Gender-diverse and neurodiverse youth share more than just the word ‘diverse.’ These groups are not mutually exclusive populations but instead have considerable overlap. Estimates of the co-occurrence of neurodiversity and gender diversity vary. However, some research suggests that autistic individuals and gender diverse individuals are largely overlapping groups. Autistic individuals may be up to seven times more likely, compared to allistic individuals (people without autism), to be gender diverse; others estimate autistic individuals are about three times as likely to be gender diverse (Hisle-Gorman et al., 2019; Janssen et al., 2016; Kahn et al., 2023). But who are gender diverse youth? Gender diverse individuals are not a monolith and include those that are transgender, intersex, nonbinary, gender queer, and agender. Since the phrase “autistic and gender diverse” can get a bit long, I’ll use the term neuro-gender queer to describe people who are both gender diverse and autistic moving forward.
Under the neuro-gender queer umbrella is a mosaic of unique individual journeys connected by shared struggles and successes. Although this group includes people of all ages, I will mostly discuss youth (ages 6 through 26) as that is the age group I work with mostly. The term neuro-gender queer expands the concept of neuroqueer, a term scholars and activists have used to highlight the overlap between neurodiversity and queer identities, as well as for pushing back against and questioning neuronormativity (the idea that there’s only one ‘normal’ way to think and behave) and cis-heteronormativity (the assumption that heterosexuality and being cisgender are the only or “correct” way of being; Oswald et al., 2022).
Although evidence from researchers, clinicians, and discussions in autistic and queer communities support that neurodiversity and gender diversity co-occur at high rates, the lived experiences of this population are often not discussed and are understudied (Corbett et al., 2022; Strang et al., 2023). This is particularly true of youth. As mentioned in the last edition of Autism Spectrum News, in an article by Dr. Heidi Hillman, there is a lack of research centered on autistic adolescents in general, and this is doubly true for gender diverse and autistic adolescence and perhaps even more true for those that are gender expansive such as nonbinary, gender queer, gender fluid, or agender.
Due to the intersectional stigma associated with gender diversity and simultaneous neurodiversity this nexus of identities may create unique struggles for neuro-gender queer youth. Research suggests that neuro-gender queer individuals may experience increased bias-based harassment targeting both their gender identity or expression and their neurodiversity. For example, a nationally representative survey found that 76.1% of LGBTQ youth reported in-person verbal harassment and bullying at school and 34.4% of LGBTQ youth report in-person harassment targeting disability (including neurodivergence; Kosciw et al., 2022). These types of harassment are associated with a host of negative mental health outcomes (Hatchel et al., 2018; Toomey et al., 2010). However, much of this research does not report on rates of neurodiversity in the sample, therefore making it impossible to know if neuro-gender queer individuals experience more or different harassment. As a developmental psychologist who studies stigma, discrimination, and gender development, my research has historically focused on other populations, sometimes excluding autistic youth. The study advertised below, however, represents a deliberate effort to shift focus and prioritize the lived experiences of neurodiverse and gender-diverse young people and center the voices of neuro-gender queer youth.
The health disparities that many neuro-gender queer people face are not a symptom of their gender diversity or neurodiversity, but instead a symptom of living in a neuronormative and cisnormative society. While interpersonal harassment is an important concern, it is a symptom of larger systemic inequities and a society which often stigmatize autism and other neurodiversity and operates from the assumption that everyone is, or should be, cisgender and have a binary gender identity. Mirroring this, neuro-gender queer people, and youth in particular, have been disproportionately affected by the recent policies and executive orders affecting education and healthcare. This includes recent funding cuts to the NIH, as well as hateful and factually inaccurate rhetoric directed at both autistic individuals and trans individuals. This rhetoric and related policies are not benign but instead send a message about who is and is not valued and protected by those in power. Not surprisingly, this rhetoric and policy changes may be associated with worse health outcomes and more depression and suicidality in neuro-gender queer youth (Barbee et al., 2022; Miller-Jacobs et al., 2023). For example, the Trevor Project, a leading suicide prevention and crisis intervention organization for LGBTQ+ young people saw a 700% volume increase in calls to their LGBTQ crisis line after the November 2024 U.S election. Yes, that is not a typo, a 700% increase. Given that autistic individuals are more likely to be gender diverse than allistic individuals (e.g., Kahn et al., 2023) it is likely that a sizeable proportion of those people were neuro-gender queer.
Given the current landscape, if you are yourself a neuro-gender queer person or love a neuro-gender queer person it is easy to get lost in despair and worry. “But even now there is hope left”, as J.R.R. Tolkien would say. Neuro-gender queer youth also have unique strengths that are understudied and underrecognized. For example, identification with autism as a social identity, embracing non-conforming gender expression, and reliance on supportive identity-based community are coping strategies that autistic individuals and gender diverse individuals utilize when experiencing stress and discrimination (Cooper et al., 2017; Large & Serrano, 2018). Some research also suggests that neuro-gender queer youth form strong supportive online communities that provide and offer support of both their LGBTQ and neurodiverse identities. Furthermore, many individuals and organizations are doing important work to combat current legislation targeting neuro-gender queer people and combat false narratives about autism and gender diversity. These stories should be highlighted, and these efforts are lifesaving for neuro-gender queer people.
What about those of you who love a neuro-gender queer person: friends, partners, and family members. Research has long suggested that affirming and supportive environments are the best way to support gender diverse youth. For example acknowledging and accepting both someone’s neurodiversity and gender diversity as beautiful and important parts of themselves, that do not need to be changed or hidden, is vital. This can be the first step in creating a safe, accepting, and loving home or school environment. We also know that fostering positive relationships with teachers, correct name and pronoun use, access to a bathroom of their choice, and access to gender affirming mental and physical health care are all critical to improving wellbeing in gender diverse youth and supporting thriving (Austin et al., 2020; Grossman et al., 2021; Gower et al., 2018; McGuire et al., 2010). This of course includes neuro-gender queer youth!
In summary, to best support neuro-gender queer youth loved ones, activists, researchers, educators, and clinicians must consider their simultaneous neurodiversity and queerness, moving forward. Furthermore, neuro-gender queer youth have important strengths and are creating joy and community, even as they are under attack.
In this spirit, below are some resources for neuro-gender queer youth and adults as well as their loved ones. Please note these are just a few of the amazing resources available and this is meant to just offer some starting points.
Resources for neuro-gender queer youth:
- Translifeline: Trans Lifeline’s Hotline is a peer support phone service run by trans people for our trans and questioning peers. Call us if you need someone trans to talk to, even if you’re not in a crisis or if you’re not sure you’re trans.
- LGBTQ Free Crisis Line (open 24/7): https://www.thetrevorproject.org/get-help/
- Tips for navigating healthcare as an autistic and gender diverse person: https://awnnetwork.org/wp-content/uploads/2022/11/Final-Version-Before-You-Go-Know-Your-Rights-Booklet.pdf
- Trevorspace: Online community of trans and nonbinary youth: TrevorSpace is a welcoming online social community for LGBTQ+ young people between the ages of 13-24 years old. With over 700,000 members across the globe, you can find support groups and make friends in a moderated online safe space intentionally designed for you
Resources for parents and caregivers:
- Supporting trans youth in school: https://www.s-r-a.org/trans-school-resources
- Tool Kit for transgender family resources: https://www.s-r-a.org/for-trans-youth-families
- Gender affirming resources for parents of newly diagnosed autistic youth: https://awnnetwork.org/wp-content/uploads/2022/11/FINAL-English-Parent-Packet-1027.pdf
- Guide for allyship to transgender and nonbinary youth. https://www.thetrevorproject.org/resources/guide/a-guide-to-being-an-ally-to-transgender-and-nonbinary-youth/
* The information, opinions, and views presented here are the authors and do not necessarily represent those of any employer or entity.
Sharla D. Biefeld, PhD, is a Developmental Psychologist whose research centers on experiences of identity-based harassment and ways to support historically marginalized youth. For more information regarding her research please email sdbiefeld@ua.edu or visit her lab website: https://sites.ua.edu/bodylab.
References
Austin, A., Craig, S. L., D’Souza, S., & McInroy, L. B. (2020). Suicidality among transgender youth: elucidating the role of interpersonal risk factors. Journal of Interpersonal Violence, 0886260520915554.doi:10.1177/0886260520915554
Barbee, H., Deal, C., & Gonzales, G. (2022). Anti-transgender legislation—a public health concern for transgender youth. JAMA pediatrics, 176(2), 125-126.
Cooper, K., Russell, A. J., Lei, J., & Smith, L. G. (2023). The impact of a positive autism identity and autistic community solidarity on social anxiety and mental health in autistic young people. Autism, 27(3), 848– 857. https://doi.org/10.1177/13623613221118351
Corbett, B. A., Muscatello, R. A., Klemencic, M. E., West, M., Kim, A., & Strang, J. F. (2023). Greater gender diversity among autistic children by self-report and parent-report. Autism, 27(1), 158–172. https://doi.org/10.1177/13623613221085337
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