At the Intersection of Gender Diversity and Autism: A Scoping Review of Prevalence, Methodology and Mental Health Outcomes

Autism and gender diversity are increasingly understood beyond clinical and diagnostic labels to include socially situated, personal identities representing lived experiences (Rea et al., 2024). However, despite increasing attention, the literature exploring the intersection of autism and gender diversity remains methodologically heterogeneous with reported prevalence estimates varying widely across studies (Mittertreiner et al., 2024). This could be partly due to different approaches to operationalising and sampling both autism and gender diversity which could influence the prevalences and patterns found and reported within studies, affecting the generalisability and applicability of research to policy and advocacy efforts. Beyond differences in definition and measurement, variation in sampling strategies may further influence the prevalence and patterns found and reported within studies which may limit comparability across studies and influence the range of co-occurrence statistics reported. This is important as both autistic and gender diverse populations are reported to experience increased risk of mental health difficulties. The co-occurrence of these identities may compound both minority stress and support needs. While increased risk of anxiety, depression, self-harm and suicidality is often reported among autistic gender diverse individuals (Simpson et al., 2024), there is again variability in how mental health outcomes are conceptualised, operationalised and interpreted across studies. These conceptual and methodological differences complicate interpretation of reported prevalence rates and limit understanding of both risk and protective factors within this population. Existing reviews typically do not map the breadth of research at this intersection, often excluding grey literature (Kallitsounaki & Williams, 2023) or without systematically exploring how methodological differences might influence prevalence. A scoping review is therefore warranted to synthesise existing literature on prevalence and patterns at this intersection, examine how autism, gender diversity and mental health are conceptualised and measured, and identify gaps and inconsistencies in the literature. This review aims to inform future research to support more inclusive theoretical frameworks and contribute to policy and practice for autistic gender diverse populations.