The missing clinical guidance: a scoping review of care for autistic transgender and gender-diverse people

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Bo, L., van der Miesen, A. I., Klomp, S. E., Williams, Z. J., Szatmari, P., & Lai, M. C. (2024). The missing clinical guidance: a scoping review of care for autistic transgender and gender-diverse people. eClinicalMedicine, 76, 102849. https://doi.org/10.1016/j.eclinm.2024.102849

Publication date: 27 Sep 2024 Added to AutiHub: 7 Jul 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
6
Publication authors identified as autistic
2 / 6 (33.3%)
  1. Lorna Bo
  2. Anna I.R. van der Miesen
  3. Sascha E. Klomp *
  1. Zachary J. Williams *
  2. Peter Szatmari
  3. Meng-Chuan Lai

Abstract

The co-occurrence of autism and gender diversity has been increasingly studied in the past decade. It is estimated that ∼11% of transgender and gender-diverse (TGD) individuals are diagnosed with autism. However, there is insufficient knowledge about appropriate gender-related clinical care for autistic TGD individuals. We performed a scoping review of current clinical guidance for the care of TGD individuals to identify what was said about autism. Clinical guidance documents were searched in PubMed, Web of Science, Google Scholar, Embase, Guidelines International Network, and TRIP medical database, as well as reference mining and expert recommendation. Evidence was synthesised by narrative synthesis, recommendation mapping, and reference frequency analysis. Out of the identified 31 clinical guidance documents, only eleven specifically mentioned the intersection between autism and TGD. Key concepts among the available recommendations included advocating for a multidisciplinary approach; emphasising the intersectionality of autism and gender-diverse experiences during assessments; and-importantly-recognising that autism, in itself, does not serve as an exclusion criterion for receiving gender-related care. However, detailed and practical clinical guidance is lacking due to a gap in evidence. Empirical research into the care experiences and outcomes of autistic TGD individuals using a developmental, lifespan, and strengths-based approach is needed to generate evidence-informed and tailored guidance. Funding: This study was funded through a Canadian Institutes of Health Research Sex and Gender Science Chair program (GSB 171373) awarded to M-CL.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 08:05.

Cited references
72
With a DOI
63
Without a DOI, from raw bibliography text
9
9 / 72 (12.5%) cited references include at least one author identified as autistic.
References with data to complete
7 / 72 (9.7%)
References with detected author names
67 / 72 (93.1%)
Without detected author names
5
Without a structured title
2
Without a stable identifier
8
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
559
From DOI or external metadata
559
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
150 / 559 (26.8%) names are linked to an author already present in AutiHub. 409 / 559 (73.2%) names are not yet linked.
Names linked to a person identified as autistic
15 / 559 (2.7%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 15 / 150 (10.0%). Distinct people identified as autistic: 11 / 470 (2.3%).
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