Camouflaging, mental health and sexual wellbeing in non-binary autistic adults: a cross-sectional exploratory study

Introduction This explorative quantitative study investigates camouflaging, mental health and sexual wellbeing in self-reported non-binary autistic participants. Autism research has often disregarded non-binary individuals, although overlaps exist between being gender-diverse and autistic. While camouflaging (attempts to fit neurotypical expectations to avoid stigma) has been linked to different health outcomes within cisgender individuals, research with non-binary people is lacking and no literature has looked at sexual wellbeing and camouflaging together in this population. Methods Participants completed a cross-sectional, anonymous, online questionnaire, using validated measures. We examined differences in mental health, camouflaging, and sexual wellbeing between autistic and non-autistic non-binary participants. We then used multiple regression analyses to explore the associations between camouflaging, sexual wellbeing, and mental health among autistic non-binary participants. Results Among 461 non-binary individuals (57.5% formally or self-identifying autistic), autistic participants had higher camouflaging scores but similar levels of anxiety and depression compared to non-autistic people. In autistic non-binary participants, higher camouflaging was associated with higher anxiety and depression, while higher depression was associated with lower sexual wellbeing. Additionally, higher relationship satisfaction was linked with better sexual wellbeing. No relationship was found between sexual wellbeing and camouflaging. Discussion Findings increase the understanding of camouflaging and its associations with health outcomes in non-binary people. The lack of association between sexual wellbeing and camouflaging is a novel result and calls for further investigation.