I’m non-binary, autistic, and extremely worried about trans neurodiversity screenings

At first glance, my reaction to new recommendations for transgender children’s healthcare in the UK should have been one of celebration.

After all, the authors of the controversial Cass report have vowed their findings are aimed at providing ‘holistic’ care to gender-questioning children, including extensive physical and mental health screenings.

Instead, my stomach dropped when reading that the NHS is planning on screening all children referred to gender clinics for ‘neurodevelopmental conditions’, such as autism and ADHD.

Rather than providing a much needed improvement for gender health services in the UK, these new plans reinforce the belief that being trans is caused by external factors or that a gender-questioning child is wrong about being trans because of their autism.

As a neurodivergent and non-binary person, I believe this could have devastating consequences.

The Telegraph has reported the NHS plans to make it compulsory to assess a transgender child’s mental health, familial relationships, and even their sexual development.

This includes screening all children for autism. Doctors will then see if a child’s symptoms of gender dysphoria ‘are caused by autism’ or whether they need to have their gender dysphoria treated. 

It does no harm to point out that neurodivergent people experience higher rates of gender dysphoria, but what worries me is that this treatment plan simply seems to brush off being trans as a side effect of untreated autism. 

The implication is that anyone questioning their gender is only doing so as a result of either neurodivergency or poor mental health. Ergo, being trans is caused by something and not a real experience for people who experience gender incongruence. 

I thought we’d moved past this when the World Health Organisation stopped classifying transness as a mental disorder in 2019. 

This new practice seems to have been constructed by a group of people who have completely misunderstood the needs of both gender questioning and neurodivergent people by infantalising us and viewing our traits as nothing but disorders that need fixing.

I was assigned female at birth, but I knew from a young age that I was not ‘a girl’ because I always felt ‘icky’ when being referred to in any gendered way. I just didn’t have the language to express that until recently.

It wasn’t until I was in my late 30s that I got my diagnosis of autism and ADHD, and that has led to an improvement in my ability to navigate life.

I have no doubt that, had I been diagnosed as neurodivergent sooner and received appropriate care, I would still very much be non-binary. It’s who I am and my identity is not the result of another aspect of my being.

As for the other parts of these suggested reforms, if the mental health screenings are there to genuinely treat poor mental health for trans children, that is great. If they are there to suggest children are only experiencing gender dysphoria because they are mentally unwell, the same problem as the autism screenings arise. 

Because, yes, people with gender dysphoria do experience higher levels of mental ill health, but much research has shown that is generally the result of societal attitudes, discrimination, and lack of appropriate support and awareness.

Imagine being a transgender person and seeing the vitriol being spewed about your community – the very community that has been used as a political football and dog whistle by those with influence for years. You would probably have some mental health issues too.

For me, a lack of medical diagnosis for my neurodivergence and understanding about my gender identity led to decades of mental health issues, including suicide attempts. 

I can see now that my mental health struggles were caused by not having the right support or awareness. This realisation has allowed me a new lease on life but is also why I know it is critical that trans neurodivergent children get the best help from the outset. 

And yet we are met with these reforms. 

Another flaw in the plans is to question a child about their sexual identity, but this feels entirely redundant. Sexuality and gender identity are not mutually exclusive, and to question a trans child about their sexual orientation once again seems to reinforce an idea that being trans is caused by something, or that all trans people are homogenous blocks of people with identical needs.

At the end of the day, this latest news just adds even more misunderstanding about transgender people and their needs.

Instead of properly improving services, these plans will continue to ‘other’ transgender people because of the dangerous falsehoods it will no doubt perpetuate.

Do you have a story you’d like to share? Get in touch by emailing James.Besanvalle@metro.co.uk. 

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