Intersections of Autism and Sexual and Gender Diversity Among Young People in New Zealand.
Brodie Fraser, Sujata Saha, Mary Buchanan and 6 others
Transgender and non-heterosexual young people in New Zealand had higher rates of an Autism diagnosis than their cisgender, heterosexual peers, after adjusting for age, ethnicity, and area.
This is a population prevalence finding, not a treatment effect.
Key findings
1Among 1,266,453 young people aged 5–24, 18,699 (1.47%) were identified as Autistic through diagnosis codes in hospital, specialist mental health, and disability support services records.
2After adjusting for age, ethnicity, deprivation, and urban/rural residence, the standardised Autism rate was 4.00% among transgender young people (2.9 times the cisgender rate of 1.52%), 3.93% among those with a gender outside the male/female binary (5.8 times the female rate of 0.68%), and 2.22% among non-heterosexuals (1.8 times the heterosexual rate of 1.38%).
3The authors state that most SGD individuals are not Autistic and that this association should not be read as explaining the broader health disparities these young people face, which are shaped by social and structural factors.
Still to come
How it was doneWhat they found
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What it does not show
The Autism identification method is unvalidated and relies on hospital, specialist mental health, and disability services records only; it misses diagnoses made in primary care or outpatient settings, so it likely undercounts the true Autistic population. It does not include young people who have not been able to access a formal diagnosis of any kind. The method uses DSM-IV-era diagnostic codes, which may capture conditions no longer classified as Autism, such as Rett syndrome. For under-15s, parents or caregivers may complete the Census form on the child's behalf, so young people who are not yet 'out' to their family may not be counted as SGD. The study used only self-reported Census responses (excluding StatsNZ-imputed values), which increased missing data: 11.8% for gender, 18.2% for transgender status, and 27.2% for sexuality. The 2023 Census was the first to include sexuality and 'another gender' options in New Zealand, so there is no historical time series or independent whole-population data to validate the accuracy of these variables.
Declared interests
Funded by Cure Kids (reference 3643). The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read the higher Autism rates among SGD young people as a causal link or as an explanation for the poorer health outcomes these young people face. The study is cross-sectional and descriptive, and the authors themselves state the association should not be interpreted as explanatory of broader health disparities. The Autism identification also relies on unvalidated administrative records that likely undercount the true Autistic population, so the actual rates in both groups may differ from what is reported here.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →