When Elijah’s daughter approached him about being trans and wanting to change her name, he felt skeptical partly because she was young.

Elijah had heard that there is a link between autism and gender dysphoria and thought that his child may be autistic. He got support from child and adolescent mental health services (CAMHS) who concluded that his child was on the autistic spectrum.

Elijah’s feels that his child’s gender identity is due to autism, anxiety and social contagion*. He also thinks that it’s partly due to teachers and pupils affirming the new identity giving his daughter a previously unknown kudos and ‘celebrity’. But he sees social media as having had the biggest influence.

Elijah refers to his daughter by her birth name and does not use new pronouns. He does not believe that his child is old enough to make what he describes as a “momentous decision”. He says he tries to be compassionate and understand his child’s perspective but feels that he has to be firm while she is a child. In his view, it is important to “wait and see” what their child decides when she is older and can process their thoughts in a more adult way. He is okay, however, with her dressing and styling her hair in a masculine way.

Elijah thinks medical transitioning doesn’t help young trans people and sees it as ‘an endless process with no end goal that results in being a lifelong patient with associated mental and physical distress.’

Elijah’s child is currently on a waiting list for a gender identity service and has been for seven or eight months. He is not keen for the appointment to go ahead as his views of the service are negative and he doesn’t think hormone blockers are safe.

He hopes that his child can settle down to be ‘comfortable in her own skin’ and also explore her sexuality and not fixate on ‘gender’ so that she does not feel she needs to seek a medical transition.

At the time of the interview, he hoped that he could find a health professional that can adopt a cautious exploratory approach to understand the underlying reasons a child would come to the conclusion their body was wrong. He planned to avoid any therapist who unquestionably affirms this belief.

A suitable therapist was found, and Elijah says his daughter has been very happy by her own choice to continue seeing them and the initial results have been positive.
Elijah says to other parents of trans identifying children to try and keep their mind occupied by going out and doing physical activities with them. He says to try to keep them off negative social media but also acknowledges this is not always possible. He also said a parent support group (Bayswater Support) was a vital source of help.

By doing this with his own child, Elijah believes he has ‘seen a difference in their mental health when doing something positive and physical, outside away from screens “telling children to hate their bodies.’

Elijah says that since he spoke to us, his daughter has stopped requesting an immediate medical pathway. She has told him she is glad he did not agree to early requests for medication and acknowledged that would have been wrong at that time. She has not ruled it out in the future.

She still goes by a different name at school and dresses in a ‘unisex’ way.

*The link between autism and gender diversity and the existence of social contagion/‘rapid-onset gender dysphoria’ remain contested in terms of research evidence. For example, see:

Turban, J. L., & van Schalkwyk, G. I. (2018). “Gender dysphoria” and autism spectrum disorder: Is the link real? Journal of the American Academy of Child & Adolescent Psychiatry, 57(1).

Restar, A.J. (2020) Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of “Rapid-Onset Gender Dysphoria”. Arch Sex Behav 49.

Elijah added this final message:

“You may think reading above I am a horrible abusive parent denying my child’s wish to live as her authentic self and causing her unnecessary distress and she will simply do it all anyway when she leaves home – this may be true.

Hurrying a child into a medical pathway that causes irreversible mental and physical harm may cause much more distress in the long term – this may also be true.

Turban et al paper was critiqued by many other scholars who work in autism and gender dysphoria, who came together to write two critiques of it.

In this one, the authors “are concerned that perpetuating misunderstanding about the co-occurrence places individuals at risk”. Strang et al (2018) Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals J Am Acad Child Adolesc Psychiatry. 2018 Nov;57(11):885-887.

In the other, the authors asked for “a nuanced approach…[to] help avoid creating a new area with polarized opinions, this time regarding a potential GD-ASD link. this seems counterproductive and not contributing to better care for those who need it.” van der Miesen AIR, Cohen-Kettenis PT, de Vries ALC. Is There a Link Between Gender Dysphoria and Autism Spectrum Disorder? J Am Acad Child Adolesc Psychiatry. 2018 Nov;57(11):884-885

Papers that describe the association of ASD and gender dysphoria:

Emily Patel, ‘Understanding gender identity development in gender variant birth-assigned female adolescents with autism spectrum conditions’ (University College London, 2019)

Nabbijohn et al, ‘Gender Variance and the Autism Spectrum: An Examination of Children ages 6-12 Years’, Journal of Autism and Developmental Disorders, vol 49, pp. 1570-1585 (2019)

Russell et al, ‘A Longitudinal Study of Features Associated with Autism Spectrum in Clinic Referred, Gender Diverse Adolescents Accessing Puberty Suppression Treatment’, Journal of Autism and Developmental Disorders, vol 51, pp. 2068-2076 (2021)”