Challenges and Strategies for Gender-Affirming Hormone Therapy in Autistic Transgender Adults

September 9, 2026 2 Min Read

Study Explores Hormone Therapy Experiences Among Autistic Transgender Adults

A recent investigation conducted at an Australian tertiary hospital’s Gender Endocrinology clinic sheds light on the experiences of autistic transgender and gender diverse (TGD) adults undergoing gender-affirming hormone therapy (GAHT). The research highlights unique challenges faced by this population in adhering to prescribed hormone treatments and suggests practical strategies to improve therapy adherence.

Research Design and Participants

The study comprised two components: an online survey (Study A) and a mixed-methods qualitative study (Study B). Study A included 112 participants divided into three groups: 35 adults with a formal autism spectrum disorder (ASD) diagnosis, 46 self-identifying as autistic, and 31 non-autistic individuals, all undergoing GAHT. Study B involved in-depth semi-structured interviews with six autistic TGD adults alongside assessments using the Adult/Adolescent Sensory Profile to better understand sensory processing differences.

Key Findings: Sensory and Executive Function Challenges

Results indicated that autistic TGD adults often experience greater difficulties adhering to GAHT regimens compared to their non-autistic peers. These challenges were associated with sensory processing differences—such as heightened sensitivity to medication administration methods—and executive function difficulties, including managing routines and remembering doses.

Participants shared their healthcare and social experiences while undergoing hormone therapy, revealing that sensory discomfort and cognitive barriers can interfere with consistent treatment adherence.

Strategies to Support Hormone Therapy Adherence

The study identified several approaches that autistic TGD adults found helpful in maintaining their hormone therapy schedules. These included:

Reflecting on past sensory experiences to anticipate and mitigate discomfort
Establishing consistent daily routines to integrate medication administration
Incorporating hormone therapy into existing personal care habits
Involving trusted individuals in medical appointments for support
Engaging with peer support networks to share experiences and advice

Implications for Clinical Practice

While existing guidelines acknowledge the impact of autistic traits on healthcare, specific recommendations to support GAHT adherence in autistic adults are limited. This research offers preliminary evidence that tailored strategies addressing sensory and executive function challenges can enhance treatment adherence and overall patient outcomes.

Healthcare providers, including endocrinologists, may consider integrating these insights into clinical care plans to better support autistic TGD patients undergoing hormone therapy.

Limitations and Future Directions

The study’s sample size, particularly for qualitative interviews, was modest, and findings may not generalize to all autistic TGD individuals. Further research is needed to develop and evaluate targeted interventions that address the nuanced needs of this population.

For more detailed information, see the original study published ahead of print in the Journal of Clinical Endocrinology & Metabolism: source.