Minority Stress, Camouflaging, and Mental Health Outcomes in Transgender and/or Non-binary Autistic Adults

Background: This study sought to examine the role of autistic and gender minority stress, resilience, and camouflaging in predicting mental health outcomes in transgender and/or non-binary autistic adults in the United Kingdom. Methods: In total, 412 transgender and/or non-binary autistic participants completed an online survey. This survey consisted of the Gender Minority Stress and Resilience Scales, Autistic Minority Stress and Resilience Scales, the Camouflaging Autistic Traits Questionnaire, the Depression, Anxiety and Stress Scale, and the Posttraumatic Stress Disorder Checklist. Results: The final models in hierarchical regression predicted depression (R-2 = 0.24), anxiety (R-2 = 0.26), stress (R-2 = 0.21), and posttraumatic stress (R-2 = 0.32). Camouflaging remained a significant unique predictor of anxiety and stress. Internalized anti-autistic prejudice remained a significant unique predictor of each model. Everyday anti-autistic discrimination uniquely predicted anxiety and posttraumatic stress. Gender minority negative expectations uniquely predicted depression and posttraumatic stress. Conclusion: These findings suggest that gender and autistic minority stress and camouflaging significantly predict a proportion of variance in depression, anxiety, stress, and posttraumatic stress experienced by transgender and/or non-binary autistic adults.