How to support the health and wellbeing of trans autistic young people: A review of the research

First published online 18 Feb 2024.

Why this study was done

Transgender (trans) and autistic youth each face unique challenges, especially in school settings. When a young person is both trans and autistic, these challenges can overlap and intensify—leading to higher risks of bullying, anxiety, depression, and even suicidal thoughts. This study reviewed existing research to understand what kinds of support help these young people thrive.

What the study did

The researchers reviewed 20 studies from around the world that focused on school-aged youth (ages 5–18) who are both trans and autistic. They looked for patterns in what supports were most helpful for improving mental health, wellbeing, and quality of life.

What the study found

The review identified five main areas where support is needed:

1. Clinical Adaptations

• Clinics should be sensory-friendly (e.g., quiet, calm lighting).
• Therapists should build trust slowly and use clear, structured sessions.
• Visual aids and written materials help with communication.

2. Thinking and Communicating About Gender

• Trans autistic youth may struggle to express their gender identity due to communication or rigid thinking patterns.
• Therapy should include tools like scripts or role-playing to help with self-advocacy.
• Supportive families and schools can reduce distress and improve mental health.

3. Executive Functioning Support

• Many autistic youth have trouble with planning, organising, and managing tasks.
• Tools like checklists, routines, and visual planners can help.
• Families and schools can support by helping manage appointments and daily tasks.

4. School Support

• Schools should have clear anti-bullying policies and support gender affirmation (e.g., correct names/pronouns, inclusive bathrooms and uniforms).
• A safe and inclusive school environment is a major protective factor for mental health.

5. Socialisation

• Many trans autistic youth feel isolated or misunderstood.
• Peer support groups (online or in person) can help build community and reduce loneliness.
• Clinicians should be trained to recognise autism traits in gender-diverse youth and vice versa.

What this means

Trans autistic youth face unique and complex challenges. With the right support—especially in clinics, schools, and families—they can experience better mental health, stronger self-esteem, and a higher quality of life. However, the research highlights several important gaps that need to be addressed:

• More research, especially involving the voices of trans autistic youth themselves.
• Larger, more diverse studies (most current research is based on white participants).
• Better training for clinicians and educators to understand both autism and gender diversity.

This study was conducted by:

Jessica Manley, Prof. Charlotte Brownlow, A/Prof. Annette Brömdal

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Disclaimer: The QDRN has utilised generative AI to refine the wording of this plain language summary. All content has been checked for accuracy, appropriate tone and clarity and approved by the author.