It’s Time to Embrace Disabled Trans People
A few years back, when I was first seeking gender-affirming care, a doctor told me he wasn’t comfortable treating me because he didn’t think my autism was “under control.” Another provider, a therapist, refused to write me a letter supporting my treatment because of my disability. They weren’t the only medical professionals who doubted my gender identity or hesitated to provide me with gender-affirming care, and I soon learned that I had to hide or downplay my autistic traits to get the care I needed—something that many autistic people don’t have the privilege to do.
This wasn’t my first fraught experience in a medical setting. Like many other disabled people, I was familiar with the tension of wanting and needing health care that I could get only from a system that so often devalued my autonomy and self-determination. But even still, being turned away from gender-affirming care felt devastating.
So many trans people face obstacles to getting health care, which for many can include gender-affirming care. Sometimes it’s outright hostility; sometimes it’s dealing with dangerously ignorant providers or jumping through seemingly endless procedural hoops. One study found that, in 2020, nearly half of transgender people experienced mistreatment by providers, like refusal of care and verbal or physical abuse. More than two-thirds of trans people of color were mistreated, a stark reflection of the ways that racism and anti-Blackness reinforce and exacerbate these barriers.
That’s the trans health care crisis that our lawmakers should be solving. But instead, so many of them are making it even worse. Just this year, politicians introduced over a hundred bills attacking gender-affirming care, most often with trans youth in their crosshairs. And nearly a dozen states have passed these cruel bills into law.
At their core, these legislative attacks on gender-affirming care are bound in racist, ableist, and sexist beliefs about who should get to make decisions about their bodies and their futures. And those beliefs become very explicit when their proponents talk about autistic trans people.
Autistic people are a lot more likely to be trans or transcend gender stereotypes. That’s one of the things that makes the autistic community so beautiful, and autistic trans people should be celebrated and embraced. But for anti-trans extremists, the overlap of trans and autistic people is a sign of something nefarious. They claim that autistic people are being misled and manipulated into thinking that they’re trans, that we can’t truly understand our own gender, that we can’t be left to make decisions about our care.
Proponents of medical bans haven’t been shy about saying this out loud, but now we’re even seeing this narrative reflected in the laws themselves. A medical ban in Georgia that became law just last week offers the justification that trans people are more likely to be autistic. (The law also parrots the misleading and sexist claim that the “unexplained rise” in gender dysphoria diagnoses is mostly occurring among girls.) Missouri’s attorney general has threatened to issue an “emergency regulation” that could require, among other things, that young people be screened for autism before receiving gender-affirming care.
The belief that autistic people shouldn’t be trusted to make decisions about gender-affirming care isn’t limited to anti-trans lawmakers. This assumption—this doubt about autistic people’s competence to make decisions about our care—was there implicitly in my experience with providers, an experience that is far from unique among autistic trans people. And it’s part of a broader attempt to limit disabled people’s bodily autonomy and restrict our rights, often done purportedly for our own protection.
On this year’s Trans Day of Visibility, disabled trans people are more visible than ever—but too often, that visibility is limited to being a high-profile talking point in the fight to restrict gender-affirming care. We deserve more than that. We deserve acceptance, pride, and self-determination. Today, let’s commit to changing the narrative and embracing disabled trans people.