Like many others, I am concerned about teenagers being railroaded into irreversible medical procedures under the banner of “progressive” transgenderism. But I have a particular reason to be worried about a very vulnerable subgroup — neurodivergent (ND) girls, i.e. girls with dyslexia, dyspraxia, attention deficit disorder (ADD) and similar conditions.

That’s because I am autistic and dyspraxic with ADD myself, having myriad, often contradicting manifestations. Typical ND challenges are working out social rules, dealing with the physical environment and coping with change, even if it is beneficial and others consider it unimportant. Change can bring anxiety about what might now be expected of us and how likely we will be to disappoint. We can have unusually high abilities in niche areas, which contrast sharply with the exhausting struggle with everyday life skills that others take for granted.

I shudder to think how easy it would have been to persuade the adolescent me that my struggles, including trying to coordinate this body, were because I was really a boy and that all could be fixed by surgery. Multitasking, housework and many other things expected of girls were a struggle. Whereas my logic and mathematical strength were considered male traits, as was being dreadfully untidy and disorganised. My very neurotypical (ie “normal”) mother despaired of her only daughter being so useless at housework. She would try and dissuade my occasional enthusiastic fits of baking. “We can buy these dear”. From bitter experience she knew that what I would produce would be perfectly palatable, but my exhaustion and the state of the kitchen would be less appealing. With all these indicators of female failure, if I had been gay as well, then it would have been case closed.

I wasn’t surprised then, when I read that research showed autistic lesbians were disproportionately represented amongst those who regret transitioning. Since then, I have seen further studies that autistic people are between three and six times as likely as others to consider themselves trans or non-binary. Particularly recently, there has been a reported increase in the proportion of adolescent girls coming forward identifying as boys, noted in a House of Commons’ report. 

The National Autistic Society says that, “There is some evidence to show a link between gender dysphoria and autism, and that autistic people may be more likely than other people to have gender dysphoria.” It notes that “the reasons why” are not well explained. I think the What is being established. I am suggesting a possible Why. 

There are generally differences in the way neurodivergence manifests itself between the sexes. Boys tend to have hyperactivity with their ADD, whilst girls tend to hypoactivity. We can be quietly daydreaming and underachieving in the corner whilst the boys are creating havoc. We are generally better at masking, so our difficulties can be well hidden, and expectations to be “normal” are a bigger burden. The exhaustion that comes from struggling with our conditions is exacerbated by trying to hide our distress or at least its degree. We do this because, however inconsiderate others judge us to be, we actually don’t want them to be inconvenienced or even just uncomfortable. We also want to avoid the judgement for making an unacceptable fuss. So it is part altruism but also part self protection. 

I am not suggesting that males don’t mask or try to control their manifestations. I would think both genders can relate to quotes like “mild autism [a misleading out of favour term] means YOU experience my autism mildly, not that I do”. Diagnosis can be the key to gaining essential support and can help dealings with others. However there will always be those who just won’t understand the condition, especially if there is an emergency or someone else is having a hard time. People who need wheelchairs or who can’t see, are expected to be empathetic to others in times of trouble but no one expects them to be cured for the duration of that trouble. Many, even if they know that we are neurodivergent, still presume to judge what we should find easy. Girls are less liable to be diagnosed anyway because, all too often, assessors are looking for how the conditions manifest in males, and in so many ways “it’s different for girls”.

All of this means that low self esteem can be a major problem. Diagnosed or not, NDs can have a strong sense that there is something fundamentally and shamefully wrong and unacceptable about them.

How easy would it be to be swept along by this socio-cultural tidal wave

How seductive would the trendy response to someone transitioning be — i.e. being told how brave you are, and experiencing the sense of being accepted after such feelings of inadequacy and self doubt? How easy would it be to be swept along by this socio-cultural tidal wave and let yourself be cheered all the way to the operating theatre? With Keir Starmer proposing a “trans inclusive” ban on conversion therapy, which would make it illegal to question someone’s “gender identity”, unpicking such psychological complexities is more important than ever. We may be about remove the chance to create the space for young people to appreciate how neurodivergence may be impacting them and protect them from irreversible self-harm.

Much more research is needed. I am sure there are overlapping issues with ND boys. They may not damage themselves as much with masking strategies but that can make them more open to ostracisation because of behaviour that they are less able to control. I don’t know as I was never an ND boy and thank God, I am past being vulnerable to pressure to believe I was.