Communication Strategies to Support Self-Advocacy in Transgender Youth With Autism Spectrum Disorder: A Literature Review

This literature review examines effective communication strategies for clinicians supporting youth with co-occurring autism spectrum disorder (ASD) and transgender and gender-diverse (TGD) identities, with the goal of enhancing self-advocacy related to gender identity and mental health. Approximately 11% of individuals who are TGD are also diagnosed with ASD, highlighting a complex intersection of identities often met with misunderstanding or dismissal by peers, parents/guardians, and health care professionals. High rates of anxiety, depression, suicidal ideation, and communication challenges are prevalent in this population, furthering complications. Based on 21 studies selected per PRISMA 2020 guidelines, the review underscores the importance of evidence-based tools that can be used to help aid treatment and communication; although, many of these tools are not diagnostic. Clinicians are encouraged to implement ASD screenings and LGBTQIA+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual/aromantic/agender) training, as well as address systemic barriers. Affirming and individualized care is essential to improving outcomes for youth with ASD who are TGD.