Both are diagnosable mental disorders. Why would a physician ignore that when the request is made to do reassignment surgery?
Every one of the five or six studies I’ve read on gender dysphoria notes comorbidity psychoses in around 60-70% of cases.
Mostly it is minimally autistic females.
I don’t think there’s much of an overlap between autism and narcissism. In fact I see autism and sociopathy as polar opposites. Autistic people mean well but simply have no idea how neurotypical people work. Sociopaths know all too well how to manipulate others into doing what they want; they just don’t care about anyone but themselves.