Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status?
Mélanie Couture, Josiane Courteau, Sébastien Brodeur and 7 others
PMID 40568737WHAT IT FOUND
Autistic females were diagnosed later than males, averaging 22.2 versus 13.9 years.
Adults relied heavily on hospital and emergency care, while children used outpatient clinics. Sex differences in healthcare use varied significantly depending on age at diagnosis and intellectual disability status.
Key findings
01Females received an autism diagnosis later than males, with a mean age of 22.2 years compared to 13.9 years for males.
02Individuals diagnosed in adulthood were more likely to have their first diagnosis recorded during a hospitalization or emergency department visit, whereas those diagnosed in childhood received diagnoses in outpatient clinics.
03Healthcare use patterns differed by sex, with females diagnosed in adulthood without intellectual disabilities using significantly more services for physical illnesses than males.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on administrative data, which excluded private sector diagnoses (e.g., by psychologists or speech-language pathologists) and services not covered by public insurance. The definition of incident cases required a 10-year clearance period, which may have misclassified adults with undiagnosed autism prior to 2002 as new cases. Data on important variables such as race, gender identity, and socioeconomic context beyond prescription drug insurance status were not available. The study did not capture the reasons for non-diagnosis or the potential for missed diagnoses in individuals who did not seek or receive care.
Declared interests
The authors declare no competing interests. The study was supported by the Canadian Institutes of Health Research and other Canadian funding bodies.
The easy way to misread this
Do not interpret the later diagnosis age in females as evidence of a distinct clinical presentation that requires different assessment tools. The data reflects healthcare system interactions and diagnostic timing, not necessarily a difference in the core symptoms of autism.