Autistic and transgender/gender diverse people's experiences of health and healthcare.

The sample was recruited via convenience sampling, likely biasing it towards individuals with more health problems or negative healthcare experiences. The TGD autistic group was small (n=174), which may have led to underpowered analyses for comparisons between the two autistic groups. There was no TGD non-autistic comparison group, so it is unclear if some difficulties are specific to the intersection of autism and gender diversity or common to TGD individuals generally. Data were self-reported and subjective, relying on patient perceptions rather than objective clinical records. The survey excluded individuals with suspected or self-diagnosed autism, limiting generalizability to those not formally diagnosed. The sample was predominantly white, female-assigned at birth, and highly educated, which may not represent the broader autistic and TGD populations.

The authors declared funding from Rosetrees Trust, Cambridge and Peterborough NHS Foundation Trust, Autism Centre of Excellence at Cambridge, NIHR Cambridge Biomedical Research Centre, NIHR Applied Research Collaboration East of England, Simons Foundation Autism Research Initiative, Wellcome Trust, Innovative Medicines Initiative 2 Joint Undertaking, Templeton World Charitable Fund, and Medical Research Council. No specific conflicts of interest were detailed beyond these funding sources.

Do not assume that all autistic patients have the same healthcare needs. The study highlights that transgender/gender diverse autistic adults face unique and compounded barriers, particularly in accessing care and communicating with providers, which are distinct from those faced by cisgender autistic adults.