Reproductive health and healthcare experiences in autistic and non-autistic individuals assigned female at birth

Womens Health (Lond). 2026 Jan-Dec;22:17455057261465645. doi: 10.1177/17455057261465645. Epub 2026 Jul 7.

ABSTRACT

BackgroundDespite increased recognition of autism in women and girls, their reproductive health remains underexplored. Understanding reproductive health burden and healthcare experiences is essential to identifying barriers and improving support for conditions that can impact quality of life.ObjectivesInvestigate reproductive health and healthcare experiences among autistic compared to non-autistic individuals assigned female at birth (AFAB).DesignWe conducted a cross-sectional online survey in the UK (April 2024-July 2025) among individuals AFAB aged 18-40 years recruited via convenience-sampling from autism networks, social media, and Prolific.MethodsIn total, 311 participants were included (165 self-reported autistic [M=31.1 years, SD=6.2], 146 non-autistic [M=30.6 years, SD=5.5]). The survey, developed with input from autistic people, covered reproductive health conditions, knowledge and management of reproductive health, and reproductive healthcare experiences. Group differences were analysed using logistic regressions, chi-squared and Wilcoxon rank-sum tests. Healthcare inequality (HIE) scores were calculated overall and for five subdomains as composite of negative reproductive healthcare experiences. Associations between autism and HIE were examined using logistic regression.ResultsAutistic participants reported more reproductive health conditions (44% vs. 28%) and symptoms (95% vs. 84%) than non-autistic participants. Age-adjusted regression models indicated higher odds for any condition (OR=1.96[1.21-3.17], p <.01) and any symptom (OR=3.23[1.44-7.25], p <.01) with OR for specific conditions/symptoms ranging from OR=1.09[0.57-2.09], p=.799 to OR=3.97[2.43-6.50], p <.001. Adjusting for other neurodivergence attenuated estimates; however, the overall associations for any symptom remained statistically significant (p <.05). Autistic participants were more likely to report irregular menstrual cycles, menstrual cycle-related mental health and sensory experiences changes and poorer reproductive health knowledge and management (all p <.001). HIE scores overall and across subcategories were higher among autistic individuals. Autism diagnosis was associated with higher overall HIE scores (OR=2.86[2.37-3.45], p <.001) and domain specific HIE scores (OR_range = 1.81[1.49-2.22]-5.31[3.56-8.13], p <.001).ConclusionAutistic individuals AFAB face increased reproductive health burden, greater difficulty managing their reproductive health, and significant healthcare inequities. Tailored education and individualized service adjustments are essential for equitable reproductive care in autistic individuals AFAB.

PMID:42411262 | DOI:10.1177/17455057261465645