Book Review: Is This Autism? by Donna Henderson, Sarah Wayland, and Jamell White

Introduction

In my years as a psychotherapist working with neurodivergent individuals, I’ve encountered a growing body of research that underscores the complex and often intertwined relationship between autism spectrum disorder (ASD) and gender diversity. A recent systematic review on ASD and gender dysphoria/incongruence revealed a pooled prevalence estimate of ASD diagnoses in those with gender dysphoria at around 11%, with some studies suggesting that the rate could be as high as 15 to 35% among autistic individuals without intellectual disability. The intersection of these identities is not just statistically significant; it also profoundly shapes the lived experiences of those who navigate the world through the dual lenses of neurodiversity and gender diversity.

Clinical psychologist Eileen T. Crehan, Ph.D., an assistant professor at Tufts University, has observed that the rates of lesbian, gay, and bisexual (LGB) identification among autistic individuals are two to three times higher than in the general population. This intersectionality invites us, as mental health professionals, to expand our understanding and approach to care in ways that are both inclusive and affirming.

It is against this backdrop that Is This Autism? by Donna Henderson, Sarah Wayland, and Jamell White emerges as an essential resource. The book not only provides clarity on the diagnostic complexities of autism but also offers a deeply empathetic exploration of how autism manifests across diverse populations, including those who are Two Spirit, trans, nonbinary, and queer. For therapists, educators, and caregivers alike, this book is an invaluable tool that bridges the gap between academic research and practical application, offering insights that are crucial for fostering an inclusive therapeutic environment.

Is This Autism? challenges us to reconsider our assumptions about autism, particularly in the context of gender diversity and neurodivergence. It invites us to see beyond the challenges associated with autism and to recognize the unique strengths that autistic individuals bring to our communities. As a therapist deeply committed to providing gender-affirming care, I find this book to be a beacon of hope and understanding in a field that is rapidly evolving.

Overview of the Book

Is This Autism? is meticulously structured to navigate the reader through the intricate process of diagnosing autism across various stages of life and in diverse contexts. The authors, Donna Henderson, Sarah Wayland, and Jamell White, bring a wealth of clinical experience to the table, which they seamlessly blend with real-world examples, creating a narrative that is as informative as it is compassionate.

The book is organized into comprehensive sections that delve into the core characteristics of autism, the co-occurring conditions that often accompany it, and the profound impact that autism can have throughout an individual’s lifespan. What sets this book apart is its unwavering commitment to the neurodiversity paradigm, which recognizes that autism is not merely a set of challenges to be managed but also encompasses a range of strengths and unique abilities that can be harnessed in the right environments.

The authors emphasize the importance of a holistic approach to diagnosis, one that takes into account the full spectrum of an individual’s experiences and identities. This includes a keen awareness of how autism intersects with other aspects of identity, such as gender diversity. The book’s inclusion of both clinical insights and personal narratives makes it an invaluable resource for clinicians who are striving to provide more inclusive and affirming care, particularly for clients who are Two Spirit, trans, nonbinary, and queer.

Moreover, Is This Autism? does not shy away from addressing the complexities of comorbid conditions, such as anxiety, depression, and sensory processing disorders, which are prevalent in many autistic individuals. By offering strategies to recognize and address these co-occurring conditions, the book provides a robust framework for clinicians who aim to support their clients in a holistic and affirming manner. Through this comprehensive approach, the authors guide the reader not just in identifying autism, but in understanding and embracing the full spectrum of neurodivergent experiences.

Key Concepts Covered in the Book

Is This Autism? is not just a guide to diagnosing autism—it is a profound exploration of the diverse ways in which autistic individuals experience the world. As a psychotherapist who works with trans*, nonbinary, and queer individuals, many of whom have been diagnosed with autism or identify as neurodivergent, I find the book’s emphasis on the neurodiversity perspective to be particularly impactful. This perspective challenges traditional, deficit-based views of autism by recognizing that autistic individuals possess unique strengths that deserve acknowledgment and celebration, alongside the challenges they may face.

One of the key concepts explored in the book is sensory processing differences. The authors, Henderson, Wayland, and White, provide a nuanced discussion on how heightened sensory awareness, often perceived as a challenge, can actually be a significant strength in certain contexts. For example, in my practice, I’ve seen how clients who are highly attuned to sensory details can excel in environments that require meticulous attention to sensory inputs, such as art, music, or even culinary arts. The book’s approach encourages therapists to help clients harness these sensory sensitivities as assets, rather than solely viewing them as obstacles to overcome.

The authors also delve into the cognitive processes of autistic individuals, highlighting abilities such as associative thinking and systematizing. These cognitive traits can lead to innovative problem-solving and creativity, which are often underappreciated in conventional therapeutic settings. For example, I have worked with clients who possess an extraordinary capacity for systematizing—organizing information, recognizing patterns, and creating structured approaches to complex problems. This ability, often overlooked or misunderstood, can be incredibly empowering when recognized and nurtured within therapy. The book provides strategies for therapists to support clients in channeling these cognitive strengths towards personal growth and mental wellness.

Another standout concept in the book is the exploration of social communication differences. The authors emphasize that what may appear as social challenges in one context can actually be strengths in another. For instance, many autistic individuals develop unique strategies for understanding and engaging in social interactions, especially in environments where they feel safe and accepted. This resonates deeply with my practice, where creating a gender-affirming and neurodiversity-affirming space allows clients to explore and express their social identities without fear of judgment. The book supports this approach by offering insights into how these social communication styles can be embraced and leveraged in therapy, rather than being pathologized.

The discussion on the intersectionality of autism and gender diversity is particularly relevant to my work. The book acknowledges that autistic individuals are more likely to identify as trans*, nonbinary, or queer, and that these intersecting identities can profoundly influence their experiences and needs. Henderson, Wayland, and White advocate for a holistic approach to care that considers these intersections, offering practical guidance for therapists working with clients who navigate both neurodivergence and gender diversity. This approach aligns with my commitment to providing inclusive, affirming care that respects and uplifts the full spectrum of my clients’ identities.

Finally, the book’s emphasis on resilience and adaptability stands out as a critical aspect of supporting mental wellness in autistic individuals. The authors highlight how traits such as hyperfocus, consistency, and a strong sense of integrity can be powerful tools for navigating the complexities of life. In my practice, I’ve seen how clients who embrace these strengths often develop a profound sense of self-efficacy and resilience. The book provides concrete examples and therapeutic techniques for helping clients recognize and cultivate these strengths, contributing to their overall well-being.

Is This Autism? offers an invaluable resource for therapists who are committed to supporting the mental wellness of autistic individuals, particularly those who are also navigating gender diversity. By embracing a neurodiversity perspective and recognizing the inherent strengths of autistic individuals, the book empowers therapists to provide care that is not only more effective but also more compassionate and affirming. It encourages a shift away from merely managing deficits towards fostering a therapeutic environment where clients can thrive as their authentic selves.

Practical Applications in Therapy

Is This Autism? is not just a theoretical exploration of autism; it is a practical guide that can be directly applied to enhance therapeutic practices. For therapists, especially those working with marginalized communities, this book offers a wealth of actionable insights that can be integrated into everyday clinical work.

One of the book’s strengths is its emphasis on creating an affirming therapeutic environment that recognizes and nurtures the strengths of autistic individuals. For example, the authors provide strategies for helping clients harness their unique cognitive abilities, such as hyperfocus and systematizing, to develop coping mechanisms and problem-solving skills. In my own practice, I’ve found that when clients are encouraged to utilize these strengths, they often experience increased self-esteem and a greater sense of agency in their lives.

The book also offers practical guidance on addressing sensory processing differences in therapy. This is particularly relevant for clients who may feel overwhelmed by certain sensory stimuli, which can impact their ability to engage in traditional therapeutic settings. The authors suggest various accommodations, such as modifying the therapy environment or using sensory aids, to create a space where clients feel safe and supported. These adjustments can make a significant difference in a client’s ability to participate fully in therapy, especially for those who are also navigating gender diversity.

Additionally, the book’s discussion on social communication differences provides therapists with tools to better understand and support clients who may communicate in non-traditional ways. The authors advocate for a flexible approach that values and adapts to the client’s communication style, rather than forcing them to conform to neurotypical norms. This is particularly important when working with trans*, nonbinary, and queer clients, who may already feel marginalized in other aspects of their lives. By validating and embracing their unique ways of communicating, therapists can help these clients feel more understood and respected.

Moreover, Is This Autism? underscores the importance of considering intersectionality in therapy. The authors provide case studies and examples that highlight the diverse experiences of autistic individuals who are also part of the LGBTQ+ community. These real-world examples offer valuable lessons on how to approach therapy with sensitivity to the complex interplay of gender, sexuality, and neurodivergence. For therapists like myself, who are committed to providing inclusive care, this section is particularly enlightening and reinforces the need for a holistic approach that honors all aspects of a client’s identity.

Finally, the book encourages therapists to adopt a strengths-based approach, which can be transformative for clients who are used to focusing on their deficits. By shifting the narrative to one that celebrates their abilities and potential, therapists can help clients build a more positive self-concept and foster resilience. This approach is not only empowering but also aligns with the neurodiversity paradigm, which advocates for acceptance and appreciation of neurological differences.

In summary, Is This Autism? equips therapists with practical tools and strategies that can be immediately applied to improve the therapeutic experience for autistic clients, particularly those who are also navigating gender diversity. The book’s focus on strengths, sensory processing, social communication, and intersectionality makes it an indispensable resource for any therapist committed to providing inclusive and affirming care.

The Role of Intersectionality and Identity in Autism

One of the most compelling aspects of Is This Autism? is its deep exploration of intersectionality—the way multiple identities and experiences intersect to shape the lives of autistic individuals. For therapists, understanding these intersections is crucial to providing truly affirming and effective care, especially when working with clients who are trans*, nonbinary, queer, or otherwise marginalized.

The authors of Is This Autism? recognize that autism does not exist in a vacuum; it interacts with various facets of identity, including gender, race, sexuality, and socioeconomic status. This intersectionality is particularly significant given the higher prevalence of gender diversity and LGBTQ+ identities among autistic individuals. By acknowledging and addressing these intersections, the book equips therapists to better understand the unique challenges and strengths that arise from these overlapping identities.

For instance, the book discusses how societal expectations and norms can exacerbate the challenges faced by autistic individuals who also identify as gender diverse. These clients may experience heightened anxiety or dysphoria due to the pressures of conforming to both neurotypical and cisnormative standards. Is This Autism? provides strategies for therapists to create a more inclusive and supportive environment where clients feel safe to explore and express their full identities.

Moreover, the book emphasizes the importance of cultural competence in therapy. It encourages therapists to be mindful of how cultural backgrounds can influence the way autism is perceived and experienced. For example, in some cultures, neurodivergence might be stigmatized, leading to additional barriers for autistic individuals seeking support. The authors advocate for an approach that is both culturally sensitive and aware of the intersectional challenges that clients may face.

In my own practice, I’ve seen how these intersectional identities can profoundly influence the therapeutic process. Clients who are both autistic and gender diverse often have unique insights and perspectives that can be incredibly enriching when they are given the space to be their authentic selves. Is This Autism? supports this by offering practical guidance on how to navigate these complexities in therapy, ensuring that all aspects of a client’s identity are honored and integrated into their care.

The book also addresses the potential for resilience and empowerment that comes from embracing intersectionality. By helping clients understand and accept their multifaceted identities, therapists can foster a sense of pride and agency. This is particularly important for clients who may feel marginalized or misunderstood in other areas of their lives. Is This Autism? provides tools for therapists to help clients build resilience by recognizing the strengths that come from their unique combination of identities.

In conclusion, Is This Autism? goes beyond a traditional understanding of autism by integrating a nuanced view of intersectionality and identity. It challenges therapists to expand their practice to be more inclusive, culturally competent, and sensitive to the diverse experiences of their clients. For anyone committed to providing holistic and affirming care, this book offers invaluable insights and practical strategies that can transform the therapeutic relationship.

Ethical Considerations in Autism Diagnosis and Therapy

In any therapeutic context, ethical considerations are paramount, but they take on added significance when working with autistic individuals, particularly those who are also navigating other marginalized identities. Is This Autism? offers a thoughtful exploration of the ethical dimensions of diagnosing and treating autism, emphasizing the need for practices that are not only clinically sound but also respectful, inclusive, and empowering for the client.

The book highlights several key ethical considerations, starting with the importance of informed consent. The authors stress that clients—and, where appropriate, their families—should be fully informed about the diagnostic process, the implications of a diagnosis, and the therapeutic options available to them. This is particularly crucial when working with clients who may have had negative experiences with healthcare providers in the past, such as trans*, nonbinary, or queer individuals. Ensuring that clients are active participants in their care, rather than passive recipients, is a core ethical principle that the book reinforces.

Another critical ethical issue discussed in the book is the potential for harm in misdiagnosis or overdiagnosis. Is This Autism? advocates for a careful, nuanced approach to diagnosis, one that avoids labeling clients in ways that could limit their opportunities or reinforce negative stereotypes. The authors caution against relying solely on diagnostic criteria without considering the broader context of the client’s life, including their cultural background, gender identity, and personal experiences. This approach aligns with the principles of anti-oppressive practice, ensuring that clients are not reduced to a diagnosis but are seen as whole, complex individuals.

The book also addresses the ethical responsibility of therapists to challenge societal norms and biases that can negatively impact autistic individuals. This includes questioning the pathologization of behaviors that are simply different, not disordered, and advocating for a shift in societal attitudes toward neurodiversity. By promoting acceptance and understanding of autism as a natural variation of human experience, Is This Autism? encourages therapists to be agents of change, working to dismantle the stigma and discrimination that autistic individuals often face.

Finally, the authors emphasize the importance of confidentiality and trust in the therapeutic relationship. For clients who are part of marginalized communities, such as the LGBTQ+ community, maintaining confidentiality is not just a legal obligation but a vital component of creating a safe space where clients can explore their identities and experiences without fear of judgment or exposure. The book provides practical advice on how to navigate confidentiality in complex situations, ensuring that the client’s privacy and dignity are always upheld.

In summary, Is This Autism? offers a comprehensive guide to the ethical considerations that must underpin any work with autistic clients. By advocating for practices that are informed, respectful, and client-centered, the book supports therapists in providing care that is not only effective but also just and compassionate. This ethical framework is essential for any therapist committed to anti-oppressive, intersectional practice, and it ensures that the dignity and autonomy of autistic individuals are always at the forefront of the therapeutic process.

Integration of Client Voices and Personal Narratives

One of the most impactful elements of Is This Autism? is its integration of client voices and personal narratives, which adds depth and authenticity to the clinical insights presented. The authors have made a conscious effort to include the perspectives of autistic individuals, ensuring that their voices are central to the conversation about autism diagnosis and therapy. This approach not only enriches the content of the book but also aligns with the principles of anti-oppressive and intersectional practice by valuing the lived experiences of those who are often marginalized in clinical settings.

Throughout the book, the authors weave in personal stories from autistic individuals, illustrating the diverse ways in which autism manifests and the unique challenges and strengths that accompany it. These narratives provide invaluable context for the clinical concepts discussed, allowing therapists to see beyond the diagnostic criteria and understand the human experience of autism. For clients who are also navigating gender diversity or other marginalized identities, these stories can be particularly resonant, offering them validation and a sense of connection.

As a psychotherapist, I’ve found that incorporating client voices into therapy can be transformative. When clients see their experiences reflected in the stories of others, it can help them feel less isolated and more understood. Is This Autism? offers a model for how therapists can use personal narratives to build rapport, foster empathy, and create a more collaborative therapeutic relationship. By centring the voices of autistic individuals, the book encourages therapists to listen deeply and to honor the expertise that clients bring to their own care.

Moreover, the inclusion of these narratives underscores the importance of individualized care. The book illustrates that there is no one-size-fits-all approach to autism diagnosis or therapy; each client’s journey is unique, and their personal experiences must guide the therapeutic process. This is particularly important in an anti-oppressive framework, where the goal is to empower clients and support them in navigating their identities and experiences on their own terms.

In summary, the integration of client voices and personal narratives in Is This Autism? is a powerful reminder that at the heart of every diagnosis and treatment plan is a person with a story. By highlighting these stories, the book fosters a deeper understanding of autism and encourages therapists to approach their work with humility, curiosity, and a commitment to truly seeing and hearing their clients. This human-centered approach is what makes Is This Autism? not just a guide for therapists, but a compassionate call to action for more inclusive and empathetic care.

Conclusion

Is This Autism? is an essential addition to the library of any therapist, educator, or researcher working with autistic individuals. It’s a great book for those of us with a neurodivergent diagnosis, too, as it gives us more power to understand ourselves in regards to an often confusing clinical setting. The book’s balanced approach—celebrating the unique strengths of autistic individuals while addressing the challenges they face—offers a fresh perspective that is both hopeful and practical. It is a resource that aligns with the values of an anti-oppressive and intersectional practice, making it particularly valuable for those who work with marginalized communities, including Two Spirit, trans, nonbinary, and queer clients. By integrating clinical expertise with the lived experiences of autistic individuals, the authors provide a guide that is not only informative but also deeply empathetic.

For those who are ready to read, I recommend borrowing this book from your local library or purchasing it from a queer-inclusive bookstore. Supporting local, community-focused businesses not only enriches your practice but also helps foster a more inclusive and diverse literary landscape. You can find your local library through an online search, or visit bookstores like Cross and Crows Books or Little Sisters in Vancouver, Glad Day Bookshop in Toronto, and Venus Envy or Halifax Bookmark in Halifax.

If the themes in this book resonate with you, consider exploring gender-affirming therapy through our practice. Our team is dedicated to providing inclusive, affirming care that meets you where you are. You can schedule a free 15-minute consultation with Audrey Wolfe, RCC, or join the waitlist to work with me, Clayre Sessoms, RP, RCT, RCC, RCAT, CCC, ATR-BC.

Stay engaged by bookmarking our blog for more therapy-centric book reviews and therapeutic resources tailored to meet the needs of Two Spirit, trans, nonbinary, and queer clients. Our commitment is to support and uplift the diverse voices within our communities, ensuring that everyone has access to the compassionate care they deserve.

Reference

Henderson, D., Wayland, S., & White, J. (2023). Is this autism? A companion guide for diagnosing. Routledge.