“Gender is a big itchy sweater”: An autistic man’s reflection on the itchiness of masculinity

Content warning: In this essay, I discuss transphobia and ableism. I also write about a serious car accident I was involved in.


“There’s been a great pressure to affirm these children as trans… without appropriate exploration,” said David Bell, a psychiatrist from the United Kingdom, in an April 2022 appearance on the BBC. He continued, “35% of these children are on the autistic spectrum.” 

Bell and his small group of associates oppose gender-affirming clinical practices. In other words, unlike their colleagues who see it as vital to accept and affirm people’s own sense of their gender identities, Bell and his associates argue that clinicians should be more skeptical when children identify as a gender other than the one they were assigned at birth. Bell claims to be concerned about the future wellbeing of trans children who might later come to regret their decision to use puberty blockers or hormones. Of course, as journalist Caitlin Moscatello’s reporting suggests, Bell and his associates’ “concerns” have prevented numerous trans adolescents in the UK from accessing puberty blockers and hormones. As Moscatello shows, Bell’s “concerns” have created even more obstacles in an already lengthy and tedious process of accessing gender affirming healthcare for trans children in the UK. It’s hard to imagine that these children would feel Bell is acting in their best interests. 

When I first heard David Bell’s statement about trans autistic children, I was puzzled by what he seemed to think about the percentage of autistic children he included in his warnings. “35% of these children are on the autistic spectrum,” he said while speaking to the BBC about trans children seeking gender affirming healthcare. For Bell, autism is seen as a further reason to doubt trans children’s gender identities. To me, that interpretation suggests a profound ignorance about autistic experience. 

As an autistic man, I do not believe that autistic children are less capable than their neurotypical peers of understanding and making informed decisions about their gender identities. Rather, based on my own autistic experience, I expect autistic children to have a very keen sense of gender norms and expectations and their relationships to them. I would expect that we share similar struggles with respect to gender, struggles well captured by writer Siona Larsen’s itchy sweater metaphor. Larsen quipped on twitter that gender is a “big itchy sweater that doesn’t fit right”. I have definitely found my masculinity to be quite itchy and ill-fitting. It is a bit too tight in the neck and can be a bit suffocating. 

Nick Walker, an autistic and transgender psychologist, has written about “neuroqueer theory”, which is a useful tool for thinking about why autistic people are so aware of gender norms. Walker’s neuroqueer perspective stresses that compliance with the norms and expectations of cis-heterornomativity is a practice that neurodivergence can make challenging.  In her book, Neuroqueer Heresies, Walker writes that most people experience the local gender norms they’re exposed to, as if they were somehow “natural”. Walker, however, argues that autistic people find norms related to both cis-heteronormativity and neuronormativity “ill-fitting”. She writes 

The entwined nature of neuronormativity and heteronormativity means that the compulsory performance of neurotypicality is never a gender-neutral performance, but instead is strongly tied to the performance of binary heteronormative gender roles. Normative performance of whichever gender one was assigned at birth is central to what it means to be “normal” in the eyes of the present dominant culture. Thus, when the enforcers of normativity demand that a child “act normal,” it’s ultimately a demand to either act like a “normal boy” or like a “normal girl”

Neuroqueer theory suggests that, for neurodivergent people, gender may rarely be experienced as “natural,” in the way it often is for neurotypical cis people. In other words, neurodivergence may make the experience of wearing the gender sweater forced upon you at birth more unbearably itchy and uncomfortable. While David Bell implies that autistic children are ill-prepared to make their own decisions about gender, Nick Walker suggests the reverse: that autistic children are likely to be especially insightful with respect to gender norms and how they see themselves in relation to those norms. I have written before that I believe Walker’s ideas speak to my experiences with gender, and I elaborate here on my own experience to illustrate what I mean when I say that autistic people, including children, are highly attuned to the social workings of gender. 

I’m a cis-heterosexual man, which means, more or less, that, upon my birth, someone checked out my genitalia and declared me to be male. From then on, others have seen and responded to me as male: a boy and, later, a man. I have been sexual only with women, as was the norm I was presented with as a child and adolescent, so I think of myself as heterosexual. Describing my relationship to my gender identity in this distancing or hedging way feels appropriate to me. My gender feels less like a natural part of me and more like some uncomfortable article of clothing that I’m wearing to satisfy someone else’s expectations. 

I’m not suggesting that I feel there’s a gender identity that would be a more “natural” fit for me. I’m not suggesting that I suffer from gender dysphoria. I’m not suggesting that others don’t consistently recognize me as a man; they do. My propensity for growing facial hair is a reliable indicator of my masculinity to almost everyone I meet. 

I am suggesting that my autism makes the compliance with cis-heteromasculinity more difficult than it is for my nonautistic peers. Because of my autism, I’m more conscious of pervasive gender norms than most of my cis-heterosexual male counterparts are. Like many other autistic people, I do not feel connected to the gender group I belong to. Psychologist Kate Cooper and her colleagues conducted a survey with 219 autistic people and 267 neurotypical people and found “high levels of gender transition and incongruence in the autistic participants compared to [neurotypical] participants”. 

For the purpose of illustrating this gender incongruence or “itchiness”, I will describe the clash between the ideas about masculinity I’ve been exposed to and my autistic nervous system. I will do so by discussing my relationship with cars. 

Like everyone else around me, I learned from a young age that men like cars. I gleaned this idea from countless aspects of my surroundings as a child and adolescent. The overall message I received about gender and automobiles is well represented by a 2011 article in Men’s Health written by automotive journalist Dan Neil. Neil suggests a primal connection between men and automobiles, especially the very fast and powerful kinds. He writes

Men and cars. We get this, don’t we? If you have testes jangling in your jeans, you understand that guys love cars, even if you can’t quite articulate why. They make us feel cool. They look sexy, and make us look sexy (maybe). They are fun and loud and empowering and dangerous at a time when society conspires to take those manly thrills away from us in a thousand subtle ways. Young or old, gay or straight, hair-highlighted hipster or bush-bearded loner, guys dig cars. It’s the one machine that defines our tribe.

As a young man, I was socialized into the culture that Neil describes. Contrary to Neil’s claims, however, I do not dig cars, or trucks, or any other motor vehicle. I do not experience them as “fun” and “empowering” but rather as intensely “loud” and “dangerous”, qualities that, to me, are intensely unpleasant. Ideas like Neil’s have long made me feel as though I am unable to fulfill the expectations of the club of masculinity. 

One of my most intense early memories of automobiles happened when I was around ten or eleven. I was staying with my aunt, uncle, and cousin while my parents were traveling for work. I was excited for this opportunity to spend time with my cousin who was several years older than me and very athletic, and thus intensely cool in my young mind. One day during my visit, he invited me to come along with him to play basketball with his friends. I was excited to be asked to join him and his older friends. We got on our bikes and started riding. 

I grew up far from the car-filled streets that are typical of any city, even small ones, like the one my cousin lived in. At first, he and I rode through some quiet neighborhood streets, and I was comfortable. We then came to a highway that we had to ride alongside for a short stretch. My cousin began riding on the shoulder, as if he had done this a thousand times, and he probably had. I tried to follow him. However, I quickly became overwhelmed by the noise and the gusts of wind caused by the constant stream of cars passing beside me. As I heard the sound of every car approaching and then speeding past me, I experienced sharp pains as if each one had hit me. I was so overwhelmed that I could not continue riding, even though I desperately did not want to show any vulnerability to my older much cooler cousin. I stopped, and my cousin turned around to see what was wrong. He decided to take me back to his house and forgo basketball for the day. The next day, he left to play basketball with his friends, this time without me. 

The feelings that I experienced as a boy – the overwhelm from the cars speeding past – is an unfortunately common experience for me living in a place – metropolitan Washington, DC – that has been designed with the convenience of cars and drivers in mind. Any time I walk around the city, I have to concentrate to convince my mind and body that cars driving on the street next to me are not a genuine threat to me on the sidewalk, just a few feet away from their path. 

Dan Neil also notes that learning to drive is a culturally significant moment for a young man. He writes “[b]ecoming a driver is also an enormous landmark in a man’s life — his mechanical bar mitzvah, if you will. With it comes his identity.” As a young man in the rural Midwest, I understood driving to be not only practical but also linked to the performance of manhood in much the way Neil suggests. I learned to drive and got my driver’s license soon after my sixteenth birthday. I experienced learning to drive as a developmental milestone, signaling a stage in my life that would bring with it greater independence. 

I was a competent but nervous driver. I avoided many situations that made me uncomfortable, especially driving in busy urban areas. When I first got my license, my father surprised me with a diesel Volvo that was older than I was. That car was built like a tank, so I felt safe riding in it. It was also unbelievably slow to accelerate, and its maximum speed was not much higher than the posted speed limit on the country roads I drove, fifty-five miles per hour. Dan Neil might be disappointed in my lack of interest in “manly thrills”. Many of my male peers certainly were.

Eventually, that old Volvo began to spit black exhaust from all sides, and my father suggested that we look for a different car. We went to the local dealership and took out a loan for a used Pontiac Sunfire. It was only a couple of years old and had low mileage. In many ways, it was an enormous upgrade from my Volvo, but it never felt as safe to me. 

My relationship with the Pontiac Sunfire was short lived. After several months, I totaled it. On a clear winter day, I was driving home from school on the very familiar route between my family’s home and the small town we lived outside of. I approached a curve in the road, saw a patch of ice, and began to slow down. When my tires made contact with the ice, the car swerved, and I tried to compensate carefully, as I had learned to do when driving in the winter. As the car slid, one of the tires blew, and I lost control. I drove off the road, and the car rolled. For a moment as the car hung in the air, I didn’t think I would live. The next thing I knew I was hanging upside down by my seatbelt. After breaking the glass out of a side window, I emerged mostly unscathed but noticeably concussed. The car, however, was beyond repair. 

I had always been a nervous driver and passenger, but this accident made me even more uneasy in cars. It gave me a sense of how quickly and easily a driver can lose control of a vehicle, especially when driving on snow and ice. When I ride in a car in winter weather, I am constantly aware of the contact between the tires and the surface of the road, and the presence of ice and snow disrupting that contact. I monitor my internal sense of the car’s traction obsessively and feel constantly as though I am just on the edge of danger. I notice every unexpected motion, no matter how small, and each one disrupts my breathing and heartbeat. I find there to be nothing fun or empowering about riding in a car like this. Usually when I finally arrive at my destination after a trip through ice and snow, I am exhausted from the stress of riding and feeling so unsafe. 

I still have a valid driver’s license, but I haven’t driven in years. Although men in heterosexual relationships like mine usually assume the role of driver for the couple, my wife, Molly, always drives us. I can think of only a handful of times when I have driven the two of us anywhere. Neil’s article makes it clear that this is one more way in which I seem to deviate from conventional norms of masculinity. Society often reminds my wife and me that our driving arrangement is unexpected. For example, new acquaintances often mistakenly assume that I, the man, am the driver in our relationship. 

Throughout my life, many people around me have centered cars, trucks, and other motor vehicles in their socializing. I find it impossible to behave in recognizably masculine ways in response to stimuli from automobiles. For example, on many occasions, I’ve seen men performatively rev their engines for one another: the owner of the car doing the revving, and the others providing approval for all the noise. They say things like “Listen to her purr” that express their apparent delight at being bombarded with the sounds of a combustion engine. I usually wince, shut my eyes, clench my jaw, and brace myself for the sonic pain. I know what conventional ideas about masculinity suggest I should do in these moments, but my hypersensitivity and trauma from cars impacts my sensory experience of automobiles. I do not relish their sounds like the purr of a cat, I recoil at the noise. In these moments, I find it hard to conform to the version of masculinity Neil celebrates. Other men’s nervous systems allow them to nod approvingly at the roar of an eight cylinder engine several feet from them. The best I can do is hunker down mentally and physically while I wait for the sonic assault to pass. 

These are just a few example memories from decades of experiences with cars, many of them traumatic. Cars are just one of the many aspects of my life in which I’ve experienced my masculinity as itchy and ill-fitting. Although there are many experiences that suggest this big itchy sweater doesn’t seem to suit me very well, I’m not aware of a better alternative, and, so, I wear it anyway, at least for the time being.  

This awareness makes me skeptical of David Bell’s suggestion that autistic transgender children are not capable of making informed decisions about their gender identities. Autistic people experiencing cis-heteronormativity as uncomfortable and choosing not to comply does not seem like cause for concern to me. It seems like a cause for celebration.