While the link between autism and gender dysphoria has received increasing attention, the phenomenon of gender dysphoria co-occurring with autism remains unclear owing to the lack of autistic transgender perspectives. Therefore, we explored the gender dysphoria experiences of 15 Japanese autistic transgender adults, obtaining two key findings. First, their gender dysphoria experiences were diverse; some were related to gender incongruence, whereas others were not. The latter were characterized by resistance to the societal gender norms themselves, sensory disgust related to autistic sensory sensitivities, uncertainty regarding the gender norms of the social majority, and the autistic burden of living in a gendered society. Second, by examining the participants' life stories of being autistic in society, we found that most of them not only accumulate distress over gender norms (i.e. gender dysphoria) but pervasive social norms as well, which we termed pervasive social dysphoria. In other words, most participants experienced gender dysphoria as a subset of pervasive social dysphoria. These findings indicate that future research and practice need to further affirm the internal perspectives, such as by investigating which among the diverse gender dysphoria experiences co-occur with autism or a link between autism and pervasive social dysphoria, and by providing support for both gender dysphoria and pervasive social dysphoria in practice.