The autism spectrum disorder (ASD) is characterized by problems in social communication and interaction, along with repetitive behaviour and specific interests.

The prevalence of ASD in the general population has increased and is estimated at 1%. It is still unclear whether this increase has to do with a real increase or an improved detection.

The prevalence of trans people with autism has only been studied to a limited extent to date, but studies point to an increased number. A 5-fold increase in ASD and/or autistic traits is reported in trans adults. Gender variance and/or atypical gender development are also more often found in children and adolescents diagnosed with ASD. It is unclear how autism and being transgender are interrelated, probably there is a complex causal relationship, in which biological, social and psychological factors play a role (Van Der Miesen et al., 2016).

At the clinical level, it is important to know the impact of the joint occurrence of ASD and being transgender. First, it is important to explore whether the gender identity exists independently of the autism-related symptoms. If it is established that both autism and gender variance are effectively present, it is advisable to initiate appropriate guidance and, if necessary, gender affirming treatment. It is also important to motivate these patients as much as possible to participate in the diagnostic and therapeutic process. Starting the (hormonal) treatment can lower the threshold for outing. Overall, it can be stated that in trans patients with ASD, counselling and treatment are largely similar compared to trans patients without ASD, taking into account the patient’s pace and a flexible attitude on the part of the care provider (Strang et al., 2016).​