Mental Capacity, Autistic Adults, and Medical Treatment

If you’ve been on my website at all in the past twenty-four hours, you would’ve probably seen this:

Now, let me tell you why this letter is so important.

As we all know, there is an overlap in the Autistic and Trans Communities. Autism is often seen as a comorbidity of being Trans and vice versa. It is more common for an Autistic person to be Trans because we experience gender differently than Neurotypicals and other Neurodivergents.

With that being said, let’s look at the current court review – a father is going down a legal route to try and stop his 21-year-old Autistic child from having reassignment surgery. This ADULT has been transitioning since she was 13 and started puberty blockers at 16 – “against [her] parents wishes”.

Now, she’s planning on having reassignment surgery in a week (most likely now delayed). Still, her parents are trying to block it from happening on the premise that Autism makes them vulnerable and not Mentally Capable…

The legal bid should be struck down immediately since this is an ADULT that has chosen her treatments since she was 16 – she’s now 21, with no diagnosis change*, and is a legal adult in every way.

Considering that her doctors have gone forward with treatments, they deem her mentally capable under the Mental Capacity Act 2005, which allows people to make life decisions (medical, monetary, etc.) from age 18.

Her parents’ reasoning in the legal bid is that the human brain doesn’t fully mature until age 25. They suggest the woman in question shouldn’t be allowed to choose her treatments because “**[She] may chronologically be an age but, maturity wise that’s not the case. At the moment [she’s] 21, but [she’s] probably acting like [she’s] 16 or 17″[1].

Besides the absurd amount of ableism, and transphobia since the parents are repeatedly misgendering their daughter, let’s discuss the idea that Autistic Adults don’t have the maturity for medical decisions and what deems someone as mentally capable:

Mental Capacity is determined via the following questions:

  1. Is the person able to make the decision (with support if required)?
  2. If they cannot, is there an impairment or disturbance in the functioning of their mind or brain?
  3. Is the person’s inability to make the decision because of the impairment or disturbance?[2]

If they cannot do the following, then they’re not mentally capable:

  1. understand the information given to them
  2. retain that information long enough to be able to make the decision
  3. weigh up the information available to make the decision
  4. communicate their decision – this could be by talking, using sign language or even simple muscle movements such as blinking an eye or squeezing a hand.[2]

Most Autistic Adults, of varying support needs can do all these things.

By speaking with a patient, Doctors can assess whether the person is irrational, not taking in information, unable to communicate their decision, etc.

What ableists class as “Mental Maturity” has nothing to do with it because if we go by the neurotypical idea of “Mental Maturity”, – a large group of adults would be classed as mentally incapable.

The streets of any major city in the UK at 1 AM on a Saturday would be enough of a display of the lack of mental maturity in adults older than 25.

So, let’s skip the idea that people must be “mature” to make decisions about THEIR healthcare and consider whether someone can listen to their options, weigh them up, and communicate their decision and reasoning.

Because the route to reassignment surgery in the UK is challenging and has many hurdles, including a psychiatric evaluation.

And I’m confident that a psychiatrist is more likely to be able to determine a person’s Mental Capacity rather than a Transphobe trying to control their adult child.

If you believe that disabled individuals should be allowed to make their own decisions, if they pass the requirements of the Mental Capacity Act of 2005, please read the open letter and sign it. Please show your support for both the disabled and trans communities before our rights are stripped from us.

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References and Notes:

[*NOTE]. Mental Capacity is routinely reassessed when someone has a degenerative condition or a new diagnosis. It is unnecessary to repeatedly reassess Autistic Adults as the disorder has no degenerative nature. Therefore, an Autistic person deemed capable at age 16 will remain capable at 21 as long as there are no further diagnoses such as – but not limited to – Alzheimer’s, Dementia, and Anterograde Amnesia.

[**NOTE]. Out of respect for the Trans Woman, I have amended the pronouns of the original quote to reflect the pronouns she likely uses.

[1]. Quote From Parent – “Father launches a last-ditch legal bid to stop his ‘vulnerable’ autistic son, 21, from having a sex change next week” – Daily Mail:

[2]. Mental Capacity Act 2005 at a glance – SCIE:

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