Health Disparities Among Sexual and Gender Minorities with Autism Spectrum Disorder.
LGBTQ+ autistic adults carry heavier health burdens and steeper care barriers than straight autistic peers.
01Research in Context
What this study did
Costa et al. (2020) sent a survey to LGBTQ+ adults with autism. They asked about health status, doctor visits, and care refusals.
They compared answers to straight, cisgender autistic adults. The goal was to see if being LGBTQ+ adds extra health hurdles.
What they found
LGBTQ+ autistic adults reported worse health across the board. They also faced more barriers, such as providers saying no to care.
Mental illness rates were higher in the LGBTQ+ group. Unmet medical needs were common.
How this fits with other research
George et al. (2018) saw the same pattern first. Their 2018 survey showed mental-health symptoms rise as minority labels pile up.
Lewis et al. (2021) dug deeper one year later. They recorded large-scale stories of autistic LGBTQ+ adults being denied reasonable help.
Menezes et al. (2025) widened the lens to youth. They found autistic kids face more discrimination for disability, race, and sexual identity than peers. Together, the four studies draw a timeline: the problem starts young and snowballs into adulthood.
Why it matters
Your intake form should ask both autism status and gender or sexual identity. If a client checks both boxes, plan for extra mental-health screening and service navigation help. Offer referrals to LGBTQ+-friendly providers and add self-advocacy goals to the treatment plan. Small steps now can prevent big gaps later.
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02At a glance
03Original abstract
We explored the health and health care experiences of people with autism spectrum disorder (ASD) who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+) using data from a national, internet-based survey of adults with disabilities supplemented by focused interviews. LGBTQ+ respondents had significantly higher rates of mental illness, poor physical health days per month, and smoking compared to straight, cisgender respondents with ASD. LGBTQ+ respondents also reported much higher rates of unmet health care need, inadequate insurance provider networks, and rates of being refused services by a medical provider. Examining the intersection of LGBTQ+ identity and ASD reveals compounded health disparities that insurers and medical providers are not adequately addressing, particularly as individuals transition to the adult medical system.
Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-020-04399-2