Mental and Physical Health Conditions Among Sexually Diverse and Gender-Diverse Autistic Adults

The purpose of the study was to investigate mental and physical health diagnoses for sexually diverse and/or gender-diverse (SGD) autistic adults.

We conducted a cross-sectional study using electronic health record (EHR) data from Kaiser Permanente Northern California. Participants were individuals with an autism diagnosis enrolled in the health plan between 2015 and 2019. SGD individuals were identified via sexual orientation and gender identity data or a stepwise methodology involving computerized searches of the EHR. Diagnostic codes for mental and physical health conditions were examined during the study period.

Of 4159 autistic participants, n = 122 were identified as sexually diverse and n = 90 as gender diverse. Using multivariable logistic regression models adjusted for age, race/ethnicity, and gender identity, we found that both the sexually diverse and gender diverse groups had greater odds of mental health diagnoses compared with individuals not identified as SGD. Sexually diverse adults had greater odds of alcohol or drug dependence, and gender-diverse adults had greater odds of other psychoses compared with individuals not identified as SGD. Both sexually diverse and gender diverse groups had greater odds of some physical health diagnoses, including pain not elsewhere classified, migraines, and gastrointestinal disorders, compared with individuals not identified as SGD.

SGD autistic adults had greater odds of diagnosis of some mental and physical health conditions than autistic adults not identified as SGD, warranting further research on structural and interpersonal factors that affect their well-being and how best to support them.