3 - intersectionality in autism research

2 different speakers

what’s intersectionality?

social and political identities can overlap and combine

who introduced the idea of intersectionality with their critical race theory?

Kimberle Crenshaw

identities that can intersect

gender, race, class, sexuality, disability, age etc.

importance of considering intersectionality

important as minority identities can overlap to create structures of oppression and discrimination

key points of intersectionality

• identities interact multiplicatively

• context is important

• power structures are key and the problem is systemic

• marginalised identities + perspectives matter

Mandell et al (2022)

• structural racism in healthcare access and stereotypes

• clinician bias

• mistrust in healthcare system

• language barriers

lower POC’s likelihood of getting/seeking diagnosis.

clinician bias can also cause misdiagnosis due to lack of research.

why intersectionality matters for research

• reduce sampling bias - some members of a pop. > likely to be selected than others

• increase generalisability - how applicable your results are to wider pop.

intersectional approach on a study on autism + employment outcomes

• q1: are employment barriers the same for autistic ppl across class backgrounds?

• q2: do autistic women face diff workplace discrim than autistic men? what about autistic women from minoritised ethnicities?

how to address intersectionality issues in autism research?

• recruit and sample from underrepresented groups

• participatory research

• challenge the ‘deficit’ models

who are gender-diverse ppl?

ppl who don’t identify as cisgender (the gender you’re born with)

link b/t gender-diversity and autism

autistic ppl are 1.68x more likely to identify as trans/other gender identities (Pecora et al., 2020). important as autistic ppl experience gender dysphoria more

extreme male brain theory (Kung, 2020) → GD + autism overlap

very outdated: men = systematic, women - empathetic → autistic ppl have ‘extreme male brains’ as they think systematically & ‘lack’ empathy. so gender transition happens

autism + gender diversity overlap (outdated psych theories)

1. delayed gender consistency: autistic ppl are ‘delayed’, so there’s a delay in how they choose identitiy

2. obsession: autistic ppl obsess over topics and become obsessed w/the idea of being gender-diverse

autism + gender diversity overlap (social theory)

resistance to social norms: high rates of non-binary identities in GD autistic samples aligns w/their resistance to societal conditioning (Walsh et al., 2018). links w/flattened priors: autistic ppl are < susceptible to social influence

Strauss et al 2021; Kung, 2023: autism + gender-diversity

individually, autistic + GD populations have poorer health outcomes. this worsens when these identities co-occur.

Adams et al (2025) → autism and healthcare access

• 3.7% diagnosed + 1.1% self-id autistic denied gender affirming care due to austism

• 25% diagnosed + 36% self-id didn’t share they had autism

reasons for inadequate healthcare access for autistic GD ppl

• fear of disclosing

• lack of professional understanding

• lack of training on this intersection

• lack of clinical guidance

• sensory + comms barriers

poorer outcomes for autistic GD ppl

• greater risk for suicidal thoughts and behaviours (Mournet et al., 2024)

• 2.3x > likely to report a physical health condition, 10.9x > likely to report a mental health one(Green et al., 2025)

• autistic trans ppl have worse overall health compared to other GD ppl (Adams et al., 2025)

DSM-V: diagnostic differences

• autism underdiagnosed in Black kids. > likely to be misdiagnosed w/behavioural disorders (APA, 2013)

• women diagnosed later than men (APA, 2022)

• late diagnosis happens in kids from oppressed ethnic minorities (APA, 2022)

ICD-11: diagnostic differences

cultural behaviour diffs (e.g., little eye-contact as respect) may contribute to late autism diagnoses (WHO, 2022)

autism in girls

girls may mask (APA, 2022), contributing to the lack of research and difficulty of getting diagnosed (National Autistic Society, 2022)

structural racism and lack of diagnoses

community integrated + academically able Black kids experience under-diagnosis (Bobb, 2019)

lack of rep in autism research

systematic review of 1K articles found only 25% reported race/ethnicity. of these, only 7.7% were Black compared to 64.8% white (Steinbrenner et al 2022)

Black autistic women and girls…

can be stereotyped as an “angry Black woman”, when being assertive (Burkett, 2020)

Lovelace et al (2022)

there’s only been 3 academic papers on Black autistic women in the last 77 years and none looked @ intersectionality