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

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Bo, L., Miesen, A. I. R. v. d., Klomp, S. E., Williams, Z. J., Szatmári, 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
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Authors

Publication authors
6
Publication authors identified as autistic
1 / 6 (16.7%)
  1. Lorna Bo
  2. Anna I. R. van der Miesen
  3. Sascha E. Klomp
  1. Zachary J. Williams *
  2. Péter Szatmári
  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.

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Cited references
72
Total cited references integrated for this publication.
Cited references with an identified autistic author
7 / 72 (9.7%)
Cited author occurrences identified as autistic
9 / 559 (1.6%)
Among occurrences linked to AutiHub author records: 9 / 132 (6.8%). Distinct cited authors identified as autistic: 7 / 470 (1.5%).
Cited author occurrences linked to AutiHub author records
132 / 559 (23.6%)
Distinct linked cited authors: 77 / 470 (16.4%)
Linked cited-author occurrences not identified as autistic
123 / 132 (93.2%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 123 / 559 (22.0%). Distinct linked cited authors not identified as autistic: 70 / 77 (90.9%).
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