Symmetric linear least-squares solution
I assume that $A$ is onto, so that $H:=A^TA$ is positive definite. Minimizing $\|AX-Y\|_F^2$ in Frobenius norm (the least square) among symmetric matrices $X$ yields the optimality condition that $$\langle AS,AX-Y\rangle=0$$ for every symmetric $S$. This amounts to saying that $A^T(AX-Y)$ is skew-symmetric. In other words, $X$ is the solution of the Lyapunov equation $$HX+XH=A^TY+Y^TA=:K.$$ The explicit formula is $$X=\int_0^\infty e^{-tH}Ke^{-tH}dt.$$