How is psychological wellbeing experienced by autistic women? Challenges and protective factors : A meta-synthesis

Yau, Natalie and Anderson, Sonia and Smith, Ian (2023) How is psychological wellbeing experienced by autistic women? Challenges and protective factors : A meta-synthesis. Research in Autism Spectrum Disorders, 102: 102101. ISSN 1750-9467

Abstract

Background: Autistic women are at higher risks of experiencing mental health difficulties and suicidal behaviours than the general population. However, there are barriers to diagnostic assessments and mental health support reported by autistic women. To date, there is little research into how psychological wellness is experienced by autistic women. Therefore, the aim of this meta-synthesis was to explore this. Method: A systematic literature review of existing qualitative studies was carried out. Twelve papers met the inclusion criteria for this review; the findings of which were collated and synthesised using a seven-step meta-ethnographic approach from which three themes emerged. Results: Three themes were generated from the 12 qualitative studies: (1) “I tend to fall between the cracks": misunderstood and ostracised; (2) "The hidden hurt"; and (3) having to meet the expectations of others. There are important findings from the meta-synthesis which suggest there are increased risks of exploitation for autistic women. Furthermore, social camouflaging in addition to societal, cultural, and gendered expectations can have detrimental influences on psychological wellbeing for autistic women. However, mutual acceptance, belonging, and support were identified as protective factors of psychological wellbeing. Conclusions: Increased knowledge and training for professionals supporting autistic women is needed, particularly during different life stages such as the peri- and postnatal period and the menopause. There is also a need to promote better awareness of safe relationships to reduce risks of abuse and exploitation for autistic women. Adaptations to communication, cognitive and sensory challenges, and psychological therapy are also suggested.