(PS4-67) Sample Characteristics and Anxiety Rates in Gender-diverse Autistic Youth

Background: Autism spectrum disorder (ASD) has been studied in relation to anxiety and depression with research indicating that autistic people experience higher rates of comorbid depression and anxiety than the general population (Strang et al., 2012). Gender diversity, a term describing genders that fall outside the binary male and female genders (American Psychology Association, 2015), has also been explored in connection with anxiety and depression, with studies finding that people who identify as gender-diverse have higher rates of anxiety and depression than cisgender people (Lefevor et al., 2019). More recently, research has reported that autistic people have greater rates of gender diversity than the general population (Strang et al., 2023). The present study aims to describe sample characteristics from an ongoing longitudinal study of alcohol and substance use in autistic youth, and to examine an association between gender diversity, anxiety and depression.

Methods: The current sample includes autistic youth ages 12-24 recruited from the Rhode Island Consortium for Autism Research & Treatment (RI-CART) registry, SPARK Research Match Program, outpatient clinics, community groups, and university campuses.

Inclusion criteria are: a formal ASD diagnosis by a licensed healthcare provider; IQ composite score of 75 or greater on the Kaufman Brief Intelligence Test, Second Edition (KBIT-2), and verbal fluency in either English or Spanish. Participants completed the PROMIS Pediatric Short Form 8-item measures for Anxiety and Depressive Symptom, as well as a demographic survey, including items pertaining to race, ethnicity, sex at birth, and gender identity.

Results: The current sample consisted of 206 autistic youth with a mean age of 18.85 years (SD=3.7) with 65.9% of the sample aged 18 or older. 38% were in middle/highschool, 36% in postsecondary school, and 25% were not currently in school (but out of high school). The majority of participants were non-Hispanic (87%) and white (85.6%). Sex at birth was: male (54.4%), female (45.1%). Gender was male (52.4%), female (28.8%); 21.3% of the overall sample identified as gender-diverse.

A simple linear regression was used to test the association between gender diversity and anxiety and depression rates in autistic youth. Gender diversity was associated with greater anxiety (β=3.239, SE=1.274, p < .001). Results showed no significant associations between gender diversity and depression.

Conclusion: The present study’s findings of significantly higher rates of anxiety, but not depression, in autistic youth who identify as a gender minority are in contrast to other recent studies (Uljarević et al., 2020). As anxiety and depression are often experienced in tandem, it is unclear whether these results are unique to the present study or indicative of differences between anxiety and depression comorbidities in autistic youth who identify as a gender minority. Further research is needed to understand these findings as they hold many implications for autistic gender minorities experiencing stigmatization. It will be important to further explore the intersection of anxiety and gender diversity in autistic youth to develop treatments that will address their particular needs.