Health and Health Care Access of Autistic Transgender and Nonbinary People in Canada: A Cross-Sectional Study.
Noah Adams, Kai Jacobsen, Lux Li and 5 others
PMID 40151657WHAT IT FOUND
Autistic transgender and nonbinary people in Canada report worse health, more unmet needs, and frequent misgendering than allistic peers.
Many hide their autism during gender-affirming care assessments to avoid denial. Clinicians must treat these identities as separate and valid.
Key findings
01Nearly half of autistic participants reported fair or poor general health, compared with one quarter of allistic participants.
02A significant proportion of autistic participants avoided sharing information about their autism during mental health assessments for gender-affirming care to ensure access.
03Autistic participants were more likely to report that mental health providers repeatedly misgendered them or failed to separate their mental health concerns from their transgender identity.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was a convenience sample recruited online and at community events, so it is not representative of all transgender and nonbinary people in Canada. The study did not adjust for multiple comparisons, meaning some significant findings could be false positives. Data on specific provider interactions were only collected for a subset of participants who had accessed care in the past year. The study did not measure the frequency of provider visits, so higher reported negative experiences might reflect more contact rather than worse care.
Declared interests
The study was approved by research ethics boards at Western University, Unity Health Toronto, and Wilfrid Laurier University. No specific funding sources or commercial conflicts of interest are detailed in the provided text.
The easy way to misread this
Do not assume that autistic transgender patients are confused about their gender identity or that their autism should delay gender-affirming care. The data show that many patients hide their autism specifically to avoid this kind of gatekeeping, and that explicit denial of care due to autism is rare compared to the fear of it.