Etiology Does Not Define Us


My latest special interest is the intersection of autism and gender, and as I’ve been reading I’ve noticed that one of the core concerns of service providers is whether gender nonconformity is CAUSED by autism or not. This is often followed up by assertions that for many autistics gender nonconformity is long lasting and thus should be treated.

I find myself mildly perplexed by the proximity of these two sentences, as if the underlying cause of a source of discomfort or identity somehow validates that identity, gives it a stamp of approval. My sense of gender is deeply entwined with my understanding of myself as autistic, but that does not make my gender less real or less important, less deserving of recognition or (if it were causing me distress) treatment. More important questions seem to me to be how intense the feelings are, if they do persist over time, how much they interfere with someone’s life, and how permanent the proposed solutions are.

This is just another example in the obsession with etiology that appears whenever we have someone who is different. Difference is ok if it’s 100% innate and you definitely can’t change it and it’s certainly not your fault because you didn’t choose it nuh uh not even a bit. If your difference came from some kind of grand a priori category handed down by God or Nature, then it is acceptable, but otherwise you’re just being different and we can’t accept it.

We see this in the way that many advocates have taken to the “born this way” language with gusto. You can’t criticize this sexuality because it’s innate, it’s natural (see: the naturalistic fallacy). We see it when people suggest that others aren’t REALLY asexual or lesbian or trans, but really they’re those things because of trauma or a medical problem or mental illness (as if those things aren’t completely real and valid reasons to have an identity). People are OBSESSED with the idea that choosing to be different could be bad, but if it’s something you’re stuck with I guess we have to accept it. But there are lots of pieces on why that kind of attitude isn’t actually super great, and how there actually would be nothing wrong at all if someone chose to be gay.

So why do we care if ASD is part of why someone feels gender dysphoria? Perhaps it’s true that people with ASD are less likely to be influenced by societal expectations of gender, and thus are less likely to conform to gender roles, so Person X is only trans because they’re autistic. So what? It’s not as if there’s some magic day in the future in which the autistic person will suddenly become neurotypical and their dysphoria will disappear. Those feelings are still real, and their identity is still real: it really truly doesn’t matter why they have the identity they do. Even if those feelings do change 20 years in the future, we all have that possibility with every choice we make. Why is it suddenly invalid for a disabled person to make long lasting decisions about their body and identity because they might regret it later? Disabled persons are due the same ability to make serious and potentially risky decisions that all of us have.

Sure, there are some instances in which the origin of a feeling seems to be important, like if someone on the spectrum was stuck in some major black and white thinking and thought that liking “girly” things made them a girl, but I find myself utterly confused as to why it matters otherwise WHY someone feels as if they’re a different gender so much as what the impact is on the person of those feelings and whether it would improve their quality of life to recognize them as a different gender.

Perhaps even worse is the implication that autistic traits are in some way invalid, temporary, disordered, or wrong. Traits that are part of autism are still real and valid. they’re not symptoms, they’re not going to go away when we get better. They’re who we are, and while sometimes we can come to better arrangements with our brains (improving executive functioning, lowering anxiety), the basic thought patterns ain’t gonna change.

My mental health and neurodivergence affects my identity in tons of ways. That doesn’t invalidate my identity, nor should it mean I don’t get to make identity affirming, serious, important decisions. Good gravy.