Abstract Introduction/Objectives The coexistence of Autism Spectrum Disorder (ASD) and gender issues has gained increased recognition. Traits of ASD in social, communication, and behavioral domains can hinder gender exploration. Research shows higher rates of gender incongruence and dysphoria among autistic individuals, influenced by factors like alexithymia, social anxiety, and communication challenges, which can complicate gender identity. This study examines the psychosocial experiences of autistic individuals with gender concerns, focusing on factors affecting their mental health and well-being. Materials and Methods This qualitative, exploratory, descriptive study involved 20 individuals with ASD and gender-related issues, recruited from clinics and support groups. Data were collected through semi-structured interviews adapted to participants’ needs, plus validated scales measuring gender dysphoria, social anxiety, and alexithymia. Thematic content analysis identified key patterns, following ethical guidelines (Brazilian Resolution No. 466/2012), with informed consent. Results Findings highlighted difficulties in emotional understanding, the impact of social stigma, and gender affirmation strategies used by participants. Significant correlations were observed between social anxiety, alexithymia, and severity of gender dysphoria. Family and social environments influenced gender development. Interventions, including hormonal and psychosocial approaches, were linked to improved mental health and expanded support options. Conclusion The link between ASD and gender identity is complex, requiring personalized, sensitive approaches. Skilled professionals and targeted interventions are vital for fostering inclusion, respect, and mental health. Policies and practices acknowledging gender diversity within autism are essential, along with ongoing research into sexuality and gender identity in this population. Financing No conflict.
Rêgo et al. (Sun,) studied this question.