Physical health of autistic girls and women: a scoping review

Abstract

Background There is a growing recognition of sex and gender influences in autism. Increasingly, studies include comparisons between sexes or genders, but few have focused on clarifying the characteristics of autistic girls’/women’s physical health. Methods A scoping review was conducted to determine what is currently known about the physical health of autistic girls/women. We screened 1112 unique articles, with 40 studies meeting the inclusion criteria. We used a convergent iterative process to synthesize this content into broad thematic areas. Results Autistic girls/women experience more overall physical health challenges compared to non-autistic girls/women and to autistic boys/men. Emerging evidence suggests increased prevalence of epilepsy in autistic girls/women compared to non-autistic girls/women and to autistic boys/men. The literature also suggests increased endocrine and reproductive health conditions in autistic girls/women compared to non-autistic girls/women. Findings regarding gastrointestinal, metabolic, nutritional, and immune-related conditions are preliminary and inconsistent. Limitations The literature has substantial heterogeneity in how physical health conditions were assessed and reported. Further, our explicit focus on physical health may have constrained the ability to examine interactions between mental and physical health. The widely differing research aims and methodologies make it difficult to reach definitive conclusions. Nevertheless, in keeping with the goals of a scoping review, we were able to identify key themes to guide future research. Conclusions The emerging literature suggests that autistic girls/women have heightened rates of physical health challenges compared to non-autistic girls/women and to autistic boys/men. Clinicians should seek to provide holistic care that includes a focus on physical health and develop a women’s health lens when providing clinical care to autistic girls/women.

Toward a Gender-Sensitive Approach of Psychiatric Rehabilitation in Autism Spectrum Disorder (ASD): A Systematic Review of Women Needs in the Domains of Romantic Relationships and Reproductive Health

“…Compared with autistic men and typically developing women, women with ASD report more often comorbid physical health conditions (e.g., polycystic ovary syndrome, 7.8 vs. 3.5% in the general population) (49) and less utilization of women's health services (OR = 0.59, 95% CI = 0.48-0.72) (50). The barriers to accessing adequate healthcare include providers' lack of knowledge and dedicated training regarding autistic women' needs for care and the lack of specific services for adults with ASD (22,49,50). Although it has been proposed that autistic women's lower access to women's health services could be explained by less frequent sexual experiences (50), several studies have reported the opposite (23,24,34).…”

Health characteristics of reproductive-aged autistic women in Ontario: A population-based, cross-sectional study

“…Specifically, it is important to raise the awareness of clinicians providing women's health care (e.g. primary care physicians, obstetricians, and gynecologists) of the care needs of their autistic patients (Kassee et al, 2020).…”

“…Growing evidence suggests that such interventions lead to better reproductive, maternal, and neonatal outcomes, including improved fertility and lower rates of pregnancy complications, preterm birth, congenital anomalies, and maternal and neonatal mortality (H. K. World Health Organization, 2012). While we know little about autistic women's pregnancy outcomes and experiences, recent research suggests that they are at increased risk of medical and psychiatric complications (Gardner et al, 2016;Kassee et al, 2020;Pohl et al, 2020;Rogers et al, 2017;Sundelin et al, 2018). Understanding the health profiles of reproductive-aged autistic women is a prerequisite for improving their perinatal care and preventing adverse maternal and neonatal outcomes.…”

“…Small sample sizes limit the generalizability of current research (Kassee et al, 2020). Few existing sex-specific, population-based studies permit identification of health characteristics of reproductive-aged autistic women because findings are not disaggregated by age (Cawthorpe, 2017;Croen et al, 2015;Rydzewska et al, 2018Rydzewska et al, , 2019.…”

Does the M-Chat-R Give Important Information for the Diagnosis of the Autism Spectrum Disorder?

“…The literature also suggests increased endocrine and reproductive health conditions in autistic girls/women compared to non-autistic girls/women. However, the findings regarding gastrointestinal, metabolic, nutritional, and immune-related conditions are preliminary and inconsistent [20].…”