ASD and Sexual and Gender Minority Identity in College Students (Original Submission)

Abstract

Objective: The current study builds on existing literatures on autism spectrum disorder (ASD) and sexual and gender minority (SGM) identities and is the first to examine prevalence rates, associated functional impairments, and treatment engagement levels for SGM and non-SGM populations with and without ASD cross-sectionally via a large nationwide college-student sample across 3 years. Methods: Using data from the American College Health Association-National College Health Assessment (ACHA-NCHA) III, we analyzed data from 82,030 college students (ages of 18-25 years old) randomly selected from 75 US colleges and universities across three years. Included ACHA-NCHA-III measures consisted of self-reported demographics, SGM identity, ASD diagnosis, stress, academic impairment, mental health symptoms, and treatment engagement. Results: We found a 2.7% prevalence of ASD in the SGM group, compared to a 0.9% prevalence among the non-SGM sample. Autistic college students with SGM identities had the highest levels of stress and averse academic and mental health outcomes across groups. Conclusions: These findings emphasize the need for mental healthcare providers to consider SGM identity in autistic college students to inform treatment. Implications for autistic college students with an intersecting SGM identity include the need for tailored supports and resources at multiple levels (e.g., academic, mental health).