A study dismantles prejudices about the “authenticity” of trans identities among autistic youth

A study published on 23 October 2025 by Aimilia Kallitsounaki and her colleagues in the journal European Child & Adolescent Psychiatry explores the nature of gender identity among autistic and non-autistic young people followed in specialist clinics, as well as among their parents. Its starting point is a recurring controversy : some clinicians assume that the gender diversity observed more frequently among autistic youth than in the general population stems directly from cognitive characteristics associated with autism (an obsessive and stereotyped interest in gender), rather than from an authentic experience of gender potentially facilitated by lower sensitivity to social norms. To test this hypothesis, the researchers combined two types of measures : an explicit assessment of the sense of belonging to a gender and an implicit measure, the Implicit Association Test (IAT), designed to probe automatic associations between the concept of self and gender categories.

The first part of the study involved 209 young people aged 7 to 16, divided into four groups : autistic or non-autistic, and either referred to a gender clinic (thus expressing an identity not aligned with sex assigned at birth) or cisgender. All participants had a good level of language ability and lived in the United Kingdom. The autistic participants had received a formal diagnosis, confirmed using standardized tools such as the ADI-R and the BOSA (the latter adapted from the ADOS-2 for digital / online administration). The aim was to assess whether implicit and explicit profiles of gender identity differed according to the presence or absence of autism, and whether autistic cisgender children differed from their non-autistic peers in terms of weaker identification with their assigned sex.

Statistical analyses showed that, at the implicit level, young people referred to gender clinics – whether autistic or not – more quickly associated the concept of “self” with the gender opposite to that assigned to them at birth. This result indicated an automatic identification with their experienced gender rather than with their sex of assignment. By contrast, cisgender young people showed a strong implicit association with their assigned sex. Performance was comparable between autistic and non-autistic children: autism neither weakened nor altered the coherence between lived gender and implicit identity.

Explicit measures, based on a self-report scale assessing the feeling of being “a boy” or “a girl”, led to the same conclusions. Trans or questioning young people identified with their experienced gender with an intensity equivalent to that with which cisgender children identified with their assigned sex. No differences related to an autism diagnosis were detected, contradicting the idea of a more blurred or unstable gender identity among autistic youth. In short, within this population, autism neither altered the clarity nor the solidity of gender identity.

The second part of the study broadened the perspective to the 217 parents or guardians of the participating children. The researchers examined whether the degree of identification with assigned gender varied depending on the child’s situation. Parents also completed a version of the IAT and filled out an explicit questionnaire about their identification with the gender group corresponding to their sex at birth. The results revealed that parents of children referred to gender clinics, whether autistic or not, expressed a slightly weaker explicit identification with their own gender than parents of cisgender children. By contrast, their implicit results did not differ, suggesting automatic stability of gender identity alongside a more flexible conscious positioning.

This convergence between parental results and those of the young participants led the authors to propose the idea of a familial aggregation of gender diversity, regardless of the presence of autism. In other words, certain families – of autistic or non-autistic children – might share greater openness or variability in how gender is conceptualized, whether this has a genetic, cognitive, or cultural basis.

These observations invalidate the hypothesis that gender diversity among autistic people is merely a manifestation of restricted interests. On the contrary, autistic youth displayed gender identity profiles indistinguishable from those of their non-autistic peers, both at the automatic and declarative levels. The researchers emphasize that these data should help ease clinical doubts regarding the “authenticity” of the gender experiences expressed by autistic children. They also invite a rethinking of care pathways, which are too often marked by suspicion or delays when an autism diagnosis is present.

The authors nevertheless note several limitations : most participants were English-speaking and based in the United Kingdom, which restricts cross-cultural generalization. Children with intellectual disabilities were not included, leaving open the question of gender diversity within this subpopulation. Finally, the implicit task used relied on binary categories, making it less suitable for exploring non-binary identities.

At a theoretical level, this work fits within a broader movement challenging pathologizing approaches to gender in autistic contexts. Its findings align with those of a similar study conducted with adults by the same research team (Kallitsounaki and Williams, 2022). By adopting a rigorous experimental protocol and a dual implicit-explicit approach, Kallitsounaki’s team provides strong empirical evidence in support of the depathologization of trans and gender-nonconforming experiences among autistic youth.

The practical implications of these results are substantial: they argue for clinical assessment grounded in the recognition and respect of expressed identities, without presupposing that an autism diagnosis undermines their validity. Professionals are urged to abandon explanatory models that, without evidence, equate gender diversity with a consequence of a neurodevelopmental condition, and instead to promote equitable and inclusive support pathways. By shedding light on the continuity of identity mechanisms between autistic and non-autistic youth, this study marks a decisive step toward an integrated and non-stigmatizing understanding of the links between autism and gender.