Experiences of females on the autism spectrum through the perspective of minority stress theory: a review

Abstract

Introduction: People on the autism spectrum, especially females, are at high risk of co-occurring psychiatric and psychological conditions, suicidal ideation, and psychiatric hospitalization. The minority stress theory offers a framework for understanding mental health disparities by focusing on the influence of social factors. The current review aims to synthesize the literature on the experiences of autistic females in terms of the unique, chronic and socially based stressors that emerge at the intersection of sex/gender and autism. Methods: We conducted a literature search in a systematic way on the Web of Science and Scopus databases, applying the specified inclusion and exclusion criteria. We chose a narrative manner of data presentation. Results: Based on the evidence from 104 studies of various methodologies, we show that the burdens encountered by autistic females are more than the sum of strains common for the females and for autistic individuals. Females on the autism spectrum face also specific challenges related to their not meeting social gendered expectations and the stereotypical image of autism. Discussion: This intersectional disadvantage can enhance our understanding of the adverse mental health outcomes observed in this population. We emphasize key directions and provide methodological recommendations for future research in this area. Additionally, we underscore the importance of enhancing practitioners' understanding of the unique characteristics of female autism and the specific vulnerabilities faced by this group to improve support and outcomes.