Study finds health disparities for LGBTQ+ autistic adults

In one of the first large-scale surveys on the health outcomes of LGBTQ+ autistic adults, researchers found that these adults saw a range of health disparities more often than straight, cisgender autistic adults. The findings were published in February in the Journal of Autism and Developmental Disorders.

In addition to reporting twice as many poor physical health days, more than twice the number of LGBTQ+ autistic respondents to the survey reported having a mental health condition.

Despite the greater need for mental and physical healthcare services, LGBTQ+ autistic adults had a higher rate of those needs being unmet.

More than 35 percent said they were refused services by a medical provider, in addition to being more likely to have their insurance not accepted by a healthcare provider.

Thirty-five percent of study respondents with autism also identified as LGBTQ+ in the National Survey on Health and Disability. Other research has estimated that about 4.5 percent of adult Americans identify as LGBT. More than 1200 autistic adults were among the respondents.

“The healthcare system is not currently working for many LGBTQ+ autistic adults, when this group has a greater need for health services,” said Dr. Andy Shih, Ph.D., senior vice president, public health and inclusion at Autism Speaks. “A great deal of work must be done to address these disparities, and at a minimum, all providers must become better aligned with guidelines in clinical care.”

Clinical care guidelines for transgender autistic adolescents were published in 2016, focusing on assessment, treatment and six specific challenges: including social functioning, medical treatments and medical safety, risk of victimization/safety, school and transition to adulthood issues. The guidelines recommend that providers screen transgender patients for autism, and that those with an autism diagnosis be screened for gender concerns to ensure the full range of their healthcare needs are addressed.

In addition to analyzing survey data, researchers conducted interviews with four respondents to illustrate the data analysis.

One respondent said he withholds disclosing his autism diagnosis in order to receive better healthcare services. Others indicated not receiving preventive care, in some cases for many years, due to previous experiences with providers who do not practice gender-affirming care. Others felt providers dismissed sexual health topics when their autism diagnosis was known.

“Health research has historically shown broad unmet health care needs among the LGBTQ+ community, and our own research at Autism Speaks demonstrates a large unmet need for healthcare for people with autism,” said Shih. “Where these groups intersect, the community and the healthcare system need to come together to provide added support and remove barriers to appropriate care.”