Exploring the Social and Emotional Impact of Puberty and Adolescence on Autistic People Assigned Female at Birth

Abstract

Background:

Emerging research suggests that puberty and adolescence may be particularly difficult for autistic people assigned female at birth (AFAB), but there is currently very little exploration of this transition from a lived experience perspective. In this study, we aimed to retrospectively examine firsthand accounts of puberty and adolescence among AFAB autistic people, the first study to our knowledge to broadly do so.

Methods:

We conducted semi-structured interviews with 17 autistic people AFAB about their personal experience of puberty and adolescence. We used reflexive thematic analysis to generate themes from the data.

Results:

We developed three main themes from the data. Theme 1, “The overwhelming nature of puberty,” focused on issues such as distressing bodily changes and sensory discomfort (e.g., menstruation). Theme 2, “Navigating the adolescent world,” focused on the experience of feeling different, trying to cope with not fitting in, and finding support in others. Theme 3, “Victimization experiences,” highlighted the prevalence of social and sexual violence against our participants.

Conclusions:

Overall, our findings suggest that puberty and adolescence can be an especially difficult time for autistic people AFAB. In addition to bodily changes such as menstruation, dealing with sensory discomfort and a rapidly changing social landscape can result in extreme distress.

Community Brief

Why is this an important issue?

Many autistic people assigned female at birth (AFAB) may have trouble managing the demands of puberty and adolescence. Such demands involve the sensory load associated with pubertal development (e.g., menstruation) and navigating an increasingly complex social world. It is important that we understand autistic people AFAB’s lived experiences of puberty/adolescence, to better improve the support and care they receive during this time period.

What was the purpose of this study?

The purpose of this study was to better understand the social and emotional impact of puberty and adolescence on autistic people AFAB from a lived experience perspective.

What did the researchers do?

We interviewed 17 autistic people AFAB about their experiences of puberty and adolescence. We used a reflexive thematic analysis to develop three themes from the data. Reflexive thematic analysis is a form of qualitative analysis where a researcher develops patterns and meaning from what participants say and uses this to form common themes.

What were the results of the study?

Theme 1, “The overwhelming nature of puberty,” focused on issues such as distressing bodily changes and sensory discomfort (e.g., menstruation). Theme 2, “Navigating the adolescent world,” focused on the experience of feeling different, trying to cope with not fitting in, and finding support in others, such as friends and family. Theme 3, “Victimization experiences,” highlighted the prevalence of social and sexual violence against our participants.

What do these findings add to what was already known?

Our findings suggest that difficulties in puberty are multifaceted and include sensory and social challenges that can have an incredibly negative impact on mental health. They also suggest that autistic people AFAB may be at higher risk of being sexually exploited during adolescence. Interestingly, our participants reported parents being supportive of their sexual and romantic development, helping them to access contraception.

What are potential weaknesses in the study?

Our participants consisted of mostly White, English-speaking people recruited online. Our participants were also adults reflecting on their experience of puberty. It is possible that autistic people currently going through adolescence and puberty may highlight different issues.

How will these findings help autistic adults now or in the future?

Our findings help us to better understand the kind of support that autistic people AFAB might need to make puberty and adolescence less distressing. This includes targeted education about sexual exploitation and help with choosing sensory-friendly sanitary products.