When 17-year-old Marcus wanted to ask questions about sexual health, the idea of walking into a clinic full of strangers felt impossible. A new Swedish study suggests he is far from alone — and that simple technology might be part of the answer.
Researchers at the Karolinska Institutet in Stockholm examined more than 450,000 young people ages 12 to 22 over four years. They looked at nearly 500,000 visits to youth clinics, which offer free sexual and reproductive health services. Their findings, published in the journal Autism Research, reveal a stark gap: autistic young people, especially boys and young men, were roughly half as likely to visit these clinics in person compared to their peers without autism.
The picture was very different for young people with ADHD. About half of all girls and young women with ADHD had attended an in-person visit, compared with roughly one-third of their peers without a diagnosis.
"An interesting finding was that the differences between the groups were smaller when it came to digital care, such as chat and video consultations," said Lovisa Hellsten, a PhD student at Karolinska Institutet who led the study. "This may suggest that such channels of contact lower the threshold for certain groups, such as autistic youth."
The study found that once autistic young women actually made their first visit, they used health care services at almost the same rate as their peers. That detail gives researchers hope.
"This indicates that taking that first step to make contact can be a significant barrier," Hellsten said. "We hope that the results will contribute to better health care planning so that more young people will receive the right support."
Researchers cannot yet say exactly why autistic youth avoid in-person clinics. Some may find the sensory environment overwhelming — bright lights, unfamiliar noises, long waits. Others may struggle with social interaction or fear judgment. But the pattern around digital care suggests that flexibility in how young people reach out could make a real difference.
The study was conducted between 2018 and 2022, a period when online health consultations were still developing rapidly. Researchers say the findings may look even more encouraging today as digital services have become more widespread and sophisticated.
Youth clinics in Sweden offer confidential advice on contraception, sexually transmitted infections, relationships, and mental health — services every young person deserves access to regardless of how their brain is wired. If a simple video call or online chat can help autistic young people cross a threshold they previously could not, that is a small change with the potential to protect real people from real harm.
The study was conducted in collaboration with the Center for Epidemiology and Community Medicine in Region Stockholm, drawing on health register data that allowed researchers to track who sought care without identifying individuals.