Table 4.

Summary of suggested adaptations for autistic people seeking support for gender dysphoria

Structure of appointments

Having proper notice for appointments

Support with long journeys to clinics or option for remote appointments

Provide a clear outline of a typical process of attending a gender clinic and different gender journeys

Have an initial ‘say hello’ appointment with no specific clinical tasks

Have a parent, partner or other supporter at appointments

Have a regular clinician for each appointment

Have longer or shorter appointments as needed

Order the agenda of appointments considering patient energy and comfort levels

Environmental adaptations

Ensure gender neutral toilets are available

Demonstrate LGBT and autism awareness in waiting areas and clinic

Clinician awareness of the sensory environment at clinics

Quiet waiting area

Consider turning off lights or loud equipment, for example clocks and computers

Consider temperature in clinics – consider patient control over opening windows etc

Communication adaptations

Check patient understands the purpose of questions asked in assessments

Use clear, slow, nonpatronising communication without use of technical language

Use forced‐choice questions or open questions with prompts

Present information in manageable chunks

Allow time for the patient to respond and check understanding

Minimise gesture, eye contact and use an even tone and volume when speaking

Provide support and structure for patient to identify and communicate about emotions

Use special interests to increase engagement

Use written and visual resources as needed, for example videos, charts, pros and cons lists, tables, diagrams and gender maps

Check preferences for remote communication, for example using emails rather than phone calls