Kayden Clarke was a 24-year-old trans man who identified as having Asperger’s syndrome (a form of autism) and PTSD, among other challenges. He died on February 4 when police, responding to a suicide call, shot Kayden as he lunged at them with the kitchen knife he was holding. I will leave it to others to discuss the police response to the suicide call. What I want to address is what could have reduced the chances that Kayden and the police officer who shot him would ever be in that room together.

Kayden made a number of YouTube videos. The final two were made in December 2015 and January 2016. In the first, he happily shares that he finally has insurance that will allow him to begin medical transition. He says, “I get everything I was supposed to have. I can breathe. The anxiety is gone.” Several weeks later he posted a video full of fury and despair, recounting how the gender specialist he went to told him that she could not write a letter of referral for testosterone treatment until Kayden’s Asperger’s “disease” was fixed. In this video, Kayden said several times, “I don’t know what to do. I’m at my wit’s end. I don’t know who to turn to.” Several weeks after that last video was posted, Kayden was dead.

New research indicates that about 20% of the transgender population is autistic. A separate review of autistic people found that more than 20% identify as transgender or nonbinary. Many people in both the autistic and the transgender communities would say this high co-ocurrence is no surprise. Unfortunately, much of the clinical community lags in its preparation for working with this overlap.

Professionals who work with transgender and gender nonbinary people need to understand the experience of autistic people and know how to respectfully and effectively work with them. Those who work with autistic and other neurodivergent people need to understand the transgender experience and have the cultural sensitivity, as well as the skills and resources, to support their needs as transgender youth or adults. The coincidence of trans-identities and autism should no longer be viewed as a rare, interesting phenomena, as has long been the case with autistic individuals. The myth of autism rarity has resulted in few therapists getting sufficient training in autism and neurodivergence, while the thought that autistic gender dysphoria was not true dysphoria has resulted in many delays and rejections of gender treatment for trans autistic people.

There is no doubt in my mind that Kayden Clarke would be alive today if he had been referred for medical transition. He would be making You Tube videos featuring his deepening voice and talking about top surgery. While the challenges of living with autism in a neurotypical world would remain, the affirmation of his capacity to choose a path based upon his inner sense of self would have given him additional strength in dealing with these challenges. He should not have died, and he should not have had to work as hard as he did to simply be himself and follow his dreams. Kayden’s videos and his subsequent death are an aching lesson in the power of our words and actions and of our failures to speak and act. It is time for gender specialists, neurodiversity specialists, and trans and neurodivergent people to come together, learn from each other and dispel the ignorance and prejudice that makes the world such a hard place for people like Kayden.

Steps to Better Serve Autistic Transgender Clients

Gender Specialists

Learn to use language that is respectful and supportive of neurodivergent people. Just as you do with trans people, always use the language that your client uses. In general, when speaking of or about neurodivergent people, use language that does not privilege the majority (e.g., use neurotypical and neurodivergent just as you would cisgender and transgender). Here is an excellent reference on language.

Take a basic course in neurodiversity. While many courses on autism are available, they are not all respectful to autistic people. An excellent online course is available through the Zur Institute. You might also find workshops on neurodiversity at transgender conferences.

Review blogs written by neuroqueer people. Review journal articles about the overlap of autism and transgender/nonbinary identity.

Think about how you can make your office and your communication more comfortable and accessible for autistic clients, and make these changes available to all clients. Many people have never been identified as being autistic and the accommodations you make available to all may present the first time a professional considered their needs—needs they have held silence about so as to not be shamed.

Develop a consulting relationship with a gender specialist who has more experience with autism and other forms of neurodivergence. Form consulting/referral relationships with neurodiversity specialists in your area.

Develop a list of resources, both physical and online, for neurodivergent clients.

Autism and Neurodiversity Specialists