Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status?

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Couture, M., Courteau, J., Brodeur, S., Chiu, Y., Courteau, M., Dubé, E., Thomas, N., Lesage, A., Fombonne, É., & Dufour, I. (2025). Male and Female Healthcare Trajectories in Autism: Are There Any Differences Considering Age at Diagnosis and Intellectual or Developmental Disabilities Status? Autism Research, 18(8), 1674-1692. https://doi.org/10.1002/aur.70072

Publication date: 26 Jun 2025 Added to AutiHub: 6 Aug 2026 Type: Article Article language: English
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Authors

Publication authors
10
Publication authors identified as autistic
1 / 10 (10.0%)
  1. Mélanie Couture
  2. Josiane Courteau
  3. Sébastien Brodeur
  4. Yohann Chiu
  5. Mireille Courteau
  1. E. Dubé
  2. Nina Thomas *
  3. Alain Lesage
  4. Éric Fombonne
  5. Isabelle Dufour

Abstract

ABSTRACT The aim of this study was to compare the healthcare trajectories (HCTs) 2 years after a first diagnosis of autism according to sex, age at diagnosis, and intellectual or developmental disabilities (IDD) status. This is a retrospective cohort study using health administrative data from Québec, Canada. The cohort included all individuals with a first diagnosis of autism registered by a physician between April 2012 and March 2015. HCTs were stratified by sex, presence of IDD, and age at diagnosis (youth, adult), and analyzed using state sequence analysis across healthcare settings, providers, and reasons for use. Our cohort included 5289 individuals, 76.6% were male, and 26.3% were adults at the time of diagnosis. The healthcare use decreased slightly over time, though intensity was higher in females. Sex differences in HCTs were strongly influenced by IDD status and age at diagnosis. While no significant sex differences were observed in HCTs for individuals with IDD diagnosed with autism in adulthood, the psychiatric condition profiles showed notable differences between males and females. Hospital days nearly doubled for females diagnosed in childhood compared to males, while males with IDD diagnosed with autism in childhood and males without IDD diagnosed in adulthood had fewer physical illness visits. Although physical and mental health challenges appear largely managed in ambulatory care during youth, high hospitalization rates in those diagnosed in adulthood, particularly females and those with IDD, highlight concerns about continuity of care and avoidable hospitalizations for these subgroups of patients.

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Cited references
80
Total cited references integrated for this publication.
Cited references with an identified autistic author
3 / 80 (3.8%)
Cited author occurrences identified as autistic
6 / 422 (1.4%)
Among occurrences linked to AutiHub author records: 6 / 98 (6.1%). Distinct cited authors identified as autistic: 6 / 382 (1.6%).
Cited author occurrences linked to AutiHub author records
98 / 422 (23.2%)
Distinct linked cited authors: 70 / 382 (18.3%)
Linked cited-author occurrences not identified as autistic
92 / 98 (93.9%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 92 / 422 (21.8%). Distinct linked cited authors not identified as autistic: 64 / 70 (91.4%).
6 cited bibliography entries could not be fully enriched from DOI metadata.
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