Table 2.

Themes and quotes describing the autistic experience of gender dysphoria.

Superordinate theme	Subordinate theme	Supporting quote	Number of participants included in theme
1. Making sense of distress and finding my identities	1. Experiencing and describing body distress	19: ‘I am forever stuck in a body that I am not going to like and there’s no way I can go back to how I was before puberty’.	21
	2. Making sense of who I am	9: ‘My identity is something that I’ve had to figure out and it was really difficult’.	17
	3. Intersecting and competing needs	1: ‘I’ve been told I was ill, I’ve been told I was demon possessed, I’ve been assaulted twice, I’ve been mocked, I’ve been given ECT . . . and it was all unnecessary. So it’s like a real grief’. 16: ‘I had top surgery . . . even though it’s what I want and it’s good change, it’s still change’.	19
2. Mismatch between needs as an autistic trans person and society	1. Gender as social behaviour	15: ‘I feel about gender roughly the same way that you might feel about like a big dessert at the end of a really good meal, in that the menu looks amazing and you should all have some if you like, there’s so many delicious options, they look amazing, but I am good, I will just have a coffee, thank you very much’. 23: ‘It does hurt when someone calls me . . . or perceives me as a man, I don’t like that at all’.	15
	2. Struggle of being different	2: ‘It’s only when you kind of get to secondary school and like the social expectations changed and then I really realised how different I was’.	17
	3. Battle for support	18: ‘they [gender clinician] didn’t really address me being autistic . . . it just felt a bit strange that they didn’t notice it as part of my life I guess’. 6: ‘every service I’d ever had contact with had misunderstood me, and there was actually a fear that maybe the gender clinic will be the same’.	20