Accounting for neuronormativity in transgender medicine

Autistic trans people are subject to longer wait times for gender-affirming care (GAC) and are sometimes denied care due to their autistic traits. This paper presents an analysis of semi-structured interviews with 23 autistic transgender adults in the US who have tried to access GAC. How do autistic trans people navigate the medical system to access GAC? How does the practice of trans medicine impact autistic trans people? This paper introduces neuronormative accountability as a construct connecting sociological literature on accountability with autistic researchers' conceptions of neuronormativity. Autistic trans people who deviate from neuronormativity are likely to be held to account, whether through more or more frequent appointments with providers or through outright denial of care. This paper builds on sociological work on accountability in trans medicine by providing a framework for understanding how neurodivergence becomes pathologized and subject to medical regulation.