Frustration in healthcare: Sex differences in parental perceptions of medical visits for autistic children.

Abstract

Background: Historical conceptualization of autism as male-dominant has contributed to sex disparities in accessing diagnosis and intervention services for autistic females (McDonnell et al., 2021). These disparities can have a profound impact on parental stress and child outcomes. However, little work has evaluated sex disparities in accessing healthcare. Accordingly, this study sought to evaluate sex differences in frustration accessing healthcare for parents of autistic youth.

Method: Utilizing the National Survey on Children's Health (NSCH) data spanning 2016-2022, this study analyzed a nationally representative sample (N=7,740, M _age =10.61, 21.4% female) to determine sex differences in risk of frustration with healthcare services. Ten domains of frustration were evaluated using relative risk ratios comparing parents of autistic females to parents of autistic males. Risk ratios >1.0 indicated an increase in risk among females, whereas a risk ratio <1.0 indicated a decrease in risk for females.

Results: Compared to parents of autistic males, parents of autistic females were more likely to endorse frustration in 5 out of 10 domains, including feeling listened to by providers, providers spending enough time with them, feeling like a partner in their child's health-decision making, feeling like the provider was sensitive to their cultural considerations, and having been provided with relevant information.

Discussion: Parents of autistic females were at an elevated risk of experiencing frustration compared to parents of autistic males. Elevated frustration experienced by parents of autistic females has implications for the continued access to healthcare for autistic females across their lifespan.