Research suggests an overrepresentation of autism spectrum diagnoses (ASD) or autistic traits in gender diverse samples, particularly in children and adolescents. Using data from the GENTLE (GENder identiTy Longitudinal Experience) Cohort at the Gender Diversity Service at the Perth Children’s Hospital, the primary objective of the current retrospective chart review was to explore psychopathology and quality of life in gender diverse children with co-occurring ASD relative to gender diverse children and adolescents without ASD. The Social Responsiveness Scale (Second Edition) generates a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) score indicating a likely clinical ASD diagnosis, which was used to partition participants into two groups (indicated ASD, n = 19) (no ASD indicated, n = 60). Indicated ASD was far higher than would be expected compared to general population estimates. Indicated ASD on the Social Responsiveness Scale 2 (SRS 2) was also a significant predictor of Internalising behaviours (Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Thought Problems subscales) on the Youth Self Report. Indicated ASD was also a significant predictor of scores on all subscales of the Paediatric Quality of Life Inventory. The current findings indicate that gender diverse children and adolescents with indicated ASD comprise an especially vulnerable group that are at marked risk of mental health difficulties, particularly internalising disorders, and poor quality of life outcomes. Services working with gender diverse young people should screen for ASD, and also provide pathways to appropriate care for the commonly associated mental health difficulties.

Purpose: This paper explores employment discrimination against gender diverse job applicants and employees in Western Australia (WA).Design/methodology/approach: Using grounded theory, this study draws on semi-structured interviews with respondents (n = 20) who identified as trans women, trans men, nonbinary or agender. Thematic analysis focused on the multiple dimensions of disadvantage experienced by respondents, including subtle, not so subtle and overt types of employment discrimination.Findings: The authors’ results point to several reasons why gender diverse individuals (GDIs) may fear the labor market, including difficulties in concealing their stigma and acquiescence to discrimination. On the other hand, our results also point to sources of organizational support, including encouragement from direct line managers and colleagues who are also Allies.Practical implications: The results of the research have important implications for sociological frameworks surrounding dramaturgy, stigma, aesthetic labor, organizational silence and social identity. Practical implications for employers, employees, human resource (HR) professionals and trade unions are also articulated.Originality/value: Whereas previous studies have prioritized the discriminatory experiences of GDIs in the US and European labor markets, this study reports on gender diverse voices in WA. Furthermore, recent work on this topic has been experimental and largely quantitative, whereas the present study offers a compelling set of profound narratives, thereby addressing calls for qualitative research that foregrounds the complexities and nuances of lived experience for GDIs and renders their voices heard.

The accurate and efficient diagnosis of rare diseases, many of which include congenital anomalies, depends largely on the specialists who diagnose them – including their ability to work alongside specialists from other fields and to take full advantage of cutting-edge precision medicine technologies and precision public health approaches. However, highly specialized clinicians operating within a historically-siloed healthcare system is antithetical to the multi-disciplinary, collaborative, and creative approach that facilitates the diagnosis of rare diseases. The Western Australian Undiagnosed Diseases Program (UDP-WA) successfully re-designed the work of the involved clinicians to facilitate teamworking across silos. To understand the effectiveness of the Western Australian program, we draw on a SMART work design perspective (i.e., work that involves Stimulation, Mastery, Agency, Relations, and Tolerable demands). We propose that the redesign was successful in part because it improved crucial psychosocial work characteristics that are less prevalent in the broader work system, as identified in the SMART model. Based on the effectiveness of UDP-WA and its SMART design, we provide a framework that clinicians, healthcare managers, and policymakers can consider when they re-design work so that they can create SMART jobs within healthcare.

A number of psychological assessment tools have been developed to describe various dimensions of gender. Some of these tools are restricted to a binary gender concept and are inflexible in reflecti...