Little rant about getting an autism/adhd diagnosis as a person under the trans* umbrella.
Right of the bat: I am (as of now) only self-diagnosed, with strong suspicions of autism or possibly audhd. My psychiatrist agrees, but can not give me that diagnosis without consulting a therapist. Nonetheless, I will refer to people of the above mentioned minority (unfortunately) as a collective “we” for easier accessibility.
I also identify as nonbinary and transmasculine, using they/he pronouns and I have had my coming out as trans* in 2015, albeit mistaking my identity as genderfluid in the beginning. Since 2020 I have been labeling myself correctly, had my social and public coming out and was even able to get my name recognized by my university.
I am certain of my identity, hence why I feel like I can speak for the trans* community. As mentioned above, I’ve completed my social transition, whereas I am still awaiting a proper referral for surgeries and a legal change.
I also want to apologize in advance for my language potentially being a bit too scholarly for a site such as tumblr. I am a university student of English and American studies and this comes naturally with the occupation. I also feel it helps me get point across more distinctively and precisely. I will however try to give examples to illustrate my thoughts.
That being said, here’s my main thesis:
I feel like we do not get enough recognition and struggle more to get diagnosed in the first place. Let me elaborate.
A lack of therapists worldwide makes it nearly impossible to get diagnosed with anything these days, but self-diagnosis after extensive research gets devaluated and ridiculed.
Whilst autism in cis women has started finally getting the recognition it deserved (don’t get me wrong, this is amazing) and cis men have been able to get a diagnosis often at an early age, we are a blind spot in the field of psychology.
It is impossible to get a therapist specializing in both gender and neurodiversity, even though they are closely linked. You have to weigh out which of the topics you want to tackle first, whilst both need to be regarded together, not separately. Therapy for both has the purpose of saving a life, but is impossible to achieve.
For the past three years I have been trying to get a therapist. I live in a big city in Germany, and whilst therapy is covered by public health insurance, many are unable to find any therapist, let alone a suited one. The one or two (out of the hundreds that exists) have long waitlists of a year and above and whilst you can pay for therapy sessions, many students like myself, who live on the bare minimum, can not afford paying 300+ Euros a month that weekly sessions would cost.
I also feel like many of us get disregarded for our special interests, hyperfixations and other symptoms. They can vary so much from those of cis women and/or cis men. We many times show symptoms of both cis men and cis women, many times show neither or ones exclusive to trans* individuals.
Of course these symptoms always vary greatly from individual to individual, yet especially in those who are afab or amab they get overshadowed or falsely attributed by/to the many mental illnesses/symptoms we have because of not identifying with the gender we were wrongly assigned at birth. I will come back to those mental issues in a bit.
I, for example, share a special interest for makeup and fashion, stereotypically seen as more feminine interests, and a special interest for motorcycles, cars, wrestling and many other stereotypically male interests. These are obsessive and hinder me in everyday life.
Not only are stereotypes harmful wherever they may apply, them being seen as such, they get disregarded as special interests/hyperfixations that come with neurodivergence. The symptoms are ignored and wrongly attributed (those aligning with the gender you were assigned at birth) or not attributed at all (those that not aligning with the gender you were assigned at birth) to a potential autism/adhd diagnosis.
However, some special interests/hyperfixations I’ve observed in many trans* people are those relating to the struggle unique to trans* individuals. They can include trans* or lgbtq+ rights, politics in general, the science behind being trans*, activism, hate crimes, police violence, gender reassigning surgeries and many others.
I suppose we, as those these issues relate to in many ways, naturally have a closer connection/desire to indulge in these topics in detail. However, this, once again, gets disregarded and not attributed to the neurodiversity but rather the issues with gender.
Coming back to a point briefly mentioned above, many of us have been wrongly diagnosed many times within our lives. Many of the symptoms naturally coming with everyday life as a trans* person have been signed off as standalone diagnoses. These include depression, anxiety, body dysmorphia, anger issues, escapism, low self-esteem and self-worth and even suicidal/homicidal thoughts.
The collection of wrong diagnoses throughout ones life, if one is lucky enough to have a therapist in the first place, comes naturally with both being trans* and having autism/adhd. This not only stems from the lack of knowledge in the healthcare system, but also the struggles we experience.
I, for example, have had both a diagnosis for social anxiety and depression through my teen years. Looking back, unsurprisingly so. I was bullied to oblivion for being outed (as both trans* and bisexual) whilst growing up in a small, Christian town. I say being outed, for both times I have been outed by those I wrongly assumed to be my friends/allies.
Transphobia and homophobia were part of my everyday life. Most human interactions I had were horrible, causing me to struggle with low self-esteem. Being ridiculed daily plus getting my trust broken so often, together with an immense burden of being overwhelmed by the noises of a school classroom caused me to go mute for most of 8th and 9th grade. I’m assuming I do not have to explain the concept of selective mutism to those reading, but this is what eventually caused my social anxiety diagnosis.
Of course, someone being bullied constantly plus struggling with severe personal trauma (I do not want to elaborate this, for it is beyond the point) will feel sad, have meltdowns (I would throw things around my room, clear my desk with my arm, punch walls and have yelling fits) and cry constantly. I was ostracized for being “the weird kid” with “weird hobbies and interests” and the loneliness made me extremely sad. Naturally, a depression diagnosis came my way.
Now, I am not saying people can not have multiple diagnoses. I, myself, do and many others do as well. Not only do many people have both autism and adhd, many people also have further mental illnesses that make their life hard.
I, for example, have been diagnosed with bipolar in my early adult years (around age 18/19). It is genetic in my case, but ever since taking medication for it, I have been doing much better. That, however, has not calmed the symptoms I personally attribute (potentially) to “my” autism/adhd. They are also not side effects of my medication, that has been ruled out.
Talking about the health system brings me to another huge flaw both people with neurodiversity and trans* individuals struggle with. Organizations and officials meant to help letting us down, failing us and making us the problem.
It starts with the health system. Simple things like autism in adults (no matter their gender identity, but especially for cis women and trans* people) not being diagnosed properly, being trans* still being (mainly legally) considered a mental disorder in many countries and vital health treatments being denied are quite literally killing us.
The suicide rates in trans* and neurodiverse people are at an all time high, the US is infuriatingly going back in history with their law-making and removing safe spaces whilst simultaneously endangering trans* individuals. That possibility of being hatecrimed both for not being cis as well as being neurodivergent has risen drastically. It shocks, angers and saddens me.
As an individual living in Germany, we might have public health insurance but not enough therapists, as previously elaborated. This and trans* people still having to go through multiple discriminatory processes to even get their gender recognized are just a few examples.
Of course we are often also failed by politicians, law makers, courts, police and any other institution that is there to defend and uphold democracy. If we even are lucky enough to live in a democratic state and not a monarchy with a power hungry heir or a state claiming to be democratic whilst their leader is clearly a dictator. (Looking especially at Russia, here.)
In Germany, for example, the government had promised to simplify the process of legally changing your name and gender by April of 2024. So far it has not made any progress whatsoever and with openly right-wing parties on the rise in most states the chances of it actually happening are minimal.
There is also a huge issue with police and not understanding who they’re protecting versus pursuing. Autistic people are often seen as aggressive in their meltdowns, causing them to be detained even when not the culprit whatsoever. Trans* people often have to let people from their opposite gender perform invasive and humiliating searches on them, something a cis person legally can contest. But we are not as lucky.
Some of the worst institutions when it comes to accommodation are schools. Trans* and neurodivergent students often get picked on by their teachers (for example through misgendering or being called upon even in their mute/overwhelmed stages). Trans* and/or neurodivergent students often get reprimanded for causing trouble, even when not the perpetrators. Neither the teachers nor headmasters seem to really care.
I have a more distinct anecdote for this one. I distinctly remember getting suspended from school for two days and having to come to the headmasters office with both of my parents in 9th grade. When I was in my teen years I had an admittedly unhealthy hyperfixation (I call it this for it was obsessive and involuntary, beyond my control and took my focus of school and any other responsibilities.) on school shooters, particularly Columbine. This was in 2015, so before liking True Crime became normalized.
Of course, as any teen I scribbled on my desk in school. Unfortunately scribbling the nicknames of the Columbine shooters was not the smartest idea. I didn’t understand that at the time, however. My sociology teacher saw after some students had told on me. I was sick that day and had no way of defending myself immediately. So instead my parents were called. I was in big trouble.
Not speaking with my classmates (due to my selective mutism) didn’t help. Neither did the fact that, due to my gender disphoria, most of my clothes were black oversized shirts, combat boots and cargo pants. I had short hair (that I had dyed black at the time.) and wore stark emo makeup. I not only fit the weird quiet kid in the back of the class stereotype perfectly but also dressed like the shooters I had been focusing on.
It was the second headmaster that called my mother. I have to give him a bit of a compliment here. His first question was not what I had done or what I was thinking. It was wether or not I was okay. (Which obviously, I wasn’t.) Unfortunately, reality looked very different when in the headmasters office.
The headmistress had returned from her vacation and absolutely tore me to pieces. She was convinced I was planning a school shooting myself. From telling me she should have just called the police, to telling me my behavior was unacceptable and inappropriate, telling me I vandalized school property (it was in pencil, I didn’t), to telling me everyone was afraid of me and all the school knew, she threw every accusation my way. It was not only intimidating, but I’ll always remember how much I had to mask in that moment.
Unfortunately the second headmaster didn’t help, telling me I should maybe look for happier interests, like flowers and bees. (Literally his words.) They didn’t understand, neither of them, that it was involuntary. I had no control over it. But neither did I. Back then, I didn’t know hyperfixations existed. I remember how guilty yet confused I felt, not understanding why everyone was so worked up about a simple scribble.
In retrospect I know the reason for the outrage. But never will I understand why on earth one would react so cruelly. The rest of my time there was hell. Half the school knew me as the person who planned a school shooting, stupidly believing I actually would. They didn’t know me, of course. Jumped to conclusions because I was different and didn’t fit in.
This school failed me hard time, just like the school before had. I’m still surprised I managed to finish tenth grade, with a friend in my class even. (We had bonded after I explained the situation to her.) I was lucky enough to go to a different school after a year of a mental health break, together with said friend who also had many issues with the school we went though, even though she was a neurotypical cis woman.
Moral of the story is: I am appalled how many times we get failed and disregarded.
But of course we do. For we, as trans* and neurodivergent people, have mastered masking. We had to pretend/were raised as a completely different person from who we actually are. Had to pretend to be and conform with a gender we were assigned at birth, even though we knew we never identified with. Had to pretend to be one of the neurotypical ones because we didn’t want to be even more different. We already didn’t fit in, neurodiversity was not something we needed.
Unfortunately, without a proper diagnosis, we never knew differently. Didn’t know why we always felt out of place, or why we suffered from constant imposter syndrome. How could we, when people constantly told us we were “normal” or “just a little sad” or “a bit of an outsider.” They didn’t see we needed help, even when the cries for help were as big as having morbid hyperfixations, injuring ourselves to fit the gender identity we wanted to fit (self-mutilation as well as wrong methods of for example binding).
And still, no one helps us.
Self-diagnosis is a last resort for many of us and many of us are not lucky enough to ever recognize who they truly are.
And that they’re okay the way they are.
I guess I’m writing this for the “weird kids.” The kids that were ridiculed for being different, the kids that never knew why they couldn’t seem to fit in. I see you. I used to be you. And only if we rise up, we cause an uproar, can anything ever change.
If you read this far I thank you. Feel free to leave comments, like, ask questions. My inbox is always open, also for anonymous questions.
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