Exploring the social and emotional impact of puberty and adolescence on autistic people assigned female at birth

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.