Health and Health Care Access of Autistic Transgender and Nonbinary People in Canada: A Cross-Sectional Study

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Adams, N., Jacobsen, K., Li, L., Francino, M., Rutherford, L., Tei, C., Scheim, A., & Bauer, G. (2024). Health and Health Care Access of Autistic Transgender and Nonbinary People in Canada: A Cross-Sectional Study. Autism in Adulthood, 7(1), 66-80. https://doi.org/10.1089/aut.2023.0024

Publication date: 28 Mar 2024 Added to AutiHub: 30 Aug 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
8
Publication authors identified as autistic
1 / 8 (12.5%)
  1. Noah Adams *
  2. Kai Jacobsen
  3. Lux Li
  4. Matt Francino
  1. Leo Rutherford
  2. ChrŸs Tei
  3. Ayden Scheim
  4. Greta Bauer

Abstract

Background: The existence and health care needs of individuals who are both autistic and transgender and nonbinary (TNB) are increasingly discussed publicly. While research demonstrating a greater prevalence of autism among TNB individuals continues to grow, little captures their experiences with primary, mental health, and gender-affirming care (GAC), particularly between self-identified and diagnosed autistic TNB individuals. This article explores this nexus. Methods: We conducted a subgroup analysis of the Trans PULSE Canada 2019 national survey (n = 2873). We included both individuals who self-reported a diagnosis of autism (n = 230) and those who self-identify as autistic without one (n = 176). We compared participant demographics, health status, and health care experiences by autistic status (diagnosed, self-identified only, or allistic [non-autistic]) using weighted chi-square tests and logistic regression analyses. Results: Of Trans PULSE participants, 14.3% were autistic (8.1% diagnosed, 6.2% self-identified). Compared with their allistic peers, autistic participants were younger, had lower levels of education, employment, and income, and were more likely to identify as asexual. They also reported worse overall general health, a higher rate of unmet health care needs, and significant mental health disparities. While few diagnosed (3.7%) or self-identified (1.1%) autistic participants reported being directly denied GAC due to autism, 25.5% of diagnosed and 36.1% of self-identified individuals preemptively avoided sharing information about it during GAC readiness assessments in the past year. Conclusions: Our findings highlight the need for changes to treatment of autistic TNB people in primary and mental health care. Future research should explore both individual responses and systematic changes to these challenges.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 12 Sep 2026 17:55.

Cited references
72
With a DOI
57
Without a DOI, from raw bibliography text
15
13 / 72 (18.1%) cited references include at least one author identified as autistic.
References with data to complete
13 / 72 (18.1%)
References with detected author names
59 / 72 (81.9%)
Without detected author names
13
Without a structured title
12
Without a stable identifier
14
References with raw author names still to review
11
References with external metadata lookup issues
2
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
264
From DOI or external metadata
264
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
12
131 / 264 (49.6%) names are linked to an author already present in AutiHub. 133 / 264 (50.4%) names are not yet linked.
Names linked to a person identified as autistic
21 / 264 (8.0%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 21 / 131 (16.0%). Distinct people identified as autistic: 16 / 224 (7.1%).
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