While the link between autism and gender dysphoria has received increasing attention, the phenomenon of gender dysphoria co-occurring with autism remains unclear owing to the lack of autistic transgender perspectives. Therefore, we explored the gender dysphoria experiences of 15 Japanese autistic transgender adults, obtaining two key findings. First, their gender dysphoria experiences were diverse; some were related to gender incongruence, whereas others were not. The latter were characterized by resistance to the societal gender norms themselves, sensory disgust related to autistic sensory sensitivities, uncertainty regarding the gender norms of the social majority, and the autistic burden of living in a gendered society. Second, by examining the participants’ life stories of being autistic in society, we found that most of them not only accumulate distress over gender norms (i.e. gender dysphoria) but pervasive social norms as well, which we termed pervasive social dysphoria. In other words, most participants experienced gender dysphoria as a subset of pervasive social dysphoria. These findings indicate that future research and practice need to further affirm the internal perspectives, such as by investigating which among the diverse gender dysphoria experiences co-occur with autism or a link between autism and pervasive social dysphoria, and by providing support for both gender dysphoria and pervasive social dysphoria in practice.Lay abstractStudies have suggested that autistic people are more likely to experience gender dysphoria, which refers to the gender-related distress emerging from personal factors and gender norms that some transgender people experience. Transgender people are diverse; some experience gender incongruence (i.e. an incompatibility between a person’s gender identity and that expected of them based on their birth-assigned gender), whereas others do not. Therefore, the association of autistic transgender people’s gender dysphoria with gender incongruence varies, and the literature has overlooked such diversity. Interviews with 15 Japanese autistic transgender adults revealed diverse gender dysphoria experiences independent of gender incongruence, such as resistance to the societal gender norms themselves, physical dysphoria caused by the imposition of gender, sensory disgust related to autistic sensory sensitivities, uncertainty about the gender norms of the social majority, and the autistic burden of living in a gendered society. Moreover, we found that most participants had not only accumulated distress over gender norms (i.e. gender dysphoria) but also over pervasive social norms, termed Pervasive Social Dysphoria. Our findings suggests that future co-occurrence research and practice must affirm these internal perspectives more, such as by providing support for both gender dysphoria and Pervasive Social Dysphoria, as autistic transgender people may experience gender dysphoria as a subset of Pervasive Social Dysphoria.

中文翻译：

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重新审视这种联系：对性别不安的不同经历进行定性分析，性别不安是日本与自闭症同时发生的普遍社会不安的一个子集

尽管自闭症和性别焦虑之间的联系受到越来越多的关注，但由于缺乏自闭症跨性别视角，性别焦虑与自闭症同时发生的现象仍不清楚。因此，我们探讨了 15 名日本自闭症跨性别成年人的性别焦虑经历，获得了两个重要发现。首先，他们的性别焦虑经历多种多样；有些与性别不一致有关，而另一些则不然。后者的特点是对社会性别规范本身的抵制、与自闭症感官敏感性相关的感官厌恶、对社会大多数性别规范的不确定性以及生活在性别社会中的自闭症负担。其次，通过研究参与者在社会中自闭症的生活故事，我们发现他们中的大多数人不仅积累了对性别规范的苦恼（即性别不安），而且还积累了普遍的社会规范，我们将其称为普遍的社会不安。换句话说，大多数参与者都经历过性别焦虑症，这是普遍存在的社会焦虑症的一部分。这些发现表明，未来的研究和实践需要进一步肯定内部观点，例如通过调查不同性别焦虑症经历中哪些与自闭症同时发生，或者自闭症和普遍的社会焦虑症之间的联系，并为这两种性别焦虑症提供支持研究表明，自闭症患者更容易经历性别焦虑，这是指一些跨性别者经历的因个人因素和性别规范而产生的与性别相关的困扰。跨性别者是多种多样的；有些人经历了性别不一致（即一个人的性别认同与基于其出生性别的期望之间的不相容），而另一些人则没有。因此，自闭症跨性别者的性别不安与性别不一致的关联各不相同，而文献忽视了这种多样性。对 15 名日本自闭症跨性别成年人的采访揭示了与性别不一致无关的各种性别焦虑经历，例如对社会性别规范本身的抵制、强加性别引起的身体不安、与自闭症感官敏感性相关的感官厌恶、对性别规范的不确定性。社会大多数人，以及生活在性别社会中的自闭症负担。此外，我们发现大多数参与者不仅对性别规范（即性别不安）积累了痛苦，而且对普遍的社会规范也积累了痛苦，称为普遍的社会不安。我们的研究结果表明，未来的共现研究和实践必须更多地肯定这些内部观点，例如通过为性别焦虑和普遍性社交焦虑提供支持，因为自闭症跨性别者可能会经历性别焦虑作为普遍性社交焦虑的一个子集。