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  • Writer's pictureSara Tookey

LGBTQIA+ and Neurodivergent: Shining a Light on Intersectionality and Mental Health

Written by Dr Sara Tookey


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As we celebrate Pride Month, it's crucial to recognise and understand the unique experiences of individuals at the intersection of LGBTQIA+ identities and neurodivergence.

This article explores the growing body of research revealing a significant overlap between neurodivergent conditions like autism and ADHD and diverse gender identities and sexual orientations. We'll delve into recent studies that highlight the higher prevalence of LGBTQIA+ identities among neurodivergent individuals, examine potential reasons for this correlation, and discuss the specific challenges faced by this community in accessing appropriate healthcare and support. By shedding light on this important intersection, we aim to promote greater understanding, acceptance, and targeted support for LGBTQIA+ neurodivergent people.


Contents:


 




What is Pride?


June is Pride Month — a time to unite and celebrate the rich identities and experiences within the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, pansexual, and others) community. Pride Month commemorates the Stonewall riots, which occurred in June 1969 in the United States. These significant protests marked a turning point in the fight for gay rights, impacting not just America but the world.


Pride is a celebration where people come together in love and friendship to highlight the progress made in LGBTQIA+ rights and acknowledge the ongoing struggles. It stands for acceptance, equality, honouring the contributions of LGBTQIA+ people, educating others about LGBTQIA+ history and raising awareness of issues affecting the community. Pride also serves as a reminder of the harmful effects of homophobia, both past and present, and emphasises being proud of who you are.




Defining Terms: Sex, Gender and Sexuality. Click the arrow to learn about how we use the terms sex, gender and sexuality in this article.

Firstly, it's important to understand that sex, gender, and sexuality exist on spectrums and can be complex, personal subjects. Sex refers to our anatomy, chromosomes, and primary/secondary sex characteristics. Gender identity is our innermost understanding of self, while gender expression is how we outwardly communicate gender. Sexual orientation describes who we are romantically/sexually attracted to. These components do not always align in a binary "male/female" or "masculine/feminine" way. There are non-binary genders, sexualities like asexual or pansexual, and intersex identities that fall outside societal norms and are included in the LGBTQIA+ acronym.


For those with marginalised identities, there can be erasure and invisibility. Those with identities society deems "normative" may not have actively examined how they define their own gender and sexuality. If these concepts are new, please approach with openness - don't make assumptions about how someone identifies. It's best to respectfully ask if someone chooses to share their identity with you.




While Pride is a joyous occasion, Pride also raises awareness about the unique mental health challenges that LGBTQIA+ individuals often face. Studies show that LGBTQIA+ people are more than twice as likely to experience mental health conditions like anxiety and depression compared to their heterosexual peers (1). This month, we want to highlight the important intersection of being LGBTQIA+ and neurodivergent, and outline how we can better support the mental wellbeing of these communities.




Mental Health Challenges for the LGBTQIA+ Community


For LGBTQIA+ people, experiences of discrimination, stigma, social isolation and lack of access to supportive services can significantly impact mental health. Negative coming out experiences, rejection from family and friends, and internalising societal prejudices like homophobia and transphobia take a major toll. The transgender community, in particular, faces extremely long wait times to access gender-affirming care, compounding issues like gender dysphoria. Research shows transgender people are at heightened risk of developing long-term mental illness (2).



The Impact of Neurodivergence


Recent years have seen an increase in research examining the connections between neurodivergence and identifying as LGBTQIA+. A growing number of queer adults who did not receive neurodivergent diagnoses in childhood are now being identified and gaining information about neurodivergent conditions later in life. However, even with this newfound awareness, neurodivergence remains widely misunderstood and lacks sufficient representation within LGBTQIA+ communities.


Defining Terms: Neurodivergence. Click the arrow to learn more.

The term "neurodivergence" encompasses a wide array of variations in how people process information, communicate socially, focus their attention, learn, and experience other neurological functions. Neurodivergent conditions include Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), dyslexia, and others. While these are classified as disorders or conditions, neurodivergence itself is not something requiring a "cure" or "fix" - it is simply one facet of an individual's identity and way of being in the world. At the same time, a formal diagnosis can provide access to supportive tools and resources that enable neurodivergent people to better navigate a world that was not built with them in mind.



Recent studies have revealed a strong correlation between neurodivergence and increased likelihood of identifying as LGBTQIA+. This includes a greater sexuality and gender variance neurodivergent people. Researchers theorize that this may be because neurodivergent individuals are more inclined to question gender and sexual norms (3).


A 2014 study reported that gender variance was found to be 7.59 times more common in participants with ASD and 6.64 times more often in participants with ADHD (4), with more recent studies confirming this increasing representation of gender variance amongst neurodivergent individuals (5; 6). 


It has been reported that 70% of autistic individuals identify as non-heterosexual (7). Another study of autistic women reported only 8% as exclusively heterosexual (8). Research from Cambridge University found that autistic people were 8 times more likely to identify as asexual or "other" sexuality compared to non-autistic peers (9). Findings suggested that autistic males were 3.5 times more likely to identify as bisexual compared to non-autistic males, while autistic females were three times more likely to identify as homosexual than non-autistic females. Autistic females were also more likely to be sexually active, identify as asexual, bisexual, and "other" sexuality, and less likely to identify as heterosexual compared to autistic males (9). An exploratory study found that 61% of ADHD participants reported a non-heterosexual sexual orientation (10). More research is needed to understand this intersection and learn how best to support these individuals.


Despite this elevated representation, LGBTQIA+ neurodivergent people face unique barriers accessing diagnosis and support due to assumptions they don't understand their genders/sexuality and are more often misdiagnosed or dismissed by healthcare providers (3; 11). Cisgender women and AFAB (assigned female at birth) individuals are chronically under-diagnosed for neurodivergent conditions like autism and ADHD, as diagnostic criteria may not account for how these conditions present in those socialised as girls. For example, researchers from University College London, Bargiela, Mandy and Steward (2016), suggested in their research that while some autistic girls can be “shy”, many can have close friends as well as an interest in making friends (12). Due to the many layers of barriers, the practice of self-diagnosis is generally considered an acceptable route for many to understand themselves better and access helpful tools and resources.





Celebrating Neurodivergent LGBTQ+ Voices 


Despite the obstacles, more neurodivergent LGBTQIA+ creators and advocates are raising awareness and sharing their stories through mainstream channels. Comedians like Hannah Gadsby and Josh Thomas, whose shows feature queer neurodivergent characters, have shared their own autism diagnoses. Photographer Nora Nord highlights misinformation about ADHD and the stereotypical focus on men. Online communities like The Autisticats, run by LGBTQIA+ autistic youth, are also providing resources and sharing personal stories. 





Supporting LGBTQIA+ Neurodivergent Mental Health 


If you are LGBTQIA+ and/or neurodivergent and struggling with your mental health, there is support available:


Employers and allies also play a crucial role by:

  • Creating clear anti-discrimination policies and practices

  • Providing training to increase understanding of LGBTQIA+ and neurodivergent identities. 

  • Offer LGBTQIA+ employee resource groups. 

  • Use inclusive language like sharing pronouns

  • Listen, amplify queer and neurodivergent voices, and take time to educate yourself as an ally.




Conclusion 


As we celebrate Pride this June, it's vital that we create more spaces where LGBTQIA+ individuals feel safe, seen, and supported in all aspects of their identities - including neurodivergence. Through continued dialogue, compassion, and community-building, we can destigmatise mental health and ensure resources are available for those navigating this intersection. At our practice, we are committed to providing LGBTQIA+ and neurodivergent-affirming care. Our services are also available to those who may not identify under the LGBTQIA+ umbrella. All are welcome.




 

RESOURCES


stack of colourful books

Resources & Groups for Neurodivergent LGBTQIA+ People


Please note that True North Psychology is not affiliated with any of the organisations listed below:




Asperger/Autism Network – Online Coaching and Groups for LGBTQIA+ People


Queer ADHD - Queer centered ADHD coaching


Queerly Autistic: Blog exploring the intersection of being queer and autistic




Atypiqueers community (London, UK)


ADDitude - Neuroqueer (Online)


 

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References


  1. Gmelin, J. H., De Vries, Y. A., Baams, L., Aguilar-Gaxiola, S., Alonso, J., Borges, G., Bunting, B., Cardoso, G., Florescu, S., Gureje, O., Karam, E. G., Kawakami, N., Lee, S., Mneimneh, Z., Navarro-Mateu, F., Posada-Villa, J., Rapsey, C., Slade, T., Stagnaro, J. C., Torres, Y., … WHO World Mental Health Survey collaborators (2022). Increased risks for mental disorders among LGB individuals: cross-national evidence from the World Mental Health Surveys. Social psychiatry and psychiatric epidemiology, 57(11), 2319–2332. https://doi.org/10.1007/s00127-022-02320-z

  2. Watkinson, R. E., Linfield, A., Tielemans, J., Francetic, I., & Munford, L. (2024). Gender-related self-reported mental health inequalities in primary care in England: a cross-sectional analysis using the GP Patient Survey. The Lancet. Public health, 9(2), e100–e108. https://doi.org/10.1016/S2468-2667(23)00301-8

  3. Bouzy, J., Brunelle, J., Cohen, D., & Condat, A. (2023). Transidentities and autism spectrum disorder: A systematic review. Psychiatry research, 323, 115176. https://doi.org/10.1016/j.psychres.2023.115176

  4. Strang, J.F., Kenworthy, L., Dominska, A. et al. Increased Gender Variance in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder. Arch Sex Behav 43, 1525–1533 (2014). https://doi.org/10.1007/s10508-014-0285-3

  5. Strang, J. F., van der Miesen, A. I. R., Fischbach, A. L., Wolff, M., Harris, M. C., & Klomp, S. E. (2023). Common Intersection of Autism and Gender Diversity in Youth: Clinical Perspectives and Practices. Child and adolescent psychiatric clinics of North America, 32(4), 747–760. https://doi.org/10.1016/j.chc.2023.06.001

  6. Gratton, F. V., Strang, J. F., Song, M., Cooper, K., Kallitsounaki, A., Lai, M. C., Lawson, W., van der Miesen, A. I. R., & Wimms, H. E. (2023). The Intersection of Autism and Transgender and Nonbinary Identities: Community and Academic Dialogue on Research and Advocacy. Autism in adulthood : challenges and management, 5(2), 112–124. https://doi.org/10.1089/aut.2023.0042

  7. Strang, J. F., Powers, M. D., Knauss, M., Sibarium, E., Leibowitz, S. F., Kenworthy, L., Sadikova, E., Wyss, S., Willing, L., Caplan, R., Pervez, N., Nowak, J., Gohari, D., Gomez-Lobo, V., Call, D., & Anthony, L. G. (2018). "They Thought It Was an Obsession": Trajectories and Perspectives of Autistic Transgender and Gender-Diverse Adolescents. Journal of autism and developmental disorders, 48(12), 4039–4055. https://doi.org/10.1007/s10803-018-3723-6

  8. Bush, H. H., Williams, L. W., & Mendes, E. (2021). Brief Report: Asexuality and Young Women on the Autism Spectrum. Journal of autism and developmental disorders, 51(2), 725–733. https://doi.org/10.1007/s10803-020-04565-6

  9. Weir, E., Allison, C., & Baron-Cohen, S. (2021). The sexual health, orientation, and activity of autistic adolescents and adults. Autism Research, 14(11), 2342–2354. https://doi.org/10.1002/aur.2604

  10. Abé, C., Rahman, Q., Långström, N., Rydén, E., Ingvar, M., & Landén, M. (2018). Cortical brain structure and sexual orientation in adult females with bipolar disorder or attention deficit hyperactivity disorder. Brain and behavior, 8(7), e00998. https://doi.org/10.1002/brb3.998

  11. Hillier, A., Gallop, N., Mendes, E., Tellez, D., Buckingham, A., Nizami, A., & OToole, D. (2019). LGBTQ + and autism spectrum disorder: Experiences and challenges. International Journal of Transgender Health, 21(1), 98–110. https://doi.org/10.1080/15532739.2019.1594484

  12. Bargiela, S., Steward, R., & Mandy, W. (2016). The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. Journal of autism and developmental disorders, 46(10), 3281–3294. https://doi.org/10.1007/s10803-016-2872-8


Other links referenced in article:



Dattaro, Laura. “Gender and Sexuality in Autism, Explained: Spectrum: Autism Research News.” Spectrum, 18 Sept. 2020, www.spectrumnews.org/news/gender-and-sexuality-in-autism-explained.








Self-Diagnosed Autistic Community: https://selfdiagnosis.org/resources.shtml  


Queerly Autistic Eclectic: https://queerlyautisticeclectic.com/ 






True North Psychology Blog (2024): Is Adult ADHD the Latest Trend? 





Netflix- Douglas, Hannah Gadsby show


Josh Thomas website


Photographer Nora Nord website


The Autisticats, run by LGBTQIA+ autistic youth, are also providing resources and sharing personal stories. 


Disability at work (UK):  accessing accommodations


All content provided on our website is for educational purposes only and should not be a substitute for professional advice from a medical or mental health professional.

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