What does autism acceptance mean to autistic adults?: discovering the path to flourishing in a socially contingent reality

Background Autistic adults are known to experience increased difficulties with mental health and wellbeing compared to the general population. Low autism-awareness and societal stigmatisation are known to contribute to the challenges that this group experiences. Whilst previous qualitative reviews have reported on autism acceptance, no known reviews have focused on autism acceptance from the perspectives of autistic adults. The current review sought to identify sense-making narratives of autism acceptance amongst autistic adults in the United Kingdom. Methods Five databases (Medline, PsycINFO, Embase, Social Policy and Practice, and CINAHL), were searched systematically, in addition to manual citation searches and Google Scholar, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in February 2025. Qualitative empirical papers reporting on lived experiences of acceptance or non-acceptance amongst autistic adults in the UK (1994 – current) were included (N = 19). Results A thematic narrative synthesis was used to identify four narrative themes: ‘Outsider Status’, Societally Unanticipated, Seeing the Self Seen, and Re-storying Autistic Identity, were developed to make sense of the lived experiences discussed. Conclusion The review identified potential benefits of creating inclusive environments for autistic adults in the workplace, higher education and healthcare. Future research is recommended to identify specific barriers and facilitators to adapting services, enabling meaningful change in the experiences of this population.