Double Helix Rainbow Kids.

Ehrensaft (2018) wrote a position paper. It tells clinicians to look for gender diversity in autistic youth. The paper does not test an intervention. It argues that gender stress is common in this group.

The author wants behavior plans to include gender supports. No new data are presented. The goal is to change clinical practice.

The paper finds that many autistic kids feel distress about gender. Clinicians often miss this. The author says screening and support should be routine.

No numbers are given. The finding is a call to action, not a data set.

Gandhi et al. (2022) extends the call. Their survey of 306 adults shows that gender-diverse autistic people report more camouflaging. This gives the 2018 paper its first hard numbers.

Arnold et al. (2026) sounds a warning. Their big scoping review says the CAT-Q camouflaging tool may be confounded by social anxiety. So use the CAT-Q, but interpret scores with care.

López (2015) set the stage. That earlier theory paper asked autism researchers to blend social context with development. Ehrensaft (2018) applies the same idea to gender stress.

You can add two quick boxes to your intake form: “Gender identity?” and “Any distress about it?” If the client says yes, weave affirming language and safe spaces into the behavior plan. The move takes one minute and can cut shame-driven avoidance during sessions.