My son wanted to transition – a routine screening for autism would have saved years of heartbreak
My second son, Jack*, was first diagnosed with autism aged 17. I had my own suspicions when he was at primary school; I sensed there was a difference between him and other children, but I didn't know what. His teacher told me that he was 'very bright' and Jack was always ahead of his peers academically. But his older brother had been clever too so it didn't cause me any real concern. He was certainly very particular and liked to organise his toys very meticulously, the Thomas the Tank Engines he collected and his beloved dinosaurs were always lined up with great precision.
Jack always gravitated towards traditional 'boys toys', he'd never had any interest in playing with the kitchen sets and dolls like his younger brother had enjoyed, or had ever expressed any desire to dress up as a girl. He was very black and white in his thinking, and was always fussy about having the labels cut out of his clothes as he didn't like the feeling. Being sensitive to sensory things like this, I now realise, is common with neuro-divergent children.
So when I discovered on the family iPad a letter Jack has composed, declaring his trans identity, I was confused and surprised. Jack was 13 when we found it. My husband and I had no inkling of this before we found that letter, which seemed to have been copied and pasted from somewhere. Jack being so bright had always been the person in the family who most enjoyed using the iPad. I think I'd set up parental controls but he'd clearly been able to smoothly navigate these.
The letter was heartbreaking: it explained that he believed he'd always felt different, had been born in the wrong body, and now he realised he was transgender he hoped my husband and I would still love him. We sat him down to ask him about why he was feeling this way, but he just closed up. 'I don't want to talk about it,' he insisted. In hindsight I think he was too young to comprehend what he was saying.
I'd only heard of transgender at this time from seeing bits on TV and the news, not understanding what to make of it I went to speak to his teacher at secondary school. I wondered if there was bullying going on, but Jack had never has issues with friendship groups before. He'd recently hit puberty though, and was increasingly awkward in social situations. So are many teens you'd think – but I've since discovered that it's common for neuro-divergent children to reach puberty and start disassociating with their own bodies as they undergo natural developmental changes.
The teacher I spoke to was very casual and said 'we deal with transgender children all the time'. I also learnt for the first time that Jack had taken part in a PSHE lesson a few weeks earlier about transgender ideology and people being 'born in the wrong body'. I'm sure this was when the idea was seeded. We were advised to speak to the school counsellor, who recommended that we speak to the Tavistock and consider putting Jack on puberty blockers. These were described to us as like being 'pressing a pause button' to allow Jack to have some time to make a decision about his gender. She also gave me the Mermaids website to refer to for advice.
Jack said that he wanted to be known as a girls' name, though mainly he seemed to be taking on a female identity when he was online, changing his profile picture and the like.
My husband, Ian and I were hugely confused. If Jack had announced that he was gay neither of us would cared, but changing his gender as a teenager seemed extreme.
There was no way I'd allow him to consider any drugs, I decided, until Jack had been seen by a therapist. With the long NHS waiting lists we decided to pay for a private assessment in the end, which indeed confirmed Jack's autism diagnosis when he was 17.
By then I'd begun searching the internet looking for advice and found support groups, such as the Bayswater Support Group, for parents of trans-identified adolescents and young people. I found our story was horribly common, and so many of the parents I spoke to in the group also had neuro-divergent children.
Then when lockdown hit things got very bad, Jack began self-harming. I blame the fact he was spending more and more time online with other people his age who all believed they were transgender and were trying to buy hormones online. Every time I'd try to talk to him he seemed embarrassed. He was very cold and became more and more isolated from the family. He became increasingly distant until, when he was 18, Jack left home for nine months to stay with friends and became entirely estranged from us.
At one point his thinking was so unclear he'd even accused us of abusing him. It was the darkest time imaginable and I ended up being signed off work. The only thing that got me through was the support of my husband along with the other parents I met in the support groups who were going through similarly horrendous experiences.
Jack kept in touch with only sporadic texts, and most days I didn't want to get out of bed, but I refused antidepressants as I felt there was no point – blocking my pain wouldn't return my son to me. But I had to keep going for the sake of my other kids. Then, out of nowhere in May 2022, when Jack was by then 19, he messaged saying he wanted to come home to collect some things from the house.
We welcomed him with open arms, we were so happy to see him and made sure not to challenge him on anything as I'd learnt from other parents this could make a child (although he was of course technically an adult by then) shut down even more. He was still dressed in his old hoodie. But I noticed he'd grown his hair long and his nails too, and I spotted fresh self-harming scars on his arms. I hugged him with all my might.
We were over the moon when Jack said he wanted to return home to live with us the next week. And a few weeks after that he came into the kitchen one day carrying a bin liner of clothes which I knew were his female clothes. When he announced 'I want to put this in the bin,' I didn't interrogate him but feigned disinterest. I was desperate not to rock the boat.
A couple of days after he said: 'I want to get my hair cut short again.'
I've learnt that with autistic boys these changes can happy very quickly. It was another two more weeks before I dared to directly ask my son 'are you still identifying as trans, and do you still want to be female?'
He looked right back at me and replied: 'No Mum, I'm not transgender – I'm just autistic.'
And that was that. That's why I welcome the news that the NHS will now ensure every child referred to a gender clinic will be screened for autism, because after everything we have been through, and all the other parents of transgender children I have met, there really is a disproportionate amount of autistic children with gender dysphoria. If these tests had been available to us on the NHS years before we would have possibly saved our family thousands of pounds that we paid for private tests and therapy - and years of agonising heartache.
Today, Jack in 22, he's in full time employment and his mental health is good. He's flying high and I couldn't be happier or more relieved. We have talked through everything and he has told me that he now believes the autism played a huge part in him believing he was transgender. How uncomfortable he felt as a teenager entering puberty, how he disassociated with his body and felt socially awkward and how that led him down towards a path of online transgender influencers.
*Names have been changed.
An expert's view
Nicola Lathey is a speech therapist and founder of The Owl centre which specialises in assessment and therapy for neuro divergent children and adults. Here she explains the connection between neuro diversity and gender dysphoria.
The news that the NHS will now be screening all trans gender children for autism is not a surprise as there is such a strong correlation between neuro-divergent children and young people and gender dysphoria. I meet parents everyday who are desperate to help and support their children to manage and accept their differences.
Masking and anxiety
Many children with autism feel a need to 'mask' who they are to try to fit in with their peer group. Often autistic children can be very anxious, (approximately 40 to 60 per cent of children with autism experience clinically significant anxiety which is considerably higher than 5 to 10 per cent prevalence of children without an autism diagnosis), and a large part of that can be down to the pressure of feeling the need to 'mask' how they might really feel.
Seeking a label
Often neuro-divergent people are actively seeking a label to help them to understand themselves better. Hyperfocus is a trait of autism so some people might hyper-focus on gender identity and pursue black and white answers wishing to change. So while you might imagine the number of trans children would reduce if they are all assessed for autism, this might not be the case as they can fixate on something – which might well be gender. There's a strong urge for autistic children to 'find their tribe'.
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