Sexually diverse and gender diverse (SGD) people have greater odds of mental health diagnoses, of alcohol or drug dependence, and of other psychoses.
This is according to a study – “Mental and Physical Health Conditions Among Sexually Diverse and Gender-Diverse Autistic Adults” by Laura Graham Holmes, Yinge Qian, Lisa A. Croen, et al – that appeared in LGBT Health.
The researchers noted (from a recent study involving 2,386 participants) that autistic people were less likely to identify as heterosexual compared with non-autistic people, and that 12.6% of autistic individuals identified as transgender. And so they wanted to investigate mental and physical health diagnoses for sexually diverse and/or gender-diverse (SGD) autistic adults.
For this study, the researchers 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.
In total, 4,159 autistic participants were tapped, with 122 identifying as sexually diverse and 90 as gender diverse. Using multivariable logistic regression models adjusted for age, race/ethnicity, and gender identity, the researchers found:
- 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; and
- 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.
Since “SGD autistic adults had greater odds of diagnosis of some mental and physical health conditions than autistic adults not identified as SGD”, this warrants “further research on structural and interpersonal factors that affect their well-being and how best to support them,” stated the researchers.
“Being both autistic and SGD could increase stress exposures that are detrimental to health over and above holding one of these identities alone. More research, particularly in comparison with non-autistic SGD people, is needed to understand the mechanisms of health disparities and how specific challenges experienced by both autistic and SGD individuals, such as health care access and quality, contribute to these disparities.”
Beyond research, and more practically, the researchers recommended for providers to “consider more comprehensive mental and physical health screening for this population to address issues as early as possible”. This is because “targeted neurodiversity- and sexual- and gender-diversity-affirming interventions that address unique aspects of intersectional minority stress experiences are needed.”
