[Gender Diversity and the Autism Spectrum: A Scoping Review of Experiences, Trajectories, and Emerging Needs...

The intersection between Autism Spectrum Disorder (ASD) and gender diversity (GD), particularly among transgender and non-binary individuals, has gained increasing attention in recent literature. This population experiences dual vulnerability related to structural stigma, pathologization, and barriers to accessing healthcare. The 2024 Cass Review (UK) has significantly influenced clinical debate, challenging affirmative care models and generating ethical and political tensions.

To explore scientific evidence published between January 2024 and April 2025 regarding the experiences, trajectories, barriers, and needs of transgender and non-binary individuals with a clinical or self-identified ASD diagnosis.

A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines. Searches were performed in Scopus, Web of Science, and SciELO between April 1 and April 21, 2025. Empirical studies-qualitative, quantitative, or mixed-methods-published in English or Spanish were included. A total of 34 articles met eligibility criteria.

Seven thematic axes were identified: mental health, ASD-GD co-occurrence, access barriers, affirmative care, structural discrimination, limited family support, and community participation. Studies reported substantial mental health burden, lack of sensory accommodations, institutional exclusion, and family rejection. Approximately 40% proposed trans-affirmative or neurodivergence-affirmative models. Most studies originated from the Global North.

The findings underscore the urgent need for culturally competent, intersectional, and rights-based models of care. In the post-Cass context, adopting an affirmative approach represents not only an ethical stance but a public health imperative to uphold the right to health for autistic transgender individuals.