« Ils ne me croyaient pas » : obstacles aux soins de sante mentale pour les jeunes adultes autistes LGBTQIA+ — une etude en partenariat avec la communaute

Titre original en anglais : “They Didn’t Believe Me”: Barriers to Mental Health Care for Autistic LGBTQIA+ Young Adults—A Community-Partnered Study

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Baczewski, L., Gohari, D., Caplan, R., Nachman, B. R., Taylor, R., McDonald, M., Rodriguez, K., Sharp, K., Smith, M., Vu, A., & Massolo, M. L. (2025). “They Didn’t Believe Me”: Barriers to Mental Health Care for Autistic LGBTQIA+ Young Adults—A Community-Partnered Study. Autism in Adulthood. https://doi.org/10.1177/25739581251387936

Date de publication: 21/11/2025 Ajout dans AutiHub: 05/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
11
Auteur·ices de la publication identifié·es comme autistes
2 / 11 (18,2 %)
  1. Lauren Baczewski
  2. Dena Gohari
  3. Reid Caplan *
  4. Brett Ranon Nachman *
  1. Ryan Taylor
  2. Meghan McDonald
  3. Kayla Rodriguez
  4. Kathryn Sharp
  1. McKinzie Smith
  2. Andrew Vu
  3. Maria L Massolo

Résumé

Contexte : Les personnes autistes lesbiennes, gays, bisexuelles, transgenres, queers, intersexes, asexuelles et/ou en questionnement (LGBTQIA+) presentent un risque plus eleve de difficultes de sante mentale que leurs homologues autistes non LGBTQIA+ et connaissent des inegalites d'acces aux soins de sante. Bien qu'un corpus croissant de recherches apporte des preuves de ces inegalites de sante, nous en savons relativement peu sur les experiences de soins de sante mentale des jeunes adultes autistes LGBTQIA+ selon leurs propres perspectives. Methodes : Cette etude contribue au corpus de donnees probantes en explorant les obstacles specifiques auxquels les jeunes adultes autistes LGBTQIA+ sont confrontes lorsqu'ils recherchent des soins de sante mentale (p. ex., une therapie). Vingt jeunes adultes autistes LGBTQIA+ (ages de 18 a 28 ans, MAge = 23,3 ans) provenant de l'ensemble des Etats-Unis ont participe a des entretiens semi-structures oraux ou ecrits sur leurs experiences de soins de sante mentale. Quarante-cinq pour cent des personnes interrogees (9/20) se sont identifiees comme de genre fluide, non binaires ou expansives de genre, et plus de la moitie ont declare souffrir d'anxiete, de depression et/ou de trouble du deficit de l'attention avec hyperactivite (TDAH). Nous avons analyse les entretiens a l'aide d'une analyse thematique de fiabilite du codage. Resultats : Les participants ont ete confrontes a de multiples obstacles aux soins de sante mentale. Ces obstacles etaient specifiquement lies a leurs identites autistes, LGBTQIA+ et a d'autres identites marginalisees. Nous avons identifie trois themes principaux : (1) l'incredulite et le deni des identites autistes LGBTQIA+, (2) les biais systemiques envers les identites marginalisees et les diagnostics concomitants retardent l'acces au diagnostic et aux soins, et (3) le manque d'aisance des prestataires pour soutenir des clients autistes divers. Conclusion : Ces resultats soulignent l'importance d'une formation accrue des prestataires de sante mentale sur l'autisme et les identites LGBTQIA+, ainsi que sur leur intersection. Les travaux futurs devraient explorer les experiences uniques des personnes autistes LGBTQIA+ racisees dans l'acces aux soins de sante mentale. Resume destine a la communaute Pourquoi cette question est-elle importante ? Les personnes autistes LGBTQIA+ sont plus susceptibles d'avoir des diagnostics de sante mentale et de declarer une mauvaise qualite de vie que les personnes autistes qui ne sont pas LGBTQIA+. Malgre cela, nous ignorons encore beaucoup de choses sur les experiences de soins de sante mentale des jeunes adultes autistes LGBTQIA+. Quel etait l'objectif de cette etude ? Nous voulions apprendre ce qui rend difficile, pour les jeunes adultes autistes LGBTQIA+, l'acces a une therapie ou a d'autres soutiens en sante mentale. Qu'ont fait les chercheurs ? Notre equipe de recherche comprenait des personnes autistes et non autistes de genres et de sexualites divers, et nous avons concu l'etude ensemble. Nous avons interroge 20 jeunes adultes autistes LGBTQIA+ (ages de 18 a 28 ans) sur leurs experiences dans leurs tentatives de recevoir des soins de sante mentale aux Etats-Unis. Nous avons appris quels elements faisaient obstacle aux participants lorsqu'ils recherchaient du soutien. Quels ont ete les resultats de l'etude ? De nombreux elements ont rendu plus difficile l'acces des participants aux soins de sante mentale. Ces obstacles etaient specifiquement lies a leurs identites autistes, LGBTQIA+ et a d'autres identites marginalisees. Nous avons identifie trois themes principaux : (1) l'incredulite et le deni des identites autistes LGBTQIA+, (2) les biais systemiques envers les identites marginalisees et les diagnostics concomitants retardent l'acces au diagnostic et aux soins, et (3) le manque d'aisance des prestataires pour soutenir des clients autistes divers. Dans l'ensemble, les participants estimaient que les medecins avaient du mal a les diagnostiquer comme autistes s'ils avaient d'autres diagnostics. Ils ont declare que les medecins avaient de la difficulte a reconnaitre leur autisme s'ils avaient d'autres identites marginalisees (p. ex., etre LGBTQIA+ ou appartenir a une minorite raciale/ethnique). Ces experiences ont rendu plus difficile l'acces des participants aux soins de sante mentale. Les participants estimaient que les prestataires de sante mentale ont besoin de davantage de formation sur l'autisme dans le contexte d'identites et de parcours divers. Que rajoutent ces resultats a ce qui etait deja connu ? D'autres etudes montrent que les personnes autistes LGBTQIA+ presentent un risque eleve de difficultes de sante mentale et peinent a trouver des prestataires qui les comprennent. Cette etude apporte des informations approfondies sur les difficultes auxquelles les jeunes adultes autistes LGBTQIA+ sont confrontes lorsqu'ils recherchent des soins et sur ce que les prestataires peuvent faire pour mieux les soutenir. Quelles sont les faiblesses potentielles de l'etude ? Cette etude comprenait principalement des participants blancs et ayant fait des etudes universitaires. Les etudes futures devraient se concentrer sur les experiences de soins de sante mentale des adultes autistes LGBTQIA+ issus de minorites raciales/ethniques. Nous avons interroge de jeunes adultes ; les etudes futures devraient donc inclure des personnes autistes LGBTQIA+ de tous ages. Comment ces resultats aideront-ils les adultes autistes maintenant ou a l'avenir ? De nombreux prestataires de sante mentale ne disposent pas d'une formation adequate sur l'autisme et les identites LGBTQIA+. Ces resultats montrent que cette formation est necessaire de toute urgence. Les participants ont partage des recommandations sur la maniere dont les prestataires peuvent mieux repondre a leurs besoins.

Background:Autistic Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, and/or Questioning (LGBTQIA+) people are at a greater risk for mental health challenges than their Autistic non-LGBTQIA+ counterparts and experience disparities in access to health care. Although a growing research base provides evidence of these health disparities, we know relatively little about the mental health care experiences of Autistic LGBTQIA+ young adults from their own perspectives. Methods:This study contributes to the evidence base by exploring specific barriers that Autistic LGBTQIA+ young adults face when seeking mental health care (e.g., therapy). Twenty Autistic LGBTQIA+ young adults (18–28 years old, MAge = 23.3 years) from across the United States participated in semi-structured oral or written interviews about their mental health care experiences. Forty-five percent of interviewees (9/20) identified as gender fluid, nonbinary, or gender expansive, and more than half reported having anxiety, depression, and/or Attention-deficit/hyperactivity disorder (ADHD). We analyzed interviews using Coding Reliability Thematic Analysis. Results:Participants faced multiple barriers to mental health care. These barriers specifically related to their Autistic, LGBTQIA+, and other marginalized identities. We identified three primary themes: (1) disbelief and denial of Autistic LGBTQIA+ identities, (2) systemic biases toward marginalized identities and co-occurring diagnoses delay access to diagnosis and care, and (3) providers’ lack of fluency in supporting diverse Autistic clients. Conclusion:These findings highlight the importance of increased mental health provider training in autism and LGBTQIA+ identities, as well as the intersection. Future work should explore the unique experiences of Autistic LGBTQIA+ People of Color in accessing mental health care. Community BriefWhy is this an important issue?Autistic LGBTQIA+ people are more likely to have mental health diagnoses and report poor quality of life compared with Autistic people who are not LGBTQIA+. Despite this, there is still a lot we do not know about the mental health care experiences of Autistic LGBTQIA+ young adults.What was the purpose of this study?We wanted to learn what makes it difficult for Autistic LGBTQIA+ young adults to get therapy or other mental health supports.What did the researchers do?Our research team included Autistic people and non-autistic people of diverse genders and sexualities, and we designed the study together. We interviewed 20 Autistic LGBTQIA+ young adults (18–28 years old) about their experiences trying to receive mental health care in the United States. We learned about the things that get in the way for participants when seeking support.What were the results of the study?Many things made it harder for participants to get mental health care. These barriers specifically related to their Autistic, LGBTQIA+, and other marginalized identities. We identified three primary themes: (1) disbelief and denial of Autistic LGBTQIA+ identities, (2) systemic biases toward marginalized identities and co-occurring diagnoses delay access to diagnosis and care, and (3) providers’ lack of fluency in supporting diverse Autistic clients. Overall, participants felt that doctors struggled to diagnose them as Autistic if they had other diagnoses. They reported that doctors had trouble recognizing their autism if they had other marginalized identities (e.g., being LGBTQIA+ or a racial/ethnic minority). These experiences made it harder for participants to get mental health care. Participants felt that mental health providers need more training in autism across diverse identities and backgrounds.What do these findings add to what was already known?Other studies show that Autistic LGBTQIA+ people are at a high risk for mental health challenges and struggle to find providers that understand them. This study adds in-depth information about the challenges that Autistic LGBTQIA+ young adults face when seeking care and what providers can do to better support them.What are potential weaknesses in the study?This study included mostly White and college-educated participants. Future studies should focus on the mental health care experiences of Autistic LGBTQIA+ adults from racial/ethnic minority backgrounds. We interviewed young adults, and so future studies should include Autistic LGBTQIA+ individuals across ages.How will these findings help autistic adults now or in the future?Many mental health providers do not have adequate training in autism and LGBTQIA+ identities. These findings show that this training is urgently needed. Participants shared recommendations for how providers can better meet their needs.

Bibliographie citée par cette référence

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Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:30.

Références citées
51
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
10 / 51 (19,6 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
24 / 245 (9,8 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 24 / 125 (19,2 %). Auteurices cité·es distinct·es identifié·es comme autistes : 22 / 219 (10,0 %).
Occurrences citées rattachées à la base AutiHub
125 / 245 (51,0 %)
Auteurices cité·es distinct·es rattaché·es : 104 / 219 (47,5 %)
Occurrences rattachées, non identifiées comme autistes
101 / 125 (80,8 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 101 / 245 (41,2 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 82 / 104 (78,8 %).
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