficult position of having to correct others, often regularly and repeatedly. This is especially difficult when they don't receive support from others, which is why challenging misgendering is an important part of trans allyship.

Members of Warwick's trans community described their experience of being misgendered as:

"Feeling as though I've just been hit. It's like a physical jolt runs through you, with the wrongness of it."

"Like a wince, and the shock of it puts you out of step with whatever you were doing. Even though it happens so regularly, the feeling never diminishes."

"It feel as though someone's saying '...but you're not really a woman' casually in the middle of a meeting, and no-one reacts. I'm put in the position of having to defend my existence, in the middle of something entirely unrelated, watched by everyone there."

What should I do if I make a mistake?

If you misgender someone, and are corrected or recognise that you have made a mistake, you should:

1. Apologise, briefly and succinctly.

A protracted apology can draw unwanted attention, and make someone feel uncomfortable rather than reassured.

If someone else has corrected you, thank them.

2. Correct yourself.

If you have used incorrectly gendered language you should restate your sentence with the correct gendered language.

If you have offered or requested something incorrectly based on someone's gender identity, or failed to provide an opportunity you should have, you should offer the correct provision for their gender identity.

3. Move on with what you were doing.
Making your mistake the focus of the conversation can prolong someone's discomfort with being misgendered.

4. Take steps to avoid making the same mistake, or similar mistakes, again in the future.

Practice using the correct gendered language, such as pronouns, for an individual you have misgendered.

Familiarise yourself with how to use sets of pronouns you are less familiar with.

Unlearn gendered assumptions you make about people you meet, on the basis of their voice, appearance, name, and/or gender expression.

Engage with self-education resources and events to help you better understand trans people, identities, and experiences.

What should I do if someone else makes a mistake?

If you become aware that someone has misgendered another person, it is helpful to make them aware of their mistake, and correct them.

For example, if someone has misgendered a trans woman, Charlie, by saying "Charlie is going to give his presentation next" you could respond by saying:

"Actually, Charlie uses she/her pronouns." or

"Charlie is going to give her presentation next."

or simply "Her" at the appropriate point.

If someone repeatedly makes the same (or similar) mistakes, you may need to respond more firmly:

"Please don't misgender Charlie."

"Charlie is a woman, and you should always use she/her pronouns when you refer to her."

It is helpful to encourage them to engage with self-education resources and training as well.

Most often, people do not intentionally misgender people, though they may not be proactive in preventing mistakes. However, sometimes people do intentionally misgender others. If you require further support challenging this behaviour, please access the Report & Support service.

Trans voices on misgendering

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Challenging Incorrect Pronouns and Misgendering

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This resource provides an introduction to what misgendering looks like in practice, and how to respond when you are witness to it. Need an introduction to pronouns first? Our introductory resource on pronouns looks at what pronouns are and how to use them, how to ask about someone's pronouns, how to share and normalise the sharing of pronouns, and why pronouns are important.

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Finding out that you have a transgender child or one who is exploring gender identity can be a jarring moment for most parents. It's not news that parents are typically prepared to handle, even if they're supportive when they receive word. There are a lot of do's and don'ts to keep in mind if your child shares that they are transgender.

For starters, understand that you're not alone. You may not know anyone else personally who's gone through this situation, but that doesn't mean that you have to navigate it solo. There are organizations and individuals out there that support parents of gender non-conforming children and teens.

Even if you feel uncomfortable with the news initially, remember that your role in your child's life is more important now than ever. Try not to take this new information as a reason to give up or feel left out. Instead, see this as an opportunity to learn more about your child.

You cannot prevent or change your child's gender identity. In fact, your child's unconventional gender identity is not a problem that needs to be corrected, but instead is something you can work with your child to nourish and explore. Gender identity is not the result of something you did or didn't go, but rather an expression of your child's natural identity.

Patience is essential. It may take a while for your child to open up further after the initial discussion. There are many issues to consider, such as how your child wants to be presented in public, and some opinions will evolve over time.

Your support can make all the difference. Remember, it takes courage for people to admit their gender identity may not match up to their biological gender. Children who are transgender often face skepticism, questioning, misunderstanding and even hostility. As a parent, you lead the way in creating a safe, understanding environment. Stand up for your child, when needed. Also accept and support how your child expresses gender, such as through clothing, accessories, hairstyles and decorations in their rooms. Studies show that good family support significantly reduces mental health struggles in transgender kids.

The way you communicate also matters. When a child expresses that they are transgender or that they are exploring their gender identity, take it seriously. Find out if they prefer to be called by a gender-specific pronoun, such as he or she, or by something neutral like "they," or by their first name when you're talking to them or with others. Be sure to ask if there's anything you can do to better help them. You might point out that there are two to four transgender kids in an average high school of 2,000 students, so they're not alone.

Approaching friends and family about the change can be tricky, but let your child lead the way. Find out how they want to communicate the transition. Do they want to tell friends and family or have you initiate the discussion? Some possibilities for disclosing the transition include holding a meeting and telling everyone at once, sharing with family members individually or writing a letter or email to people. Keep in mind that 61 percent of respondents to the National Transgender Discrimination Survey (NTDS) say that their family relationships improved after coming out as transgender. It doesn't have to be a scary proposition to tell others in the family.

When you do talk to family and friends about having a child who is transgender, take a factual, positive approach. If you're confident in how you present the situation, you'll set the tone with the response. Explain that you support your child living life authentically because it will give them a happy, successful and bright future. If people respond negatively, understand that it can take certain people longer to come to terms with the situation.

Be prepared to correct any misinformation you may hear. For example, being transgender isn't a social trend and there is evidence of gender variability going far back in time. Also, gender identity and sexual identity are two different matters. Someone who is transgender may be straight, gay or bisexual. The language people use is important. Transgender is an adjective describing someone. The correct way to say it is that "John is transgender."

Unfortunately, even though by and large transgender people lead happy, successful lives, as a group they experience higher rates of mental challenges than the rest of the population. Warning signs that let you know they might be struggling include changes in school or job functioning, sleep and eating patterns, mood, the way their relationships with friends and family are going, and their ability to manage stress.

Depression and substance abuse are the most common mental health issues, and when the struggles are severe they can lead to suicidal thoughts and attempts. The rate of attempted suicides among transgender people is at around 41 percent, compared to the national average of 4.6 percent. The good news is that families have a huge impact. Attempted suicide rates plummet 57 percent when kids have affirming parents. Other things that have a notable positive impact on adjusting to the change include access to legal documentation consistent with their gender identity and experiencing low levels of discrimination.

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What You Need to Know About Parenting a Transgender Child | Yellowbrick

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Finding out that you have a transgender child or one who is exploring gender identity can be a jarring moment for most parents. It's not news that parents are typically prepared to handle, even if they're supportive when they receive word.

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A beginner’s guide to pronouns and using pronouns in the workplace

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This blog is designed to support staff working within diversity and inclusion roles, looking to better implement understanding and usage of pronouns in the workplace. What are pronouns? Pronouns are words we use in everyday language to refer to ourselves or others. They can be an...

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the interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage.
"through an awareness of intersectionality, we can better acknowledge and ground the differences among us"

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https://gids.nhs.uk/

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My sexuality has always been a confusing concept to me. Growing up, I was far more interested in my special interests than sex or relationships, and as I entered adolescence, the differences between myself and my peers became more noticeable.

While previously it had been acceptable to talk about Doctor Who and my collection of cereal boxes, my friends now wanted to discuss who they fancied and as the topics of conversation became more mature, I began to feel ashamed. I felt odd, embarrassed - what was wrong with me? The whole idea of wanting to 'do' something to someone was alien to me. I was frustrated that my brain didn't work 'right'.

Teenage years

I remember a conversation at a sleepover party when I was 15, the other girls gossiped about their various sexual encounters, and teased me for not knowing most of the terms they used. For whatever reason, be it lack of socialising or hyper focus on my own interests, I hadn't picked up on these things. Moreover, I couldn't comprehend casual relationships - they just didn't make sense to me.

It was during my teenage years that I came across 'asexuality'. I found it useful to define my sexuality this way for some time. However, I feel it is important to explain that my lack of experience in relationships and sexuality has been greatly impacted by my long struggle with an eating disorder. At the age of 22, I still have never begun my period, and lack the hormones to feel things quite like I perhaps should. I was also in hospital most of the time between the ages of 13 and 21. It would be easy to pin all of my sexuality woes on my eating disorder, but even during periods of recovery, I didn't feel very different. If anything, I felt more ashamed of my lack of feelings, because I felt like I should be 'normal'.

Acceptance

For a long time I hated myself for this, and actively searched for a 'solution'. But through meeting people within the LGBT+ community, discovering music as a means of processing emotions and partly due to the growing awareness and acceptance of different sexualities, I have learnt that sexuality is a spectrum. Sexuality is diverse, and however I feel - however you feel - is okay. There is no normal! Be it because of autism, or otherwise (because let's face it, who really knows why people feel things differently - who knows how anyone feels anything?), we are all different, and we all experience things in our own way. If it helps you to identify as a certain label, that's great, but if you don't know, I think that's also okay.

LGBTQ+ month is an important time for me because I believe that we need to encourage honesty and openness about different sexualities. I am slowly learning about who I am, and currently I identify as bisexual, or at least, as attracted to boys and girls somewhat. I'm very lucky that the people around me are supportive and accepting - but I know of so many who were made to feel ashamed and to hate themselves by those around them. And despite the positive environment around me, feeling like I needed to hide who I was and that I was 'wrong' was still a big part of my mental health struggle. I hope that, with more acceptance and awareness, fewer people will feel that their sexuality is something to be ashamed about.
About the author
Saffron is on the Ambitious about Autism Youth Council, a final year Accounting student, budding artist and lover of science, maths and history.
Further links
Read another blog about struggling being gay by another Youth Network member.

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Being autistic and navigating my sexuality

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Ambitious about Autism is the national charity for children and young people with autism. We provide services, raise awareness and understanding, and campaign for change. Through TreeHouse School, The Rise School and Ambitious College we offer specialist education and support.

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https://reframingautism.org.au/autistic-insights-on-identity-and-self-acceptance/?fbclid=IwAR1e5eNwfF4OBxnOd6QFwigvTh297A_ZB1in93fEmGBX9mDLxoJ4Cv_cb74

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The findings have important implications for the healthcare and support of autistic individuals. The results are published in the journal Autism Research.

For many years it was wrongly assumed that autistic individuals are uninterested in sexual or romantic relationships, but this is not the case. In recent years, small studies have suggested that autistic individuals are more likely to experience a wider diversity of sexual orientations and are less likely to have sexually transmitted infections (STIs). However, the existing evidence has been limited in size and scope.

In the largest study to date on these topics, the team at the Autism Research Centre used an anonymous, self-report survey to study the sexual activity, sexual orientation, and sexual health of autistic adults. Overall, 1,183 autistic and 1,203 non-autistic adolescents and adults (aged 16-90 years) provided information about their sexual activity, sexual orientation, and medical history of STIs.

The results showed that the majority of autistic adults (70% of autistic males and 76% of autistic females) engage in sexual activity-although they do so to a lesser degree than their non-autistic peers (89% of both non-autistic males and females report engaging in sexual activity). In contrast to previous findings, the results also found that there were no differences in likelihood of ever contracting an STI, or the age at which participants first engaged in sexual activity, between autistic and non-autistic individuals.

In addition, the study found that autistic adults and adolescents are approximately eight times more likely to identify as asexual and 'other' sexuality than their non-autistic peers. And there were sex differences in sexual orientation: autistic males are 3.5 times more likely to identify as bisexual than non-autistic males, whereas autistic females are three times more likely to identify as homosexual than non-autistic females.

When comparing autistic females and males directly, autistic females were more likely to be sexually active; more likely to identify as asexual, bisexual, and 'other' sexuality; and were less likely to identify as heterosexual.

Elizabeth Weir, a PhD candidate at the Autism Research Centre in Cambridge, and the lead researcher of the study, said: "Understanding the intersectional identities of autistic individuals who are asexual, bisexual, homosexual, or 'other' sexuality is key. It is particularly important that healthcare providers and educators use language that is affirming and accepting of all sexual orientations and gender identities when providing sexual education and sexual health screening checks to autistic and non-autistic people alike."

Dr Carrie Allison, Director of Strategy at the Autism Research Centre and a member of the team, said: "We must ensure that autistic individuals are receiving equal access to healthcare and support in their choices in their personal lives, to enjoy fulfilling lives and good mental health."

Professor Simon Baron-Cohen, Director of the Autism Research Centre and a member of the team, said: "This new study is an important example of applied health research with policy relevance for health and social care services."
Reference
Weir, E., Allison, C., & Baron-Cohen, S.The sexual health, orientation, and activity of autistic adolescents and adults. Autism Research (2021). DOI: 10.1002/aur.2604

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school of clinical medicine autism research centre

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Autistic individuals are more likely to be LGBTQ+

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The findings have important implications for the healthcare and support of autistic individuals. The results are published in the journal Autism Research. For many years it was wrongly assumed that

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Suggested provision resources  services to support gender-trans-non-binary CYP - secondary age