Mental and Physical Health Conditions Among Sexually Diverse and Gender-Diverse Autistic Adults

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Graham Holmes, L., Qian, Y., Ames, J., Caplan, R., Fraser, C., Gassner, D. L., Giwa Onaiwu, M., Hunter, M., Miesen, A. I. R. v. d., Nebeker, L., Taylor, R., & Croen, L. A. (2026). Mental and Physical Health Conditions Among Sexually Diverse and Gender-Diverse Autistic Adults. LGBT Health, 13(2), 101-113. https://doi.org/10.1177/23258292251414440

Publication date: 30 Jan 2026 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English
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Authors

Publication authors
12
Publication authors identified as autistic
4 / 12 (33.3%)
  1. Laura Graham Holmes
  2. Yinge Qian
  3. Jennifer Ames
  4. Reid Caplan *
  1. Cori Fraser
  2. Dena L. Gassner *
  3. Morénike Giwa Onaiwu *
  4. Morrigan Hunter *
  1. Anna I. R. van der Miesen
  2. Lindsey Nebeker
  3. Ryan Taylor
  4. Lisa A. Croen

Abstract

Purpose: The purpose of the study was to investigate mental and physical health diagnoses for sexually diverse and/or gender-diverse (SGD) autistic adults. Methods: We conducted a cross-sectional study using electronic health record (EHR) data from Kaiser Permanente Northern California. Participants were individuals with an autism diagnosis enrolled in the health plan between 2015 and 2019. SGD individuals were identified via sexual orientation and gender identity data or a stepwise methodology involving computerized searches of the EHR. Diagnostic codes for mental and physical health conditions were examined during the study period. Results: Of 4159 autistic participants, n = 122 were identified as sexually diverse and n = 90 as gender diverse. Using multivariable logistic regression models adjusted for age, race/ethnicity, and gender identity, we found that both the sexually diverse and gender diverse groups had greater odds of mental health diagnoses compared with individuals not identified as SGD. Sexually diverse adults had greater odds of alcohol or drug dependence, and gender-diverse adults had greater odds of other psychoses compared with individuals not identified as SGD. Both sexually diverse and gender diverse groups had greater odds of some physical health diagnoses, including pain not elsewhere classified, migraines, and gastrointestinal disorders, compared with individuals not identified as SGD. Conclusion: SGD autistic adults had greater odds of diagnosis of some mental and physical health conditions than autistic adults not identified as SGD, warranting further research on structural and interpersonal factors that affect their well-being and how best to support them.

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Bibliography inclusion overview

These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.

Cited references
93
Total cited references integrated for this publication.
Cited references with an identified autistic author
6 / 93 (6.5%)
Cited author occurrences identified as autistic
7 / 610 (1.1%)
Among occurrences linked to AutiHub author records: 7 / 97 (7.2%). Distinct cited authors identified as autistic: 7 / 545 (1.3%).
Cited author occurrences linked to AutiHub author records
97 / 610 (15.9%)
Distinct linked cited authors: 73 / 545 (13.4%)
Linked cited-author occurrences not identified as autistic
90 / 97 (92.8%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 90 / 610 (14.8%). Distinct linked cited authors not identified as autistic: 66 / 73 (90.4%).
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