A suggestion by Renee Salas in a recent conversation started me thinking about how my Autism and Gender Dysphoria affect each other. It seems obvious that they will interact because both have strong neurological dimensions. In fact there does appear to be a correlation between Autism and GD in female-to-male transsexuals; however I could not find any studies investigating Autism in male-to-female transsexuals.

The primary study appears to be one published in the Journal of Autism and Developmental Disorders in 2011. One of the researchers was the well-known Prof. Simon Baron-Cohen and it is therefore not surprising that this research focused on the “Extreme Male Brain” theory. None of which helps explain Autism in female-to-male transsexuals: I can’t reconcile my own experience with this theory because GD in FtM transsexuals has been linked to prenatal exposure to estrogen, and brain structures that exhibit sexual dimorphism show similarities to cis women rather than cis men.

In the absence of any scientific evidence, all I can do is relate my own experience.

#1 Female Presentation of Autism

I remember the first time I read an article about how Autism presents differently in women because I was struck by how much of it matched my own experience. I guess it makes sense because I am a woman even though I was raised as male.

My Autism is well-masked in many situations because I have learned to mimic behaviors I observe in others. This extends to copying mannerisms, phrases and speech patterns. I am also typically a social person but I’m not one to initiate things. I rely on having one or two “gateway” friends to get me started in social situations, but I also have trouble making and maintaining friendships.

I was a hyperlexic child, learning to read before the age of two and spending many hours alone immersed in books, mostly fiction but also factual books related to my interests. At school I was always the quiet, shy one: well-behaved and academically gifted.

On top of growing up in the 70s and 80s when Autism was much less recognized, like many Autistic women of my generation there was little that indicated to anybody that I was anything more than painfully shy. Most of us were good enough at pretending to be like others that we didn’t attract attention.

#2 Gender Query

I remember being unaware of gender until I hit puberty. Of course I knew that there were girls and boys, and that girls dressed one way and played netball while boys dressed differently and played football. But that was the extent of my knowledge: I was hopelessly naive.

With puberty I became aware that my body was changing, and it affected me badly. I felt confused and conflicted: I liked the fact that it meant I fit in better with the boys at school, but didn’t like that I was a boy. I didn’t want to be, I didn’t feel like I was one of the boys, but I didn’t know that there was any such thing as Gender Dysphoria. I didn’t realize that there was another option. And I would almost certainly have been too afraid to speak about it if I had known: I used to be too self-conscious to even say the word “sex” in front of my parents.

When I was growing up there were no visible alternatives to the cis-hetero picture of gender and sexuality. I didn’t even know what “gay” meant until I was in my mid-teens: it was just an insult used by boys at school. So I had no vocabulary, no concepts to describe how I felt. Nobody to relate to. No role models with whom I could identify. Just this feeling that I was not right. And any attempt to express myself in private felt shameful.

#3 Being Different

I have always felt different to the people around me, known that I was not like them. This is a common feeling in Autism and for me has the added dimension of knowing that my body is “wrong”. I know now: it has taken a long time for me to identify why I felt the way I did.

Passing takes on extra significance for an autistic woman trying to fit in as a neurotypical man. I have been on the receiving end of homophobic bullying from time to time because of failing to act in an “appropriately” masculine way. The problem has always been that my behavior has never fitted the stereotype of masculinity. Oh, I played rugby at school but could never exhibit the aggression that the coaches wanted. I’ve always been quiet and passive, afraid of confrontation despite my physical size.

Since I discovered I am Autistic I have been less concerned with always fitting in, hiding my natural traits by aping those around me. I’ve accepted that it’s how I am; this has proved to be less stressful for me, less tiring, and I have felt happier about myself.

This openness about being myself contributed to my decision to out myself as a trans woman. Yes, I still feel different — that goes with the Autistic territory — but I’m more confident since transitioning. I no longer worry about having to “act male”: I go to work in my male shirt but I have painted nails and occasional mascara or lipstick. Whatever makes me feel good. I have fewer inhibitions about expressing how I feel. I am happy to be different, and I have been accepted for who I am.

#4 Depression

It’s no surprise I’m prone to depression since it is strongly associated with GD and is also common in Autistic people. It is something I have lived with for most of my life, causing a couple of breakdowns along the way. I am now on medication (Citalopram) and it helps but does not prevent me feeling down at times. What it does do is allow me to function, to get up in the morning and do a day’s work.

The simple fact is that I feel my body is too masculine. It does not match the way I see myself as a woman and this causes me distress. Sometimes I can look in the mirror and the face looking back at me is me, but most of the time I see a man’s face and this upsets me. One aspect of my Autism is that I focus on facial features in isolation. I look at my eyes or mouth and they are fine. But then I pay attention to the shadow of beard on my cheeks, upper lip, chin, and neck — no matter how close I shave — and it looks male. Yes, I could conceal it with makeup, but I’d still know it was there.

#5 Acceptance

One thing I have found among so many Autistic people is an open-mindedness and willingness to accept people’s differences. I believe this derives in a large part from spending our lives feeling like outsiders. It gives us an insight and understanding of how it feels to be excluded, taunted, abused just for not fitting in.

This extends beyond autism to include all manner of differences including gender and sexuality. Not only have I found it easy to accept myself for who I am, but I have received a lot of support and acceptance from other Autistic people online. This helps so much.

#6 In Summary

To round this off I’ll summarize some key points:

• I am an Autistic trans woman. My Autistic symptoms are more similar to the typical presentation in women than in men.
• I am not a stereotypical woman. I’m not butch or femme. I still wear jeans most days; they’re just cut a bit different from the ones I used to wear, but I also wear skirts and dresses when I feel like it. I don’t have to exaggerate my behavior, I don’t have to conform to anybody else’s expectations, I’m not acting a role: I’m just being myself. I’m different, I’m an individual and I’m OK with that.
• I’m not OK with some of my masculine physical characteristics and this contributes in a big way to my bouts of depression.
• I don’t have a “male” brain: being a trans woman is demonstration of that. (So much for the Extreme Male Brain theory of Autism!)
• I believe that being Autistic has helped me come to terms with GD much more easily than would have been the case if I were neurotypical because I don’t have all that mental baggage that tells people how they ought to be.