Magali Pignard : Autisme et incongruence de genre : prise de position d'une association danoise de personnes autistes
- La Petite Sirène
- Jun 10
- 4 min read
Article de Magali Pignard - 4 mai 2025
Position Statement by the Autism and Asperger Association on Medical Care in Cases of Gender Incongruence (Denmark, 2025)
As part of the public consultation launched by the Danish health authorities on their new guidelines regulating medical treatments related to gender incongruence, the Autisme- og Aspergerforeningen (Danish Association for Autism and Asperger Syndrome) has published a critical response regarding the “Framework of Good Practices.” The association expresses serious concerns about the use of potentially irreversible hormonal treatments in minors and highlights the specific vulnerability of autistic youth in relation to this issue.
They advocate for:
a systematic assessment of autism before any medical intervention is undertaken;
a cautious and non-invasive therapeutic approach as the first line of treatment;
recognition of the role of comorbid factors (psychiatric disorders, trauma, atypical development) in transition pathways.
They warn against premature medicalization, the overemphasis on pronouns in care protocols, and the risk that autistic youth may misinterpret their distress as gender dysphoria.
➥ Below: several excerpts from their position statement regarding autism-related issues, reorganized by theme.
1. Overrepresentation of Autism Among Youth with Gender Incongruence
“Research shows that individuals who identify as transgender are up to seven times more likely to be diagnosed with autism compared to the general population (Warrier et al., 2021). Several studies highlight a significant overrepresentation of autistic traits (…) among children and adolescents seeking treatment for gender incongruence (Glidden et al., 2016).
At the international level, we are seeing a trend in which individuals who regret undergoing gender modification treatments are primarily autistic. (…)
Since autism and gender incongruence are often linked, a thorough autism screening should be mandatory before any medical or surgical treatment is even considered.”
2. Confusion Between Autism and Gender Incongruence
“Autism can influence one’s understanding of identity: many autistic individuals experience social adaptation difficulties, sensory processing issues, and a black-and-white sense of self, which can make them particularly vulnerable to perceiving gender identity as a fixed truth. (…)
Autistic youth may misinterpret their own feelings and confuse gender dysphoria with other sensory or body-related difficulties. They may also be more susceptible to social influence and to identity-seeking communities.
(…)
How can we ensure that autistic children and adolescents are not mistakenly diagnosed with gender incongruence if their specific autism-related needs and challenges are not thoroughly assessed? There is currently a lack of a clear approach to prevent the overdiagnosis of gender incongruence, and to ensure that psychoeducation and self-understanding are prioritized before considering treatments that may be irreversible, such as puberty blockers or cross-sex hormones.
(…)
For autistic patients, who often interpret language and identity very literally and concretely, emphasizing pronouns can cause confusion and lead them to maintain an identity that doesn’t truly reflect who they are—or that is shaped by other influences. In such cases, this kind of approach can be more harmful than helpful.”
3. The Need for Specific Support for Autistic Children
“In other areas of children’s and adolescents’ lives, parents are expected to strike a balance between support and guidance. (…) When a young person has a disturbed self-image, it is common for parents and professionals to help them understand and manage their feelings, rather than uncritically validating behaviors or decisions stemming from those feelings. Making an exception for gender identity—by granting special status to the child’s subjective experience—creates a problematic precedent that bypasses any process of clarification.
(…)
This is especially relevant for autistic children and adolescents, who often experience school-related distress due to sensory challenges, social rejection, or an unsuitable educational environment. Many studies have shown that these children frequently develop anxiety and stress in such contexts and struggle to distinguish their internal feelings from external influences.
(…)
When an autistic child is struggling at school and simultaneously experiencing gender incongruence, it is essential to take their full situation into account, rather than focusing solely on gender identity as the only explanation for their distress. There is a real risk that autistic children—feeling different or marginalized—may seek recognition and belonging within identity categories that offer a sense of community but do not necessarily address the root causes of their distress.
(…)
For an autistic child, who often has a concrete way of thinking and tends to maintain a rigid self-concept, it is all the more important that the support offered goes beyond simply validating what they express. They need a framework that allows them to explore and understand all aspects of their identity and well-being.”
4. A Concerning Imbalance in Support Services
“Autistic individuals lack places and resources that meet their specific needs. Many turn to the LGBT+ community in Denmark, where gender identity holds a prominent place. Many autistic individuals have always felt marginalized and excluded from typical social groups.
(…)
In a context where gender identity is highly valued, and where social media presents an easily accessible rainbow world, these autistic individuals—often isolated and vulnerable—may be drawn to communities that seem to celebrate difference. In such environments, the issue of gender can become central, partly because there are no alternative support systems tailored to autistic people.
When gender identity takes up so much space, it can make it harder to explore other aspects of the self or to step back if gender dysphoria turns out to be temporary. Autistic individuals are often deeply loyal to groups where they feel accepted, and may fear losing those relationships if they begin to question their gender identity.
If support services were more attuned to the specific needs of autistic individuals—without focusing solely on gender identity—more of them might be able to explore their identity in a broader sense, and work on other dimensions of their well-being as well.”
🔍 This position also raises important questions in France about how we evaluate and support autistic youth who are dealing with gender incongruence. |
➥ Learn more:
Specific vulnerabilities of autistic individuals in relation to gender issues, by Autisme- og Aspergerforeningen (translated into French)
This website’s page dedicated to the links between autism and gender dysphoria.
How Autistic Traits Can Be Mistaken For Gender Dysphoria, Christina Buttons, March 24, 2023 — article translated into French on the PAARI website.
In 2025, Denmark is updating its 2018 guidelines on gender incongruence. Two new documents have been proposed:
Faglig ramme: a framework of best practices for the assessment, treatment, and follow-up of individuals concerned.
Vejledning: a medico-administrative directive outlining healthcare providers’ obligations (information, consent, coordination, etc.).
These texts were submitted for public consultation from December 18, 2024, to February 24, 2025, on the official government consultation website. 🔝
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