Physical health of autistic girls and women: a scoping review.
Caroline Kassee, Stephanie Babinski, Ami Tint and 6 others
PMID 33109257WHAT IT FOUND
Autistic girls and women report more physical health problems than autistic boys and men, with epilepsy and endocrine issues like PCOS standing out.
This pattern may reflect under-diagnosis in males or higher biological risk in females, rather than a simple prevalence difference.
Key findings
01Autistic girls and women experience more overall physical health conditions than autistic boys and men and non-autistic girls and women.
02Epilepsy is more common in autistic girls and women compared to autistic boys and men, though this is linked to intellectual disability and other factors.
03Autistic women have higher rates of endocrine and reproductive health issues, including thyroid disease, PCOS, and irregular painful periods, compared to non-autistic women.
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
Scoping reviews do not assess the risk of bias in the included studies, so the quality of the underlying evidence is unknown. Most included studies were cross-sectional, so they cannot prove that autism causes these health conditions or that the direction of association is one-way. The review highlights that many girls and women with autism are diagnosed later or only when they have significant co-occurring conditions, meaning the health issues found may reflect severe cases rather than the average autistic female. Definitions of sex and gender were often conflated in the source studies, making it hard to separate biological effects from social ones. There is a lack of longitudinal data, so it is unclear how these physical health risks change across the lifespan.
Declared interests
The authors declared no competing interests. The work was supported by the National Institutes of Health (NIH) and non-US government grants.
The easy way to misread this
Do not assume that autistic girls and women are inherently less healthy than boys and men. The observed differences may be partly due to ascertainment bias, where girls are only diagnosed when they have severe co-occurring conditions, while many healthier autistic girls remain undiagnosed and excluded from these studies.