Trans-rights group contests finding
The National Gender Service (NGS) has estimated that as many as 90pc of the people who used its service in 2022 may be autistic.
The NGS and As I Am, the autism charity, have said the HSE must make resources available so that it can hire staff who specialise in autism.
The figures for the number of autistic people using the NGS have been contested by the Trans Equality Network of Ireland (Teni). It said doctors are ascribing autism to trans people without a proper diagnosis, and it believes the true figure is closer to 30pc.
The NGS, which is based at St Columcille’s Hospital at Loughlinstown, supports people seeking gender-affirming healthcare. The service is under-resourced and has been formally lobbying the HSE for more resources for three years.
It is understood that without these resources, waiting lists for the service will be at least three years by 2023.
The service has said it needs new premises and 11 more staff, including a consultant psychiatrist with a special interest in autism. The NGS said this is because of the rising number of autistic people who are attending the service.
Each year, the NGS carries out an audit of its service users. A spokesman for the Ireland East Hospital Group said: “Based on these audits the NGS has seen an increase in the number of people attending their service with autistic spectrum disorder (ASD).
“This number was as low as 3pc in 2014. The last time a full service audit looking at the prevalence of ASD was in 2019. At that stage, the number was 34pc. A repeat audit is ongoing and the expectation for 2022 is that figure will increase significantly and may reach as high as 90pc. This will be confirmed at the end of this year when the audit is finalised.”
It is understood the audit counts both trans people who have had a formal autism diagnosis, and those who were found to have very clear features of autism during assessments.
The NGS has pointed out that adults can be unlikely to seek a formal autism diagnosis, unless they need one to access certain services and supports.
Dr Karl Neff, an endocrinologist at the NGS, told the Irish Independent that everyone who goes through the service is subject to a comprehensive assessment by medical experts.
“The NGS is confident that its comprehensive assessment identifies all the needs important to that individual,” he said.
“Autistic people can safely transition once a full assessment has been done and the adequate supports are in place.”
Autistic people are often disproportionately represented among the LGBTQ+ community. While there are different theories about why this is, advocates for autistic people have said it may be because autistic people can tend to see the world in more definitive, black and white ways and may be more likely to formally identify with a certain gender or sexuality than a neurotypical person.
Others believe that people who are neurodivergent may be more likely to diverge from what is sometimes regarded as “the norm” in other ways.
Adam Harris, founder of As I Am, said: “We know autistic people face major barriers to healthcare across the board, with sometimes fatal consequences. I would be very against what some people in this debate are trying to do, which is to make this a political football and take away the bodily autonomy of autistic people which is exactly what the Assisted Decision Making Act is about protecting.
“There are autistic people who are transgender. We need to make sure that they have the same choices and support to get the healthcare that they need and we need to celebrate and affirm their identity.”
Teni has contested the figures in the NGS audit. Noah Halpin, a healthcare officer at the group, said doctors are “obsessed” with establishing if trans people have autism and that too often trans people are assumed to be autistic based on certain qualities observed by doctors rather than formal diagnoses.