Autism & Developmental

A Quantitative Analysis of Mental Health Among Sexual and Gender Minority Groups in ASD.

George et al. (2018) · Journal of autism and developmental disorders 2018
★ The Verdict

Autistic clients who also identify as sexual or gender minorities carry compounded mental-health risk—screen these clients more intensively.

✓ Read this if BCBAs working with autistic teens or adults in clinic, school, or home settings.
✗ Skip if Practitioners who serve only early-childhood or strictly neurotypical clients.

01Research in Context

01

What this study did

George et al. (2018) asked autistic and non-autistic adults to fill out mental-health surveys.

They compared people who were straight and cisgender with people who were gay, bi, trans, or non-binary.

The team wanted to know if being both autistic and a sexual or gender minority adds extra mental-health risk.

02

What they found

Depression, anxiety, and stress went up as group membership became more restrictive.

Autistic adults who were also LGBTQ+ reported the worst scores.

The pattern was weaker in non-autistic adults.

03

How this fits with other research

Costa et al. (2020) asked similar questions and found the same group faces more doctor refusals and unmet health needs.

Chang et al. (2022) looked back in time and saw that low family support plus lots of repetitive behaviors predicted gender-dysphoric wishes in autistic youth.

George et al. (2018) found higher gender-dysphoric traits in autistic adults, but the direction looks opposite. The difference is simple: one counts traits (positive finding) while the other counts mental-health harm (negative finding).

Together the four papers draw the same picture: being autistic and LGBTQ+ stacks risk.

04

Why it matters

If your client is autistic, add sexual and gender identity to your intake form. Ask about depression, anxiety, and stress every visit. Offer referrals to LGBTQ+-affirming therapists. Small extra steps catch big problems early.

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Add two check-boxes—LGBTQ+ identity and preferred pronouns—to your intake form and review them at every reassessment.

02At a glance

Intervention
not applicable
Design
other
Sample size
570
Population
autism spectrum disorder, neurotypical
Finding
negative

03Original abstract

There is increased mental-health adversity among individuals with autism spectrum disorder. At the same time, sexual and gender minority groups experience poorer mental-health when compared to heteronormative populations. Recent research suggests that autistic individuals report increased non-heterosexuality and gender-dysphoric traits. The current study aimed to investigate whether as membership of minority grouping becomes increasingly narrowed, mental health worsened. The present study compared the rates of depression, anxiety, and stress using the DASS-21 and Personal Well-Being using the personal well-being index between 261 typically-developing individuals and 309 autistic individuals. As membership to a minority group became more restrictive, mental health symptoms worsened (p < .01), suggesting stressors added. Specialized care is recommended for this vulnerable cohort.

Journal of autism and developmental disorders, 2018 · doi:10.1007/s10803-018-3469-1