A scoping review of transgender experiences in people with a learning disability and/or autistic people

Purpose – This scoping review aims to explore the experiences of transgender people who also had a learning disability and/or were autistic. Inclusion criteria: studies involving primary source data on the personal experiences of transgender individuals with learning disabilities and/or autistic transgender people were included. Peer-reviewed papers of any study design were eligible. 

Design/methodology/approach – A search of CINAHL, PSYCHINFO, MEDLINE, SCOPUS and COCHRANE REVIEWS databases were conducted in August and September 2021 and updated in September 2023 and April 2025. The search identified 45 papers. Each included study was assessed using the provisional criteria for Institutional Review Boards proposed by Adams et al. (2017) for evaluating the ethical orientation of transgender health research. A hybrid inductive-deductive thematic synthesis was used, informed by Fereday and Muir-Cochrane (2006) incorporating pre-determined categories alongside iterative analytic development. 

Findings – The review identified 20 papers. Key themes including interactions between experiences of autism and gender, the intersection of learning disabilities and transgender, barriers and social challenges, negative experiences within health and social care and where they exist, support systems are valuable. Research limitations/implications – The literature indicates that transgender people with learning disabilities and autistic transgender individuals face significant structural, social and systemic barriers. Practical implications – The review highlights the need for improved health-care practices, education and further research to address the unique needs of this population. 

Originality/value – To the best of the authors’ knowledge, this scoping review is the first to systematically examine the intersecting experiences of transgender people with a learning disability and/or autism – a population conspicuously absent from both fields. Centring lived experience and applying an ethical evaluation framework across all included studies, it makes a distinctive and timely contribution to nursing knowledge.