Danish Autism Organisation Takes a Stand: Challenging Gender Ideology to Protect Autistic People
Update 27.05.25: AoA have released another huge piece you can read translated here.
This is the moment many of us have been waiting for - an Autism Organisation named Autisme-og Aspergersforeningen (Danish Autism and Aspergers Association) has finally stepped up and into the debate to protect autism advocacy from transgender ideological frameworks. Their words are refreshing, intelligent, well thought through and thorough and stand for autism advocacy against all odds.
I have previously written about them here. They produced a piece of informative non-ideological work on their website about Autism and Gender and received terrible backlash from the Trans Activist mob for not centering trans narratives and instead simply writing about the experience of Autism in relation to gender.
Not only have they stood their ground, they have now also written and released a response to a consultation about Gender.
Here, I have used Google Translate to translate into English:
Consultation response to 'Guidelines on healthcare support for gender incongruence' and 'Professional framework for healthcare support for gender incongruence'
February 23, 2025
Autisme-og Aspergersforeningen views with great concern the current guidance on healthcare assistance for gender incongruence, particularly in relation to the medical treatments offered to children and young people. The guidance allows the use of potent hormone preparations, which were originally developed for the treatment of hormone-sensitive prostate cancer and are in some cases used for chemical castration of pedophiles ( Appendix 1 ). This raises a serious question: Are we witnessing a new form of medical conversion therapy aimed at autistic children and young people?
Less than 20 years ago, attempts were made to “normalize” autism ( Appendix 2 ) and cure homosexuality ( Appendix 3 ) using the same types of hormone preparations that are used today for sex-modifying treatment , including Cyproterone acetate (Androcur) , Spironolactone , GnRH analogues (stop hormones) such as Leuprorelin , and the like. History has shown that medical experiments on autistic children have had serious consequences – and yet we are on the way to repeating the mistakes of the past.
Autism screening should be a minimum requirement
Research shows that people who identify as transgender are up to seven times more likely to have an autism diagnosis compared to the general population ( Appendix 4 ). Several studies point to a marked overrepresentation of autistic traits ( Appendix 5 ) among transgender people, especially among children and adolescents seeking treatment for gender incongruence.
Internationally, we see a trend that people who regret gender reassignment treatment are primarily autistic. This concerns us as an association, as it is certainly not unproblematic to regret having undergone gender reassignment treatment ( Appendix 6 ).
Despite this, there is no guarantee that autism will be thoroughly assessed during the assessment process. Autism can affect body awareness, self-understanding, identity and can affect the ability to assess the long-term consequences of medical treatment. Therefore, a thorough screening for autism should be an absolute minimum requirement before gender modification treatment is initiated. Especially because
" Healthcare professionals covered by the Authorization Act must act with care and conscientiousness, cf. Section 17 of the Authorization Act " ( Appendix 7 – page 1 )
Lack of focus on autism in 'Professional framework for healthcare assistance in case of gender incongruence'
The 'Professional framework for healthcare assistance for gender incongruence' provides no assurance that autism will be assessed as part of the assessment, despite the well-documented connection between autism and gender incongruence.
Autism can affect identity: Many autistic people experience challenges with social adjustment, sensory disturbances, and a black-and-white approach to self-understanding, which can make them particularly vulnerable to perceiving gender identity as a fixed truth.
Risk of misdiagnosis: Autistic youth may misunderstand their own feelings and confuse gender dysphoria with other sensory or physical challenges. They may also be more susceptible to social influence and identity-seeking communities.
No structured screening for autism: Since autism and gender incongruence are often linked, a thorough screening for autism should be mandatory before medical or surgical treatment is even considered.
Lack of autism knowledge
Therefore, we may be surprised that the working group does not prioritize health or social education professionals with knowledge and experience of autism. However, there is an overrepresentation of professionals with an ideological approach to gender modification treatment. We consider this to be both negligent and irresponsible to have omitted competent and objective inputs.
When developing a professional framework aimed at healthcare professionals, it is crucial that it reflects the professional and ethical obligations that come with an authorisation. Healthcare professionals are obliged to exercise care, objectivity and impartiality in their work, and this should be reflected in the professional framework. The present letter does not meet these requirements and therefore appears to be professionally inadequate.
“ If we have zero regrets, then we are treating too few ”
Quote: Chief Physician, Sexology Center, AUH, North Jutland Region and sits on the working group that has prepared the "Professional Framework for Healthcare Professional Help with Gender Incongruence"
Based on the available information about the members of the working group behind the national clinical guidelines for the assessment and treatment of gender incongruence, there is no direct indication that any of the members have specific training or specialization in autism. Most members represent areas such as sexology, endocrinology, plastic surgery, pediatrics, psychiatry and legal advice related to LGBT+ issues.
However, the working group includes a specialist psychologist at the Child and Adolescent Psychiatric Center, Capital Region of Denmark, but there is no publicly available information that specifically indicates that he or she has any form of specialization within autism.
Can one give informed consent for experimental treatment?
A fundamental principle of medical ethics is that patients can only give informed consent if they have been given complete and accurate information about both the short- and long-term consequences of a treatment. When it comes to gender reassignment treatment – especially for children and adolescents – there is a crucial lack of knowledge about the long-term side effects, making it impossible to obtain truly informed consent.
The professional framework for healthcare assistance for gender incongruence itself acknowledges that “ There is still only scant evidence regarding the long-term effects of medical treatment of gender incongruence in children and adolescents, which is why special demands are made on the care and conscientiousness of healthcare professionals (… )” ( Appendix 9 p. 23 ).
In practice, this means that patients are accepting an experimental treatment ( Appendix 10) whose full risk profile is not known. How can a child or young person make an informed decision when even doctors do not know the long-term consequences and therefore cannot communicate them?
Several international health authorities have pointed out the serious uncertainties surrounding hormone therapy and surgical interventions for young people with gender dysphoria. Sweden, the UK and Finland, among others, have all chosen to slow down or limit hormone therapy for young people, as there is insufficient scientific basis to assess the safety and long-term effects of these interventions.
When a treatment is experimental, the precautionary principle should be followed and patients should not be exposed to unnecessary risk. Giving irreversible treatments without solid scientific evidence is not medicine – it is experimenting on vulnerable patients.
Therefore, the guidelines should be revised so that they do not allow medical and surgical treatment of children and adolescents without a thorough, evidence-based risk assessment.
Until reliable long-term studies are available, treatment options should be based on psychotherapeutic and supportive interventions rather than medical experiments with potentially life-threatening consequences.
Autism and misinterpretation as gender incongruence
On the Danish Social and Housing Agency's knowledge platform – www.social.dk – special consultant Dorthe Beversee has written about Autism and sexuality. This also covers Gender Identity, Gender Dysphoria and Gender Diversity as well as Emotions, Puberty and Identity . These existing descriptions are neutral and cover the entire autism spectrum – not just the part of the target group that identifies under the transgender umbrella.
We also question a development where we see fewer young people coming out as homosexual, but instead changing gender. Could this be an expression of internalized homophobia or a lack of knowledge and understanding of sexuality? How can we ensure that this development is not the result of social trends, but a truly rooted identity? How can we ensure that autistic children and young people are not inadvertently diagnosed with gender incongruence without a thorough assessment of their autism-specific needs and challenges? We lack an explicit focus on avoiding overdiagnosis and ensuring that psychoeducation and self-understanding are prioritized before potentially irreversible treatments such as puberty blockers and cross-hormones.
( For further information see Appendix 1 )
Anchoring in somatic specialties rather than psychiatry
Quote: Professional framework for healthcare assistance for gender incongruence page 5
This decision prioritizes subjective experiences of stigma over a professionally justified psychiatric assessment. Stigma can be a real challenge, but healthcare decisions should be made based on medical evidence, not emotions.
We recognize that many people experience discomfort during a psychiatric evaluation. This also applies to the group we represent. Autism is evaluated in psychiatry, but is not a mental illness – it is a pervasive developmental disorder. Just as autistic people accept psychiatric evaluation as a necessary part of receiving the right support, people with gender dysphoria should recognize the need for a thorough psychiatric assessment to ensure the best possible treatment.
There is no shame in having a psychiatric diagnosis or being evaluated in a psychiatric hospital. On the contrary, the Danish Health Authority should maintain that a correct evaluation requires a psychiatric perspective, as gender incongruence often coexists with psychiatric disorders and developmental disorders ( Appendix 11 ). It would be in everyone's interest to have correct treatment.
Language use and bias
Quote: Professional framework for healthcare assistance for gender incongruence pages 6-7
In healthcare contexts, the focus should be on evidence-based treatment and an objective assessment of the patient's clinical needs. When pronouns are included as a central part of the healthcare process, the focus is shifted from a neutral and investigative approach to an ideologically driven practice, where subjective linguistic choices are given disproportionate importance.
Making the patient's choice of pronouns an essential part of the process may indicate that subjective self-understandings should take precedence over a thorough and nuanced clarification of identity and well-being. This is especially problematic when there may be other underlying factors, such as autism, trauma, or mental illness, that need to be explored and addressed.
If healthcare professionals are required to confirm the patient's chosen gender identity in advance through language, this can hinder an open and neutral assessment. For example, a patient who chooses a particular pronoun may be confirmed in an identity that later turns out to be temporary or not the final one. This practice risks locking the patient into a specific understanding of identity, rather than facilitating an open, reflective process.
For autistic patients, who often have a concrete and literal approach to language and identity, an emphasis on pronouns can increase confusion and possibly lead them to maintain an identity that is not the right one or that is influenced by other factors. In these cases, such an approach may risk doing more harm than good.
Furthermore, the focus on pronouns can overshadow the core aspects of the assessment, which should include a fundamental clarification of the causes of gender incongruence, therapeutic support and investigation of possible comorbid conditions. It is important to ensure that the patient makes informed decisions and that treatment is based on an objective assessment of real needs. There is no other area of healthcare where the patient’s language choices dictate the healthcare professional’s approach. For example, a patient with an eating disorder would not have a distorted body image confirmed by healthcare professionals. Similarly, language use should not stand in the way of an objective and critical assessment of the patient’s needs related to gender identity.
When gender identity becomes the exception
Quote: Professional framework for healthcare assistance for gender incongruence page 18
In all other contexts in the lives of children and young people, parents’ task is to balance support with guidance. For example, when a child feels left out at school, parents help find solutions rather than simply confirm the experience. If a young person has a disturbed self-image, parents and professionals will usually help to understand and process these feelings rather than uncritically encourage actions based on them. Making gender identity an exception to this approach creates a problematic precedent, where the young person’s subjective experience alone becomes governing, without allowing room for a clarifying process.
This is particularly relevant for autistic children and young people, who often experience discomfort at school due to sensory challenges, social misunderstandings or a lack of adaptation to the learning environment. It is well documented that many autistic children develop anxiety and stress as a result of these stresses, and that they may have difficulty separating external influences from themselves.
If an autistic child is struggling in school and also experiences gender incongruence, it is crucial to look at the child's whole situation rather than focusing solely on gender identity as an explanation for the problem. There is a real risk that autistic children who feel different or excluded will seek understanding and belonging in identity categories that may provide a sense of community but do not necessarily address the underlying causes of their problem.
It is possible to support a child without necessarily confirming everything they feel – in fact, it is precisely through reflection, nuance and dialogue that a child best achieves a stable and well-founded self-understanding. For autistic children, who often have concrete thinking and a tendency to maintain rigid understandings of themselves, it is even more important that support is not reduced to affirmation, but that an environment is created where the child is helped to understand and explore all aspects of their identity and well-being.
It is suggested that the parents' task is primarily to confirm the child's experience, rather than that they have a legitimate role in asking critical questions and ensuring the child's long-term well-being. Parents have a responsibility in relation to their children ( Appendix 12 ). Parents also do not give their children sweets, ice cream and soda morning, noon and night because that is what the children want. You also do not confirm a person with anorexia that they are fat, and hopefully no professionals would be able to confirm them in that feeling and help them lose more weight.
The lack of social services increases the risk of one-sided environments
It is striking that society is willing to invest enormous resources in children with gender dysphoria, while children with disabilities, such as autism, continue to be left behind. Autistic children struggle daily with inadequate schooling, minimal specialized help, and a pervasive neglect of their needs. But it does not seem to arouse the same political or economic interest as gender dysphoria. Regardless of which gender the child chooses to identify with, their autistic challenges will always be there.
At the same time, it is remarkable that gender dysphoria is no longer considered a pathological condition, but is reduced to an identity that is expected to be confirmed and medically treated without further ado. Where is the care to uncover the deeper causes? Where is the caution? It seems as if we as a society are in a hurry to appear progressive at the expense of the children who really need help.
We ask: Why is identity given such high priority, while children with pervasive developmental disorders such as autism must be included and normalized until they become so ill from the strain that they end up on early retirement when they turn 18. It is time to rethink this imbalance and ensure that all children receive the help and support they are entitled to.
There are far too few social services for autistic people. Many find community in LGBT+ Denmark, where gender identity plays a big role. Many autistic people have always felt outside and have not belonged to a group. They have often been excluded from communities with like-minded people. In a search for communities in a time when gender identity is trending and access to social media opens up a world in all the colors of the rainbow. Lonely and vulnerable autistic people can be seduced by communities that seem to celebrate otherness. In these environments, gender becomes the dominant focus because there are no other available services targeted at autistic people.
When gender identity is so prominent, it can be more difficult for them to explore other aspects of their identity or to change their perceptions if their gender dysphoria was temporary. Autistic people often have strong loyalties to communities where they feel accepted, and may therefore fear losing relationships if they change their view of their gender.
If support and social services were more targeted to autistic needs – without a one-sided focus on gender identity – more people would have the opportunity to explore their identity in a broader perspective, where other aspects of their well-being were also addressed.
Undoing and detransitioning
There is a belief that very few people regret it ( Appendix 13 ). Just as some doctors are of the opinion that we should accept that there is overtreatment. However, we must also be aware that it is a short period of time when such a large number have been treated, as in recent years ( Appendix 14 ).
Most studies are based on follow-up shortly after starting treatment. Unfortunately, there is a lack of studies based on follow-up after long-term treatment, which the Cass report from 2024 ( appendix 15 ) also mentions under point 87 of the report's recommendations. We do not actually know how many subsequently undergo detransition or wish to do so. However, the Cass report mentions that there is an indication that the number is increasing.
We must also expect that there may be large underreporting in this area. Not everyone informs the healthcare professionals who have treated them for gender incongruence medically and/or surgically about their regret. A peer study ( Appendix 16 ) of 100 detransitioned individuals indicated that as many as 76% had not informed their providers that they had detransitioned.
It is necessary to describe, prepare guidance and establish an offer for those who change their mind and then want to detransition. It is a violent process to go through a detransition. The aforementioned peer study of 100 detransitioned people describes that they experience challenges in terms of identity, social, emotional, lack of help and support as well as negative experiences with the healthcare system and challenges with detransphobia.
When the healthcare system offers medical and surgical help to transition, the healthcare system subsequently commits itself to having an offer for those who would like to detransition. This must be described and included in the treatment offer, and it must be ensured that patients being treated for gender incongruence are informed about and understand that there is a risk of regret, what this means, and what to do if the desire to detransition arises.
Autistic people are already a vulnerable group who need that guidance to be available and easily accessible; in the same way as referrals for assessment and treatment for gender incongruence.
Treatment and support for those who are rejected
It does not describe what treatment or support is offered to people who are refused gender reassignment treatment. We find this very worrying.
A refusal does not necessarily change the wishes of these people. If there is autism involved, the person can also be incredibly stuck in their thought patterns. This means, for example, that the person may have difficulty understanding the refusal or seeing other options than gender modification treatment; even if there is good reason for the person to be refused. There will be a need for therapy as well as a need for other support and treatment, regardless of the reason for a refusal. It must be described how to ensure that those who are refused are not left to fend for themselves. We are genuinely concerned that this group seeks medical and/or surgical treatment abroad, or begins medical transition on their own without medical supervision ( appendix 17 ).
Responsible gender reassignment treatment
We believe that people suffering from gender dysphoria should have the necessary help, support and treatment so that this group can experience congruence between experienced and biological gender.
At the same time, it is crucial that a thorough and holistic assessment of the individual's needs is carried out, especially when there are concomitant factors such as autism, sensory challenges or psychological difficulties. Treatment courses should be based on evidence, take into account complex causal relationships and ensure that the individual receives the best possible support to understand themselves and make informed choices.
We believe that any intervention – social, hormonal or surgical – should be made on an informed basis, with alternatives and long-term consequences carefully considered. It is crucial that no one feels pressured into a particular solution, and that the right help is tailored to the individual, respecting both identity and neurodiversity. It will be in everyone’s interest to reduce the likelihood of regret.
Recommendations
A specialist in psychiatry should be a permanent part of the multidisciplinary team – not only for separate differential diagnostic considerations.
Autism screening should be a standard requirement in the assessment, as autism can have a major impact on the patient's ability to understand and relate to their gender identity.
A more holistic and cautious assessment process should be introduced, where psychological and neurodivergent factors are given equal weight as the desire for medical intervention.
The precautionary principle should be the basis for all treatment of children and adolescents, and no one should receive irreversible medical or surgical treatment if there is significant uncertainty about the long-term consequences.
Decisions about the organizational placement of treatment services should be made based on scientific evidence, not emotional, ideological and socio-political considerations.
Assessment and treatment of gender incongruence should be anchored in psychiatry to ensure an evidence-based assessment of comorbid disorders.
Guidance should be developed and services established for those who wish to detransition. This will ensure that patients who regret their gender reassignment receive the necessary support and treatment.
It should be described what treatment or support is offered to people who are refused gender reassignment treatment. This will help ensure that rejected patients are not left to fend for themselves and receive the necessary support.
Here is the original link to their response to the Gender Consultation
https://autisme-asperger.dk/hoeringer/10399/hoeringssvar-autisme-koensinkongruens
Excellent! Thank you for posting this. So much of this is just plain common sense that it's gobsmacking that it has to be spelled out and that so many people are vehemently, even violently, opposed to it.
Young people are being preyed upon by this ideology and its adherents. Young people with autism are even more at risk. I don't understand why this is so hard to understand.
My fellow liberals who think you're being "kind" and "inclusive" by supporting this ideology -- hello??
When I first started Googling "transgender and autism" a few years ago (in the US), after my son "came out," the few sites that acknowledged the link crowed about how autism allowed a person to see beyond the strictures of conventional culture, thus perceiving one's "true self," i.e., one's "true gender," i.e., one's destiny as a lifelong patient/customer/acolyte. I hope other national autism organizations will follow the Danish example.