Summary: The Awesome Autistic Guide For Trans Teens
Executive Summary
This comprehensive guide addresses the intersection of autistic and trans identities, drawing on research showing that autistic people are seven times more likely to be trans or gender-divergent than the general population. The book reframes this correlation not as coincidence but as reflecting fundamental differences in how autism brains process concepts like gender identity. It provides practical guidance on navigating puberty, social transition, medical decisions, mental health, and community building while emphasizing that neither identity needs to be “fixed” or hidden. The text uniquely positions autistic trans people as having valuable perspectives from questioning arbitrary social rules through logical thinking and developing resilience through navigating multiple marginalizations.
Understanding Autism and Gender Diversity
The Intersection of Autistic and Trans Identities
The connection between autism and gender diversity is statistically significant and reflects how autism neurology influences identity processing. Autism affects how individuals perceive and interact with the world through traits like passionate interests, heightened sensory experiences, logical thinking, difficulty reading social cues, anxiety in social situations, and stimming behaviors.
Key insights:
- Being both autism and trans is far more common than generally recognized
- The outdated binary concept of “male” and “female” autism fails to include trans and non-binary autism people
- Autism doesn’t determine gender but may influence how individuals understand and express their gender identity
Many autism people engage in masking—hiding their true selves as a survival tactic—which can include suppressing special interests, forcing eye contact, controlling stimming, and adopting neurotypical communication styles. For those who are both autism and trans, this may mean dual masking, creating significant cognitive load and making unmasked spaces essential for mental wellbeing.
Masking and Camouflaging
Masking serves as a survival strategy but comes at substantial cost to mental health and authentic self-expression. The book emphasizes that finding spaces where you can be unmasked is not optional but essential for wellbeing. This is particularly challenging for autism trans youth who may feel pressure to conceal both their autism traits and their gender identity simultaneously.
Understanding Gender Identity
Gender As a Spectrum
The text uses a powerful analogy: claiming there are only two genders is like saying there are only two types of music (rap and classical). Gender exists on a spectrum with infinite variations, much like musical genres. Your gender identity—your internal experience of gender—is innate, not chosen. However, gender expression—how you communicate gender through clothing, hairstyle, behavior, and presentation—can be explored and adapted over time.
The book introduces several gender identity terms including agender (gender not strongly identified), autigender (gender inseparable from autism), genderfluid (gender changes regularly), demigender (partial connection to binary gender), non-binary, and transgender. It emphasizes that bodies don’t have gender—the concepts of “men’s bodies” and “women’s bodies” are social constructs, not biological facts.
Puberty and Physical Changes
Understanding Puberty
Puberty brings physical changes including voice changes, new hair growth, body shape changes, skin changes, menstruation or erections, and height/weight changes. Emotional changes include mood swings from hormonal shifts, increased sexual feelings, changes in self-perception, and heightened emotions.
For trans youth, puberty can amplify gender dysphoria—distress from the mismatch between gender identity and assigned sex. This dysphoria is real and can lead to anxiety or depression if untreated. The book validates these experiences while providing context about the biological processes involved.
Hormones and Medical Options
Everyone has both testosterone and estrogen regardless of gender identity. Puberty blockers can temporarily pause puberty, allowing more time for decision-making without permanent physical changes. Hormone replacement therapy (HRT) can help align appearance with gender identity, typically available around age 16 in many countries.
The text emphasizes that medical interventions are optional—social transitioning alone can be equally affirming. All medical decisions require consultation with gender-specialized healthcare providers who understand both autism and gender diversity.
Pronouns and Names
Understanding Pronouns
Pronouns serve as identity markers, essentially secondary names. The book covers traditional pronouns (she/her, he/him, they/them), neo-pronouns (xe/xem, ze/hir), and nounself pronouns (any word used as pronouns like frog/frogself). It recommends trying pronouns with trusted people one at a time to determine what feels right when spoken aloud.
Exploring New Names
Name changes don’t require legal paperwork initially. The book suggests experimentation through nicknames, asking friends to use different names, writing your signature repeatedly, using names in online spaces, and testing names at coffee shops where staff call out orders. This low-stakes exploration helps find what truly resonates without pressure.
Coming Out Strategies
Preparing for Coming Out
For autism people who may struggle with social unpredictability, the book provides structured preparation including a template conversation with five steps: explaining you’ve been thinking about your gender, stating your identity clearly, explaining what it means personally, requesting support and respect, and offering to answer questions.
Preparation strategies include writing notes beforehand for structure, choosing trusted people likely to be supportive, planning responses if conversations go poorly, and practicing with one person before expanding to others. This structured approach acknowledges autism communication differences while providing practical tools for disclosure.
Different Reactions to Expect
autism and LGBTQIA+ friends often understand best, having their own experience with marginalization. Neurotypical and cisgender friends may need more education about what being trans means but aren’t necessarily hostile. Parents often need time to process and may cycle through confusion, grief, and eventual acceptance. New people in your life often misgender you initially, which is usually unintentional.
Handling Challenges
Transphobia and Discrimination
Transphobia takes many forms including intentional misgendering, slurs, exclusion from gendered spaces, and subtle discrimination. The book emphasizes that transphobia is never your fault—it’s a systemic issue, not a reflection of your validity.
Response strategies include stating your identity clearly, explaining that many autism people feel similarly, asserting that labels are important to you, noting that gender exists on a spectrum, and walking away from harmful conversations when needed.
Bullying and Safety
Bullying is never acceptable, and autism trans youth face particularly high risk due to intersectional marginalization. Safety strategies include reaching out to trusted adults (teachers, counselors, family), documenting incidents of discrimination, knowing your rights at school and work, creating safety plans for difficult situations, and ending toxic relationships that cause fear or constant conflict.
Mental Health and Wellbeing
Understanding Alexithymia
Many autism people experience alexithymia—difficulty identifying and naming emotions—which can mask poor mental health, making depression or anxiety hard to recognize until severe. Warning signs include changes in sleep patterns, appetite changes, loss of interest in special interests, social withdrawal, and increased irritability or anger.
Protective Factors
The book identifies several protective factors including engaging with passionate interests (a core autism strength), connecting with neurodivergent and trans friends who truly understand dual identity, spending time with pets for unconditional affection and routine, using distraction techniques like gaming and music, seeking professional support from providers who understand both autism and gender diversity, and taking breaks from social media when it harms mental health.
Crisis Support
If experiencing thoughts of suicide or self-harm, reach out immediately to The Trevor Project (North America) for 24/7 crisis support for LGBTQ+ youth, local crisis hotlines, or trusted adults who can help you get professional support.
Building Community
Finding Your People
Families of choice become essential when biological families don’t provide support—these are chosen families of supportive people who may be other trans and/or neurodivergent people. Community options include organizations like Spectrum Intersections and Mermaids, school Pride groups and LGBTQIA+ clubs, online communities and peer support groups, mentors who are autism and trans, and local LGBTQIA+ centers and events.
Creating Support Networks
Your support network should include people who understand both autism and gender diversity, respect your pronouns and identity, provide emotional support without judgment, help you navigate challenges and celebrate successes, and offer practical assistance when needed.
Medical Decisions and Healthcare
Working With Healthcare Providers
You deserve healthcare providers who understand both gender diversity and neurodiversity. Signs of good providers include using your correct name and pronouns without reminder, understanding autism traits like sensory processing sensitivities, explaining medical concepts clearly and literally, respecting your autonomy in decision-making, and not pathologizing your autism or gender identity.
Making Informed Decisions
All medical decisions about hormone replacement therapy, puberty blockers, or surgeries should be made with specialized providers, based on your personal goals and values, informed by accurate evidence-based information, timed according to your readiness and local regulations, and reversible when possible for initial steps. The book emphasizes that you can always change your mind—medical decisions aren’t permanent commitments.
Daily Life Strategies
Managing Sensory Challenges
Sensory processing sensitivities can interact with gender dysphoria around clothing and appearance. Strategies include choosing fabrics that feel good on your skin, experimenting with clothing styles that reduce sensory issues, considering sensory processing-friendly alternatives to traditional gender expression, and creating sensory kits for managing sensory overload in public spaces.
Executive Function Support
Many autism people struggle with executive function—planning, organization, and task initiation—which can make managing medical appointments, name changes, and transition steps challenging. Support strategies include using visual schedules and reminders, breaking large tasks into smaller manageable steps, asking trusted friends or family for help with organization, and using technology (apps, calendars, reminders) for tracking.
Communication Strategies
Communication differences common in autism can impact coming out and advocacy. Helpful approaches include writing things down instead of speaking spontaneously, using scripts for difficult conversations, bringing advocates to important appointments, practicing conversations with trusted people first, and using augmentative communication if helpful.
Celebrating Your Identity
The Strength of Intersection
Being both autism and trans gives you unique perspectives and strengths: logical thinking that questions arbitrary gender rules, authenticity in living your truth despite social pressure, resilience developed through navigating multiple marginalizations, community connections with others who share your experiences, and self-knowledge from deep introspection about identity.
Finding Joy in Your Identity
Ways to celebrate and enjoy your identity include connecting with other autism trans people, creating art or creative expression about experiences, educating others when you feel safe and willing, celebrating milestones in your journey, building spaces where you can be completely yourself, and supporting others on similar paths.
Resources and Support
The book provides extensive resources including organizations like The Trevor Project for 24/7 crisis support, Spectrum Intersections for autism LGBTQIA+ people, Mermaids for UK support, Trans Youth Equality Foundation, and Gender Spectrum. It lists books by Laura Kate Dale, Wenn Lawson and Yenn Purkis, and Owl Fisher, plus online communities including forums, social media groups, Discord servers, and Reddit communities.
Final Thoughts
The book concludes by affirming that being both autism and trans is part of who you are—neither identity needs to be “fixed” or hidden. Your identity is not up for debate or justification, and you don’t owe anyone an explanation for who you are. Your authenticity is more important than others’ comfort. While the path forward may not always be easy, you don’t have to walk it alone. Countless others share your experiences and understand the unique challenges and joys of being both autism and trans. The text ends with a powerful affirmation: “You are valid. You are worthy. You belong.”