Nothing About us Without Us: Autistic, Queer and Workers’ Liberation

The intersecting struggles of ableism and transphobia are products of capitalism. Any true fight for queer and autistic liberation must be anti-capitalist.

“I don’t typically prescribe HRT for trans people of your age with autism.”

That’s what my first psychologist said to me at an appointment I made seeking vital medical care.

To some people this may come as a shock, but if you’re trans or autistic, you’re probably used to having your autonomy denied by doctors, bureaucracies and other bodies that have power over you. But why is this the case? The answer has to do with the Medicare system, the patriarchy, and capitalism’s control over our bodies. 

First, let’s talk about transphobia and the patriarchy.

In pre-industrial, hunter-gatherer societies, raising children was a communal act. In fact, almost everything was. But this changed under capitalism as people were pared off into smaller and smaller groups working increasingly specific jobs, in a phenomenon known as the “division of labour.” 

Furthermore, we are now living in a system which encourages endlessly increasing the production of goods and services for businesses to make a profit, rather than to meet actual human needs, (see “commodity fetishism”). Business-owners need an increasing number of productive employees (sellers) and customers (buyers) to make more and more profit. 

Both of these factors combined to create the patriarchal, nuclear family. In this system, a woman is tied to one man for her entire life — She is often shut out of the formalised economy, making her reliant on a man, and is instead charged with the responsibility of child-rearing. 

Any disruption of this monogamous ‘one working man, one child-rearing woman’ dynamic, such as same-sex relationships or trans people’s inherent disruption of the link between gender and reproduction, is punished or ‘corrected’. We see this in the phenomenon of so-called ‘gay conversion therapy’ — the horrific practice of traumatising queer adolescents into hiding their queerness. LGBT adults subjected to conversion therapy are more than twice as likely to attempt suicide as their other LGBT peers. We’ve seen this change in some places as society shifts from an attempt to eradicate queerness into an attempt to subsume it into capitalism through phenomena such as pinkwashing, but this is of course not universally the case.

Next, let’s talk about ableism. 

As mentioned above, capitalism requires a productive labour force in order to keep making a profit, regardless of whether it’s socially necessary.  In a service-based capitalist economy such as our own, a ‘productive’ worker is one who interacts with others in a ‘normal,’ ‘non-autistic’ way. Deviation from this norm is similarly punished and ‘corrected’ with the practice of Applied Behavioural Analysis (ABA), which seeks to traumatise autistic children into masking their autism. Autistic children subjected to ABA are more than twice as likely to report symptoms of PTSD as their other autistic peers. This is beginning to change as some employers now specifically seek out autistic employees for certain positions, but this comes more from a belief that autistic workers are uniquely exploitable due to a supposed aversion to confrontational social interactions. 

The Australian Medicare system is another bureaucracy with a similarly intrusive role in the lives of trans people — any transmasculine person seeking breast reduction surgery can speak to the difficulty of obtaining the treatment they need. Breast reduction surgery is not covered under Medicare in Australia for transmasculine individuals breaking cissexist norms, but is covered for cisgender men who have ‘excess’ breast tissue (known as gynecomastia) seeking to better fit these norms. The same is true for the difficulty trans women face in accessing the exact same medications for their medical transition that cis women can more readily access for menopause. 

This too will eventually change as Medicare’s position shifts from a near-complete denial of transness to allowing trans people to conform to gender expectations as their true gender, rather than their birth-assigned gender. For example, allowing trans men to access breast reduction surgery to uphold the idea that to be a woman is to have organs for child-rearing, and to be a man is to not have these organs. This would be a marked improvement over what we have today, but is ultimately little more than the freedom to follow harmful gendered rules in a less harmful way.  

When these factors combine, we get horrific results, such as those seen recently in the US state of Missouri. 

On the 13th of April, in a flurry of ignorance, bigotry and moral-panicking, Missouri Attorney General Andrew Bailey issued an unprecedented ‘emergency regulation’ severely restricting access to gender-affirming care for individuals in the state. In addition to requiring 15 months of psychological evaluation, the rule mandated that all individuals seeking access to gender-affirming care must be screened for autism and any so-called “social contagion with respect to [their] gender identity,” implying that autistic individuals are inherently less-capable of making decisions about their own bodies. 

This will become something of a feedback loop — if every single trans person must be screened for autism, when they otherwise wouldn’t be, then already disproportionate rates of medically-diagnosed autism recorded in the trans community will only continue to increase. As it stands, up to 70% of autistic people identify as LGBTQIA+, and more than a quarter of gender diverse people are autistic. When combined with autism’s current underdiagnosis, the result is that thousands of people will be affected by this even if they don’t know it yet. Simply put, it is impossible to truly fight for trans liberation without fighting for autistic liberation. 

However, there is a way out — a two-pronged solution. The first is gender abolition — not  in the transphobic, biologically-essentialist way. Rather, true gender abolition is the deconstruction of sex as a socially-influential institution governed by doctors, the state and capital through policed access to HRT, surgeries and other forms of care, in favour of a model of truly interpersonal relations and identities. 

Similarly, the second part of the solution is the social model of disability, which involves a movement away from constructed diagnoses gate-kept by doctors and governed by the state and capital in favour of a model based on individual needs, which can be met collectively by communities — a more humane version of the model used in pre-industrial society. However, both of these solutions necessitate a mass movement for the destruction of capitalism. 

Indeed, overt neurodiverse transness is an act of protest. To live proudly as an openly queer, openly neurodivergent person is not just a rejection of an oppressively cisnormative, neurotypical society. It is a rejection of capitalist power and a recognition that a better world is possible.

The author uses they/she pronouns.