“It’s Like a Chain Reaction of Discomfort”: A Phenomenological Qualitative Study on the Intersection of Autism and Gender Incongruence in Adolescents

PURPOSE: An overrepresentation of autism spectrum diagnoses (ASD) and autistic traits have been reported among people with gender incongruence. Several quantitative and qualitative studies have highlighted the intersection of autism and gender incongruence (GI). However, we have little knowledge on lived experiences of adolescents experiencing ASD and GI. The study aimed to shed light on lived experience of gender incongruence from the perspective of autistic adolescents. The analysis was guided by the following research question: How do adolescents with ASD and GI experience their bodies and gender in everyday life, and how do they make meaning of the intersection of autism and GI in everyday living? METHODS: This study is based on semi-structured interview guide alongside life-mode interviews of adolescents experiencing both ASD and GI. We adopted reflexive thematic analysis with phenomenology as the theoretical backdrop. RESULTS: The analysis concluded with three overarching meta-themes; "The emergence of the mismatch of gender identity and body in autistic adolescents", "The hard work of everyday routines - working all day and all night", and "Experiences of Bodily Estrangement - A Chain Reaction of Discomfort". CONCLUSION: The findings contribute to the existing literature by emphasising how sensory sensitivities and gender identity distress intensify each other and how the transition from child to adolescence, and the body, is perceived. Results indicate tailored clinical implications for adolescents experiencing ASD and GI. Clinicians should consider multidisciplinary collaboration, individualised and flexible interventions that address both sensory regulation and gender-related support to improve quality of care for adolescents with ASD and GI.