Gender identity development in autistic individuals: An interview study

Autistic individuals report more gender-related questions and gender incongruence compared to non-autistic peers. However, research on gender identity in autistic individuals lacks longitudinal perspectives and underrepresents cisgender males. This study explored how both cisgender autistic individuals and trans and gender-diverse (TGD) autistic individuals experienced their gender identity development in a broad sense. Fifteen autistic adults (aged 27–52) participated in semi-structured interviews. Data were analyzed using a qualitative longitudinal approach combining phenomenological and process analyses, guided by the Qualitative Analysis Guide of Leuven (QUAGOL). The autistic community was involved in developing research questions, study design, interpreting and discussing results. Phenomenological analysis revealed three themes: (1) exploring a comfortable identity; (2) negotiating oneself with others; and (3) interacting with societal perspectives on gender. Process analysis identified three themes: (1) learning by experience; (2) gender identity development takes time and is demanding; and (3) changing perspectives on gender. Gender-related questions shaped by individual, environmental, and societal factors were present in both cisgender and TGD autistic individuals, though convergence and divergence existed. Gender identity development was experienced as intertwined with autism and demanding, emphasizing the need for supportive environments, peer connections, and appropriate timing and conceptualization of autism diagnoses to foster positive gender identity development.