Gender Identity, Sexuality and Autism

Voices from Across the Spectrum

Eva A. Mendes, Meredith R. Maroney

• Publisher: Jessica Kingsley Publishers
• Year: 2019
• Print ISBN: 9781785927546
• eBook ISBN: 9781784505851
• Topic: Social Sciences
• Subtopic: Gender Studies
• Index: Social Sciences

Bringing together a collection of narratives from those who are on the autism spectrum whilst also identifying as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual (LGBTQIA), this book explores the intersection of the two spectrums as well as the diverse experiences that come with it.

By providing knowledge and advice based on in-depth research and personal accounts, the narratives will be immensely valuable to teenagers, adults, partners and families. The authors round these stories with a discussion of themes across narratives, and implications for the issues discussed. In the final chapter, the authors reflect on commonly asked questions from a clinical perspective, bringing in relevant research, as well as sharing best-practice tips and considerations that may be helpful for LGBTQIA and ASD teenagers and adults. These may also be used by family members and clinicians when counselling teenagers and adults on the dual spectrum.

With each chapter structured around LGBTQIA and autism spectrum identities, Gender Identity, Sexuality and Autism highlights the fluidity of gender identity, sexual orientation and neurodiversity and provides a space for people to share their individual experiences.

Part 1

INTRODUCTION

GENDER IDENTITY,
SEXUALITY AND AUTISM

Voices from Across the Spectrum

An East Indian client of mine—Eva’s—whom we shall call Nitin,1 18, came to the United States to start school as an undergrad at a well-known engineering school in Boston. He entered counseling at the behest of his parents due to depression in his second semester. In addition to addressing his depression, Nitin also had many questions around what he saw as his autism spectrum difference (ASD) traits (Table 1 in the next chapter, Terminology Tables, explains the terminology used throughout this book). He did very well academically, as evidenced by his enrollment into the prestigious engineering school, but by the second semester he reported:

I’m feeling really lonely and depressed. I have trouble making friends easily and I also think I might be gay. And, my dad has been really hard on me lately. He keeps telling me how I have to do really well in school because he’s spending so much money for my education. Also, I think I might have undiagnosed Asperger’s because I’m very much like those characters in the TV show Big Bang Theory, but I just manage to hide it really well. I haven’t made any friends here at all. I’m in my room a lot. And the academics are tough and I’m not that good at organizing and time management. When I’m feeling down, I tend to play video games a lot and lose track of time and often get behind on schoolwork. Because I’m smart, I can usually cram and get through, but I feel really stressed out and down most of the time.

As the session progressed, Nitin continued:

My dad would hate it if he knew that I was gay. I think my mom already knows, but we’ve never talked about it openly. A friend of mine in India knows about it, but she’s a lesbian, so she guessed that I was too…urh…gay too I mean. I would really, really like a boyfriend, but I’ve never even kissed a guy before, and I can’t even make friends, so having a boyfriend seems like a far-fetched dream. Lately, my anxiety is getting bad as well. I’ve been hating the way my body is too. I wish I were better-looking. I bet like most people wouldn’t even find me attractive.

Cases like Nitin’s are rather common in the ASD community. In my—Eva’s—practice as psychotherapist and counselor, there have been an increasing number of individuals on the autism spectrum, similar to Nitin, who identify as being on the spectrums of autism, gender identity, and sexual orientation.

Gender and Sexual Orientation Diversity—Prevalence within ASD Individuals

Since Asperger Syndrome first emerged as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV (American Psychiatric Association, 2000), our knowledge and understanding of adults on the autism spectrum has increased and deepened, and now we are in an era of emerging evidence that suggests that autistic individuals are more likely to identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual (LGBTQ) than non-autistic individuals. Prevalence rates of autism spectrum difference are estimated to be one in 59 or 1.69% (Baio et al., 2018), while it is estimated that almost 4.1% adults identity as LGBTQ (Gates, 2017). There are a number of studies that have highlighted the increasing diversity of sexual orientation and gender identity, although there is still very little discussion on the overlap of being autistic and LGBTQ, particularly from the perspective of those who hold these identities. Even much of the research on autism has excluded the perspectives and experiences of autistic individuals themselves. Furthermore, such research has tended to be largely diagnostic, using labels like autism spectrum disorder and gender dysphoria (formerly known as Gender Identity Disorder), which can be pathologizing, and may not fit with the way individuals view their own experiences, although such studies have increased awareness for those living at the intersection.

Our book aims to present a diverse range of voices from ASD-LGBTQ individuals, as well as some brief reflections from their partners and parents, and clinical perspectives from Eva, a psychotherapist and autism specialist, and Meredith, a researcher and clinician also working and researching at this intersection.

A number of studies have highlighted the diversity of sexual orientation or gender identity in ASD individuals. For instance, a review of recent studies on this topic found that children diagnosed with autism spectrum difference were approximately 7.59% more likely to present with gender variance than non-autistic individuals (Strang et al., 2016). Another study found that approximately 7.8% of children who were diagnosed with gender dysphoria (GD), could meet the criteria for a diagnosis of ASD (de Vries et al., 2010). In an online survey of autistic women, it was found that 50% of autistic individuals versus 21% of non-autistic individuals (within a total sample of 248 people) reported their gender identity as either trans, non-binary, or genderqueer (Bush, 2016). Finally, in a study of gender identity and sexual orientation of individuals with ASD, significantly higher rates of gender dysphoria were present among autistic individuals than in the general population (George and Stokes, 2017).

Several recent studies with autistic individuals have noted greater diversity of sexual orientation among autistic individuals (Barnett and Maticka-Tyndale, 2015; Hellemans et al., 2007). In a qualitative study with adults on the autism spectrum, 17% identified as bisexual or queer and 13% identified as lesbian or gay when reporting sexual orientation (Barnett and Maticka-Tyndale, 2015). Another study, comprised of a sample of 208 ASD participants, found that approximately 84% reported their sexual orientation as non-heterosexual (Bush, 2016). More recent research found that autistic individuals, particularly autistic women, reported feelings of sexual attraction to same-sex partners to a greater degree than the general population (DeWinter, De Graaf, and Begeer, 2017). This exploration of autism traits and diversity of sexual orientation was recently conducted in Stockholm, with authors finding that those who met the criteria for autism (as defined by the Autism Spectrum Quotient, also known as AQ-10) were more likely to identify their sexual orientation as bisexual, or incapable of fitting within the labels of either heterosexual, homosexual, or bisexual (Rudolph et al., 2017).

Critiques on Overlapping Identities

There have been some critiques on the idea that there is an increased likelihood to be diverse in gender and sexual orientation among autistic individuals. For instance, Turban and van Schalkwyk (2018) discuss the limitations with the present research in the ways that traits of gender diversity and autism are measured, calling into question whether or not there is a link between transgender identities and autism. Whether or not there is increased prevalence of diversity of sexual orientation and gender identity within individuals on the spectrum, the intersection of these LGBTQ and autistic identities has been widely discussed in online groups, platforms, and videos.

How This Book Came to Be

Eva’s Work

Eva first became aware of these intersecting identities through her clinical work with ASD adults starting in 2009. Her very first client, during her undergraduate clinical counseling internship at the Asperger/Autism Network (AANE; formerly known as the Asperger’s Association of New England), was an elderly woman who identified as bisexual and gender non-conforming and dressed in neutral androgynous clothing every day of her life, even on formal occasions. Even though she was celibate for most of her life, she had discovered her bisexuality and gender identity much before she had stumbled upon her autism diagnosis in her mid-50s. Shortly after, in her training as a couple’s counselor, Eva started working with lesbian couples where one partner identified as being on the autism spectrum. Then, a couple of years ago, Eva was requested to facilitate a Gender Identity Support Group at AANE and did so for a period of one year. ...

Table of contents

• Cover
• Title Page
• Contents
• Foreword by Wenn B. Lawson
• Part 1: Introduction
• Part 2: The Narratives
• Part 3: Discussion
• Appendix: Mendes and Maroney Autism Spectrum Difference (ASD) Diagnostic Key
• References
• Subject Index
• Author Index
• Join Our Mailing List
• Acknowledgments
• Dedication
• Copyright
• By The Same Author