Department of Psychology, Centre for Applied Autism Research, University of Bath, Bath, UK.
Research Department of Clinical, Educational, and Health Psychology, London, UK.
J Child Psychol Psychiatry. 2023 Feb;64(2):265-276. doi: 10.1111/jcpp.13691. Epub 2022 Sep 12.
Autistic people are overrepresented in gender clinic settings, but limited evidence is available to guide clinical decision making for this patient group. We aimed to generate a comprehensive understanding of the phenomenology of gender dysphoria in autistic people.
We conducted a multi-perspectival interpretative phenomenological analysis (IPA), from five different perspectives; autistic young people and adults with experience of gender dysphoria, parents of young people, and clinicians working with autistic people with gender dysphoria in both adult and young person settings (n = 68).
IPA analysis resulted in two themes, 'discovering gender identity' and 'the complexities of moving towards gender comfort'. Participants agreed that there was often an interaction between gender dysphoria and features of autism such as sensory sensitivities. There was relative consensus across groups about the need for autism adaptations to be made in gender clinics. Autistic adults were more likely to see autism as an important identity than young people, but both groups were clear that autism did not impair their understanding of gender. In contrast, some parents and clinicians working with young people expressed concern that autism did impact self-understanding.
While the groups tended to agree on the ways in which particular features of autism can compound gender dysphoria, there were a range of perspectives on the ways in which autism impacted on self-knowledge.
Recommendations for adaptations when working with autistic people with gender dysphoria are presented.
自闭症患者在性别诊所中人数过多，但可供指导该患者群体临床决策的证据有限。我们旨在全面了解自闭症患者的性别焦虑症的表现。
我们从五个不同的角度进行了多视角解释性现象学分析（IPA）；有性别焦虑症经历的自闭症青年和成年人、年轻人的父母、以及在成人和青年环境中为有性别焦虑症的自闭症患者提供服务的临床医生（n = 68）。
IPA 分析得出了两个主题，“发现性别认同”和“向性别舒适过渡的复杂性”。参与者一致认为，性别焦虑症和自闭症的特征之间通常存在相互作用，例如感官敏感性。不同群体都相对一致地认为，性别诊所需要进行自闭症适应。自闭症成年人比年轻人更有可能将自闭症视为重要的身份认同，但两个群体都明确表示自闭症不会影响他们对性别的理解。相比之下，一些父母和为年轻人服务的临床医生表示担忧，认为自闭症确实会影响自我理解。
虽然这些群体倾向于就自闭症的某些特征会如何加重性别焦虑症达成一致，但对于自闭症如何影响自我认知，存在一系列不同的观点。
提出了与有性别焦虑症的自闭症患者合作时的适应建议。
