Marina Sarris

Date Revised: April 9, 2024

People often face rejection when they say they are LGBQ+, but Jada Thompson also contended with something else when she came out: disbelief. Thompson is autistic, so some people assumed that she didn’t know what she was saying.

“Certain people see us as children. Maybe they have seen an autistic person who seems to have a child-like innocence, but that’s not usually the case,” says Thompson, who participates in SPARK, the largest ongoing study of autism.

Thompson, 25, identifies as pansexual, which is an attraction to people of any gender identity, and nonbinary, which means not simply female or male. Thompson, whose pronouns are she/they, wants to be accepted for who she is. That struggle is made more difficult by stereotypes and misperceptions about autism, sexuality, and gender, she says.

“None of my identities are really accepted,” says Thompson, who is also Black. “I found out there are a lot more queer people in the autism community. That made me feel better, and I was able to find community there.”

A new study of 651 independent autistic adults in SPARK found that a sizable number ─ about 41 percent ─ identify as lesbian, gay, bisexual, queer, or another sexual orientation that places them in the minority (LGBQ+).¹ This study did not focus on transgender, nonbinary, or other gender minority identities.

Researchers are examining the added stress those adults face and its link to their mental health and quality of life. “Autistic people are at risk for mental health challenges, and what we, and other researchers, are trying to understand is, ‘what are the factors that are driving that risk?'” explains psychologist Gregory L. Wallace, Ph.D., who led the research team studying sexual identity among SPARK adults.

Compared to the general population, autistic adults are more likely to identify as LGBQ+, have mental health conditions, and to rate their quality of life lower.

Wallace and other researchers ask: Is having two minority identities ─ LGBQ+ and autistic ─ linked to problems with mental health and quality of life?

People in minority groups based on race, disability, or LGBQ+ identity may face stress from stigma, discrimination, and rejection that affects their health, according to research. They often have less access to health care and more health problems than people who are in the majority.^2,3

Several studies, including some involving SPARK participants, found that autistic adults who were sexual minorities reported more symptoms of anxiety and depression,^1,4 mental health conditions,⁵ or unmet healthcare needs³ than heterosexual autistic adults.

By the Numbers: Sexual and Gender Identity in SPARK

For one study, Wallace’s research team asked independent autistic adults who participate in SPARK about anxiety, depression, stress, and quality of life.¹

Among those adults, ages 18 to 83, about 59 percent said that they were heterosexual, with the other 41 percent identifying as:

• bisexual, 13 percent
• asexual (not attracted to others), 9.5 percent
• gay/lesbian, 8 percent
• pansexual, 7 percent
• queer or other, 4 percent¹

By comparison, a 2022 Gallup poll found that only 7 percent of U.S. adults overall identify as lesbian, gay, bisexual, or transgender.⁶

“I’m not surprised that the rate [of sexual minority identities] in autistic adults was significantly higher than the general population, but I would not have guessed it would be this high,” says Wallace, an associate professor at The George Washington University in Washington, D.C.

Autistic women were more likely than men to be a sexual minority. LGBQ+ adults were younger than heterosexual adults, as a group. Those trends are also found in the general population.⁷

One in 10 autistic adults in Wallace’s study did not identify with the male or female sex that was on their birth certificate.And most of these gender-diverse people also identified as a sexual minority.

Asexuality was the third largest sexual identity among the autistic adults – and may be particularly misunderstood, some say. “I think a lot of people feel like my asexuality is just because I lack ‘experience’ or it’s just because I’m ‘antisocial’ as a result of my autism so they still want to ‘fix’ me,” one autistic adult told researchers in a different study.⁸

Quality of Life Concerns among LGBQ+ Autistic Adults

In a new finding, Wallace’s team noted that autistic adults who are sexual minorities rated their quality of life lower than heterosexual autistic people. In particular, they were less satisfied with their physical and psychological health, their living conditions and safety, and their ability to manage autism-related concerns. They also reported more stress.¹

That is similar to the non-autistic population. People who are gay, lesbian, and bisexual report more mental health problems, more stress, and lower quality of life, than heterosexual people.^9,10

Thompson, the SPARK participant, says it can be hard to navigate the world as someone who is autistic and LGBQ+, especially in communities that do not fully accept queer people.

“It’s really difficult to be the person I desire to be,” Thompson says. “It can be draining. The depression stems not only from me struggling to be open about my sexuality and to be my full authentic self, but it also affects the way I talk to people and the way I open up to people. There were instances that I have gotten into with certain individuals who were questioning whether being queer is a sin.” For that reason, she sometimes fears mentioning her sexual identity at all.

Vonda Burris, an autistic member of SPARK, says she lives in an area that’s not very supportive of LGBQ+ people.

Burris is a 36-year-old artist who identifies as nonbinary and pansexual. She likes to wear clothes and “rainbowy” accessories that reflect her LGBQ+ pride and artistic personality.

“Being in the South, especially being perceived as a Black woman, I get lots of looks that will make me feel uncomfortable sometimes,” she says. “It’s extra stress that others don’t have to deal with.”

Fortunately, she has someone to counteract the stress of feeling rejected: her husband, Ryan, whom she has known since they were teens. “I’m privileged,” Burris says. “I have had someone to believe in me since my formative teenage years, and he’s still with me. If I had not had someone who supported me like Ryan does, I can see it being a lot more taxing on my mental health and stress.”

Making Healthcare Providers Aware of the LGBQ+ Statistics in Autism

Wallace, the researcher, says it’s important for doctors and therapists to be aware that autistic adults are more likely to be a sexual minority than others. “People who have more than one minority identity face more stress that can affect their health,” he says.

Another research team studying the topic agreed. That team, made up of SPARK staff, recommended that healthcare providers be prepared to assess autistic adults who identify as sexual or gender minorities for mental health conditions and to offer them added support.⁵

A Disconnect at the Doctor’s Office for Some Autistic LGBQ+ Adults

A lack of awareness can affect the medical care these adults receive. In a different study, some autistic adults said that they did not get age-appropriate health care because of faulty assumptions about autism, sexuality, and gender identity.³

A 32-year-old gay man told researchers, “If I’m just a queer disabled person and I’m just going to my regular provider, not only are they going to assume that I’m not having sex, but they’re also not going to provide any accurate information there.”

Similarly, a nonbinary 25-year-old, who was assigned female at birth, said that they saw a pediatrician into their 20s and did not get referred for a gynecological exam.

“Didn’t you know that autistic people become adults?” they asked.³

Interested in joining SPARK? Here’s what you should know.

Photo: iStock

Resources

• SPARK Research Match Summary Report: Sexual Identity, Mental Health, and Quality of Life in Autistic Adults (PDF or web page)

References

1. McQuaid G.A. et al. Autism Adulthood 5, 139-153 (2023) PubMed
2. Bulatao R.A. and N.B. Anderson, editors. Understanding racial and ethnic differences in health in late life: A research agenda. Washington, DC: National Academies Press (2004) PubMed
3. Hall J.P. et al. J. Autism Dev. Disord. 50, 3071-3077 (2020) PubMed
4. Enayetallah M.A. et al. INSAR Annual Meeting (May 3-6, 2023) Stockholm, Sweden
5. Enayetallah M.A. et al. INSAR Annual Meeting (May 11-14, 2022) Austin, TX
6. Gallup News Poll website (Feb. 22, 2023) Accessed Aug. 1, 2023.
7. White J., Sepúlveda M.J. and C.J. Patterson, editors. Understanding the well-being of LGBTQI+ populations. Washington, DC: National Academies Press (2020) PubMed
8. Lewis L.F. et al. J. Autism Dev. Disord. 51, 2324-2337 (2021) PubMed
9. Krueger E.A. et al. LGBT Health 5, 242-249 (2018) PubMed
10. Institute of Medicine Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, D.C: National Academies Press (2011) PubMed