Helping Double Rainbows Shine: How Formal and Informal School Structures Support Gender Diverse Youth on the Autism Spectrum Shelley M. Barber A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Washington 2020 Reading Committee: Kristen Missall, Chair Felice Orlich Carly Roberts Ilene Schwartz Program Authorized to Offer Degree: Education ©Copyright 2020 Shelley M. Barber University of Washington Abstract Helping Double Rainbows Shine: How Formal and Informal School Structures Support Gender Diverse Youth on the Autism Spectrum Shelley M. Barber Chair of the Supervisory Committee: Kristen Missall School Psychology, College of Education Ten adolescents (14 through 19 years old) diagnosed with autism spectrum disorder (ASD) who identify as transgender/gender diverse were interviewed to better understand their perceptions and interpretations of school experiences as part of a basic qualitative study. Participants were asked to reflect on what helped them feel safe and supported in terms of their gender identity at school, what led them to feel unsafe and unsupported, and what they thought could be put in place to better support their gender identities. Table of Contents Acknowledgments............................................................................................................ i Chapter 1: Introduction .................................................................................................. 1 Chapter 2: Literature Review ......................................................................................... 5 Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) Populations ..................... 5 Gender development in neurotypical individuals ................................................... 5 Gender dysphoria in neurotypical individuals ........................................................ 8 Treatment guidelines ............................................................................................. 11 Challenges LGBTQ+ Students Face in Schools ...................................................... 12 Externalizing and academic challenges ................................................................ 12 Internalizing challenges ........................................................................................ 12 Bullying and victimization .................................................................................... 13 Negative school climate ........................................................................................ 14 Autism Populations .................................................................................................. 15 ASD and gender development .............................................................................. 16 Biological and cognitive factors ........................................................................... 17 Social factors ......................................................................................................... 20 Psychological factors ............................................................................................ 20 GD Symptoms in ASD............................................................................................. 21 Challenges Students with ASD Face in Schools...................................................... 23 Externalizing behaviors ........................................................................................ 23 Internalizing behaviors.......................................................................................... 25 Bullying and victimization .................................................................................... 26 Gender Diverse Youth with ASD ............................................................................ 29 Historical and current prevalence rates of GD in ASD ......................................... 29 Research examining the perspectives and experiences of gender diverse youth with ASD .................................................... 31 Gender Diverse Youth with ASD in Schools .......................................................... 34 Conceptual Framework ............................................................................................ 34 Intersectionality framework .................................................................................. 35 Social model of disability ..................................................................................... 38 Research Questions .................................................................................................. 39 Chapter 3: Methods ...................................................................................................... 40 Current Study Design ............................................................................................... 40 Study Design of Larger Study.................................................................................. 40 Current Study Participants ....................................................................................... 42 Measures .................................................................................................................. 43 Procedures ................................................................................................................ 45 Researcher Positionality........................................................................................... 46 Establishing Trustworthiness and Credibility .......................................................... 47 Data Analysis ........................................................................................................... 49 Chapter 4: Results ........................................................................................................ 53 Formal School Structures of Support ....................................................................... 54 Ability to transfer schools ..................................................................................... 54 Use of preferred name and pronouns .................................................................... 54 Presence of anti-bullying policies ......................................................................... 57 Access to gender-neutral bathrooms ..................................................................... 58 Gay Straight Alliances (GSAs) and other LGBTQ+ student groups .................... 61 Informal School Structures of Support .................................................................... 62 Giving room for student agency ........................................................................... 62 Upholding and enforcing formal and informal school policies ............................ 68 Personal characteristics of teachers and school staff attributing to school climate.................................................................................. 75 How to “show” support for LGBTQ+ students .................................................... 79 Participant Check-In/Member Checks ..................................................................... 84 Autism and Identity.................................................................................................. 86 Disability identity and autism identity .................................................................. 86 Autism influencing gender identity ...................................................................... 88 Chapter 5: Discussion .................................................................................................. 91 Implications for Professional Practice ..................................................................... 91 Support and allyship ............................................................................................. 91 Recommendations for Schools and Practitioners .................................................... 93 Professional development training ........................................................................ 93 Inclusive anti-bullying policies and implementation ............................................ 94 Implications for Research ........................................................................................ 95 Future research directions ..................................................................................... 96 Design Limitations ................................................................................................... 96 Conclusion ............................................................................................................... 98 References ................................................................................................................... 100 Table 1: Participant Information ................................................................................ 115 Appendix A: Interview Protocol ................................................................................ 116 Appendix B: Consent/Assent Form ........................................................................... 121 Appendix C: UW IRB Determination of Not Human Subjects ................................. 132 Appendix D: Coding Scheme .................................................................................... 134 i Acknowledgements This dissertation is the culmination of a six-year journey full of twists, turns, growth, and learning. While I initially discovered my passion for working with youth on the autism spectrum during a chance practicum,