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134. Investigating the health and healthcare of autistic adolescent and young adult females: An analysis of U.S. Medicaid Claims data
Abstract   Peer reviewed

134. Investigating the health and healthcare of autistic adolescent and young adult females: An analysis of U.S. Medicaid Claims data

Emily Hotez, Joe Wright, Jonas Ventimiglia and Lindsay Shea
Journal of pediatric & adolescent gynecology, v 39(2), pp 312-312
Apr 2026
DOI: https://doi.org/10.1016/j.jpag.2026.01.179
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Abstract

Compared with their non-autistic counterparts, autistic females experience disproportionate rates of obstetrics and gynecology (OB-GYN)-related conditions, reduced access to cervical cancer screening, disproportionate risks of sexual violence and regretted sexual experiences, and, during pregnancy and postpartum, elevated rates of complications, sensory distress, dissatisfaction with care, and postnatal depression and anxiety. They are also less likely to visit their OB-GYN provider, which may be a critical mechanism underlying their health challenges across the life course. Utilizing Medicaid claims analysis, this study aims to test the association between autism status and OB-GYN-related health conditions (i.e., endometriosis, uterine fibroids, gynecologic cancer, HIV, interstitial cystitis, PCOS, STIs, and IPV) and identify the potential moderating role of receipt of routine OB-GYN care. The current study is cross-sectional and utilizes Medicaid claims data (2008-2019). The target population features autistic female adolescent and young adult (aged 12 – 30) Medicaid beneficiaries (with and without intellectual impairment), as well as a random age-matched sample of their non-autistic female counterparts. We will utilize an OB-GYN care and services variable to indicate whether an individual has had at least two OB-GYN visits within the study period. We will conduct modified Poisson regression with robust standard errors to: 1) estimate Risk Ratios for the association between autism status and OB-GYN-related health conditions; and 2) test the moderating role of OB-GYN routine care on the association between autism and health outcomes. Statistical significance of the interaction term will be determined using a two-sided p-value threshold of 0.05. Covariates will include age at Medicaid enrollment, race, ethnicity, intellectual impairment, medication usage, provider types, eligibility type (poverty, disability, or other), and state. Primary analyses are underway. Preliminary analyses of the overall health status of autistic (n = 162,368) and aged-matched non-autistic (n = 162,368) females reveal that autistic females are disproportionately likely to experience four or more mental and physical health comorbidities (autistic: 9.6%; non-autistic: 3.9%). This study explores a potentially a novel target for health interventions for autistic females: routine preventive OB-GYN care and services. This focus will inform national efforts to identify upstream mechanisms underlying health problems in a large and under-served U.S. population.

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