Lived Experiences of Autism with a Specific Focus on Gender Dysphoria

This thesis aims to enhance understanding of the lived experience of autism from individuals’ perspectives, voices typically marginalised within research, just as their needs have been marginalised within society. The research comprises: a systematic review and an empirical study.
The literature review synthesises and critically evaluates 14 qualitative studies on the experience of autism in adulthood. Six themes representing core features of experience were identified: identity and self-perception; interpersonal relationships; sensory experiences; dating and sexual experiences; institutional experiences; employment. The findings highlight the balance required between targeting remediation of autism-related difficulties, and efforts to make society, its services, public spaces, and institutions more autism-aware and inclusive. Future research directions are highlighted including a need for qualitative research exploration of sexuality, gender identity and related support needs.
In response to this review and the small but growing body of research describing the co-occurrence of gender dysphoria in people with autism, a qualitative study was undertaken investigating the impact of autism on the experience of gender dysphoria. A theoretical framework was developed of common processes involved in understanding and addressing GD, the influence of autism and the social environment. The overall experience is captured in the core category conflict versus congruence. Individuals achieve greater personal congruence and wellbeing upon social and physical transition. However, conflicts remain related to fear of hostility and an enduring sense of difference. Services facilitating increased social support and proactively addressing gender and sexual issues are recommended.