A couple of things comes to mind: – Do you have anything else to convince yourself that you are a trans, like feeling more attracted to men or having certain behavior that looks like a female? – Have you been pressured into acting like a man throughout your life and when you failed to do so were you punished harshly? – How has your social life been? I mean, who did you interact with as a kid? Did you go out often with your friends? How about now? – You said you had autism. Do you feel being misunderstood all the time? When you were young did you try to find out who you were in general and to find any kind of “tribe” to belong? – And last but not least, where do you live?