Neuro-queering feminism: Creating space within feminism to address autistic experiences of gender oppression

Gender as an axis of oppression: The gendered hierarchy

Within feminist psychological theory, gender is understood as being both an intra and interpersonal identity that is shaped by socially constructed gender norms and experienced diversly across individuals (Macionis & Plummer, 2012). In this sense, gender is both a psychological and sociocultural phenomenon that can be categorised within existing frameworks (men, women, nonbinary, gender-fluid) but that also changes and evolves in line with expanding ideas about human identity expression (Valocchi, 2005). In contrast, sex is understood to be the biological category (male, female, intersex) that people are assigned based on their primary and secondary (neonatal) sex characteristics (Fine et al., 2023). The conflation of sex and gender is known as gender essentialism, which has been criticised by poststructural feminists for its role in normalising and perpetuating gender inequality and oppression (Skewes et al., 2018). According to this poststructural criticism, gender essentialism disregards the social, cultural, and political dimensions that construct gender and sex, and, in turn, how these reify gender inequality (Klysing, 2020).

An overarching concept within the three main feminist theoretical positions (liberal, radical, and Marxist) is that of challenging the closely related forces of gender stratification (social hierarchy, which confers greater power and privilege to men than women) and patriarchy (sociocultural structure based on the domination of men over subordinate gender minorities, notably women; Macionis & Plummer, 2012). Gender stratification and patriarchy are enforced through a concept known as the gender order—that is, how the gender binary (masculinity and femininity) (re)produces unequal power dynamics between men and women (Zinn & Hofmeister, 2022). Violence—whether symbolic, institutional, and/or interpersonal—also plays an important role in perpetuating the gender order (Almeida et al., 2023). One way the relationship between violence and the systematic subordination of gender minorities manifests is in the disproportionally high rates of male-perpetrated sexual and domestic violence across a range of contexts (Leon & Aizpurua, 2023).

Neurodivergence as an axis of oppression: The neuro-normative status quo

Similar to the concept of biodiversity, neurodiversity describes the diversity of human nervous systems occurring in nature (Pellicano & den Houting, 2021). Neurodiversity is a term used to signify the diversity of human neuro-types, and the neurodiversity paradigm is a framework for understanding and implementing a neurodiversity-informed approach to neuro-minority oppression (Walker & Raymaker, 2021). The neurodiversity paradigm was developed collectively by a group of autism rights advocates as a counter to the dominant pathology paradigm that shapes understandings of autism and other minority neuro-types (Stenning & Rosqvist, 2021). The pathology paradigm assumes that there is a universally “normal” or “correct” standard of human functioning; ways of being and doing that diverge from this normative standard are inherently pathological (Walker, 2021). The neurodiversity movement is a social movement informed by the neurodiversity paradigm. It aims to empower neuro-minority groups by dismantling the pathology paradigm and its reproduction of the neuro-normative status quo that disadvantages neurodivergent populations (Botha & Gillespie-Lynch, 2022).

A core concept within the neurodiversity movement is that of neuro-normativity. This concept refers to the hegemonic standard—or enforced range of “normal” behaviours—that simultaneously pathologises and stigmatises the diverse ways of being and doing that fall outside of this range, reifying the sociocultural structures and power dynamics that oppress neuro-minority groups by positioning these neuro-types as “inferior” and in need of “correction” (Chapman, 2020). In oppression theory proposed by Young (2014), violence is a direct way in which oppressive hegemonic structures are reproduced as marginalised groups face constant threat of unprovoked or unjustified attacks on their physical, psychological, and/or spiritual sense of safety and well-being, usually perpetrated for humiliation or subordination (Ferguson & Valls, 2021). In relation to autistic women and other gender minorities, this face of oppression manifests in the pervasive interpersonal, institutional, and identity-based violence that autistic people, especially women, experience throughout their lives, which is often normalised and blamed on their neurodivergence (Ridout, 2022).

The neurodiversity paradigm grew out of the social model of disability and shares philosophical and sociopolitical foundations with this model (Chapman, 2021). Proponents of the social model of disability argue that the organisation of society is responsible for disabling certain people. Irrespective of their impairment, a person's functional ability is limited by how environments and social systems are structured (Oliver, 2013). The neurodiversity movement also draws on the biosocial model of disability, which maintains a critical approach to the sociocultural construction of disability while also using biomedical frameworks to understand biologically based differences in functional capacity (Ellis, 2023). The biosocial model is particularly relevant for disabled people who require access to appropriate medical interventions (e.g., pharmaceutical medications, medical procedures, and specialist medical services) as part of their disability rights (B. Hughes, 2009).

While there is contention around whether or not the neurodiversity movement is relevant to autistic people with higher support needs, such as those with intellectual disabilities and/or who are nonspeaking, there is greater consensus in the autistic community than would be expected. Hersh et al. (2024) illustrate that autistic people are more likely to support the goals of the neurodiversity movement than nonautistic people. Nevertheless, there is still contention around the degree to which the neurodiversity movement reflects the experiences of autistic people who do find the medicalisation of their autism useful and, in turn, favour biomedical and behavioural interventions to alleviate the distress associated with their impairments (J. A. Hughes, 2021). In this sense, the neurodiversity movement does not reflect the differing individual experiences and meaning-making processes of autistic people. Nonetheless, the movement is underpinned by a commitment to human rights and empowering neuro-minority groups, whatever that may look like for individuals (Greenburg & Rosa, 2020).

Neuro-queer feminism as an alternative to antipsychiatry

Antipsychiatry is a sociopolitical movement broadly revolving around challenging psychiatry's dominance as an authority on human behaviour and psychosocial distress (Burston, 2018). Antipsychiatrists informed by critical theory focus more on how hetero-patriarchal, colonial, and capitalist structures are the primary catalysts for the psychosocial distress and the disablement of certain groups of people (Roberts & Itten, 2006). Conversely, libertarian antipsychiatry—the dominant position within the antipsychiatry movement—is more concerned with disrupting the notion of neurodivergence/psychosocial distress as a real phenomenon, claiming instead that it is simply a product of the psychiatric medicalisation of people who engage in problematic ways of living (Chapman, 2023).

In terms of feminist antipsychiatry, there are two key overlapping positions. The first position is that psychosocial distress is a construction of psychiatric nosology (i.e., classification of mental disorders) that medicalises women's emotions and trauma. The second is that psychosocial distress is a result of patriarchal social oppression, which psychiatric labels disregard in their conception of suffering (Kirschner, 2013). However, these positions arguably fail to consider a fundamental question: What if differences in human nervous system configurations both exist in nature and are subjugated by neuro-normative structures of oppression? Denying the existence of neurodiversity (i.e., the existence of differences in human nervous system arrangements) reinforces the dominant libertarian antipsychiatry positions which have no interest in challenging the pathology paradigm or empowering neuro-minority groups (Chapman, 2023). Similarly, to position distress as arising from oppression and alienation is valid but still arguably leaves room for the denial of neurodivergence as an axis of said oppression (Johnson, 2021).

The anti-identitarian approach of neuro-queer feminism makes it well positioned to address the tensions around psychiatric labels in feminist scholarship (Johnson, 2021). This anti-identitarian approach acknowledges that people can exercise unique forms of agency and resistance in their occupation of psychiatric labels (Egner, 2018). Those who inhabit these labels often do so in ways that challenge and disrupt the stigma embedded in their construction, allowing for the reconstruction of their subject positions (Shapira & Granek, 2019). Autistic women are an example of this. Their marginal position within the dominant conception of autism often allows for reauthoring their neurodivergent identity in more nuanced and self-empowering ways (Seers & Hogg, 2022).

Any feminist engagement with antipsychiatry should also be cognisant that contemporary proponents of antipsychiatry, across the different positions, have not expressed their support for the neurodiversity movement (Chapman, 2023). Many in the antipsychiatry movement view neurodivergent differences as arising from the pathologisation of normality, which they posit is a materially real phenomenon rather than a socially constructed one. At the same time, antipsychiatry discourse denies the existence of psychosocial and neuro-developmental disabilities, instead considering them to be individual character flaws (Arnaud & Gagné-Julien, 2023). In contrast, the neurodiversity paradigm challenges the pathologisation of human difference and rejects neuro-normativity as hegemonic (Catala et al., 2021).

Moreover, unlike the neurodiversity movement, many proponents of antipsychiatry are not inherently guided by antioppressive social justice values, and do not necessarily represent the lived experiences of the neuro-minority groups most impacted by psychiatric systems (Chapman, 2023). In this sense, the neurodiversity paradigm—and, in turn, neuro-queer feminism—is more aligned with the antioppressive, pro-diversity tenets of intersectional feminism than antipsychiatry is.

Challenging gender essentialism in autism research

The gender bias in autism research and practice is arguably rooted in the extreme male brain theory of autism (Jack, 2011). The theory proposes fundamental sex differences in the brain along a male–female continuum (Gillis-Buck & Richardson, 2014). According to this theory, autism is an “extreme” version of these male brain characteristics and is therefore more prevalent in men than women (Loomes et al., 2017). However, the extreme male brain theory has been challenged, and evidence of its role in reproducing this gender bias has been demonstrated (Moore et al., 2022). Additionally, more autistic women and gender-diverse people have subsequently been recognised (Driver & Chester, 2021). The extreme male brain theory has also been criticised by feminist scientists, who argue that it is an example of neuro-sexism: using neuroscience to reinforce problematic gender stereotypes of women as less intelligent than men (Friedrichs & Kellmeyer, 2022).

In relation to the emerging recognition of autistic women, the female autism phenotype theory has been formulated to counter the extreme male brain theory of autism (Moore et al., 2022). This theory asserts that women have distinct biological differences mediating their expression of neurodivergence (Hull et al., 2020). These differences supposedly include a greater capacity for developing social skills and relationships with others, as well as a tendency towards internalising behaviours rather than externalising behaviours (Bargiela et al., 2016). This theory has also been criticised for constructing an inverse stereotype of the extreme male brain theory that ultimately reinforces sex-based binaries and conceals gender diversity across autistic populations (Pearson & Rose, 2021). Moreover, these gender-essentialist constructions of autism disregard the role of sociocultural gender norms and expectations in mediating behaviour (Moore et al., 2022).

In contrast to the gender-essentialist theories dominant in autism research, the prevalence of gender variance (i.e., gender identities that diverge from binary feminine–masculine gender norms) across autistic populations is an emerging theme in the literature (Kourti & MacLeod, 2018). In relation to this, autistic individuals are significantly less likely to identify with their sex-based gender group than nonautistic individuals (Cooper et al., 2018). Additionally, autistic people are more likely to be transgender and/or nonbinary (George & Stokes, 2018). Gender variance is also commonly experienced by cis-gender autistic individuals and can thus be understood as a response to socially constructed gender norms rather than innate sex-based features of autism (Davidson & Tamas, 2016).

The experience of gender variance is also reflected in qualitative research that captures autistic women's reports of being ostracised for engaging in behaviours that deviate from normative gender expectations (Seers & Hogg, 2022). These experiences of gender variance are also supported by Cooper et al. (2018), who found that autistic people assigned female at birth experience significantly less attachment to femininity than nonautistic people categorised as female. However, autistic individuals also describe attempting to mask autism by performing normative gender behaviours, regardless of their gender identity (Kourti & MacLeod, 2018). Gender norms are learnt through childhood socialisation and reinforced by sociocultural practices that sanction sex-based gender expression (Seers & Hogg, 2022). Additionally, difficulty with the performance and embodiment of gender norms (linked to neurodivergent differences in movement, vocal prosody, pragmatic language, sensory-related clothing preferences, and monotropic interests) often results in targeted harassment of and violence towards autistic women, especially those who are gender nonconforming and/or queer (Barnett, 2017).

There is considerably less research about the experiences of oppression of gender-diverse autistic populations. However, emerging evidence suggests that they face unique issues related to the intersection of ableism and cis-heteronormativity, which often impedes their human rights and creates additional barriers to healthcare access (Dewinter et al., 2023). For example, gender-diverse autistic people commonly have their gender identity invalidated due to the construction of both autism and gender diversity as disorders in overlapping pathologisation discourses (Shapira & Granek, 2019). Added to this, it is often assumed that autism limits gender-diverse autistic people's capacity to understand gender identity (Barnett, 2017).

Neuro-queering feminist approaches to supporting autistic survivors of gendered violence

Autistic people experience disproportionally high rates of violence and abuse within their interpersonal relationships (Pearson, Rees, & Forster, 2022). Interpersonal violence for autistic populations appears to take a similar gendered pattern to that suffered by nonautistic populations; autistic women are more likely to experience this in the forms of male-perpetrated sexual violence and intimate partner abuse (Fox, 2024; Gibbs et al., 2022). Gender intersects with neurodivergence as autistic women experience higher rates of sexual and intimate partner violence than nonautistic women (Gibbs et al., 2021). While there is limited research capturing the prevalence of interpersonal violence for autistic gender-diverse people, emerging evidence suggests that they experience similar rates as autistic women do (Gibbs et al., 2024). However gender-diverse autistic people's experiences of interpersonal violence are also underpinned by cis-heteronormative forms of gender-minority-based oppression that heighten power differentials in their relationships, especially if they are victimised on the basis of both queer and neurodivergent differences (Cooke et al., 2024).

The historical marginalisation of autistic experiences of those other than White and male from autism research has excluded critical theoretical perspectives (e.g., feminism, queer theory, antiracism, etc.) that can usefully conceptualise the intersecting social, political, and structural mechanisms of oppression of diverse autistic populations (Strand, 2017). The absence of an intersectional feminist approach to the experiences of gendered violence of autistic people has also inadvertently perpetuated victim-blaming narratives focused on neurodivergence as the problem, disregarding the role of patriarchy, gender inequality, and ableism (Moore et al., 2022). Intersectional feminism in the context of critical disability scholarship has primarily examined how ableist and patriarchal structures overlap and interact to oppress disabled gender minorities in ways that are often underrepresented within single-axis feminist approaches (Robinson et al., 2020). Nevertheless, autistic and other neurodivergent gender minorities have so far been relatively underrepresented within feminist disability discourse (Gold, 2020).

Consequently, autistic women and gender-diverse people experience unmet support needs across all service delivery settings as they face significantly greater access barriers than autistic men do (Koffer-Miller et al., 2022). When considering the access barriers they face, autistic women and gender-diverse people may also experience unique difficulties in accessing and engaging with support services for gendered violence (Pearson, Rose, & Rees, 2022). Communication differences may make it difficult for autistic women and gender-diverse people to connect with services that require verbal communication of their experiences in order to access support, especially for those who are non- or minimally speaking (Lum et al., 2014). Sensory processing differences may also mean that noisy and unfamiliar service settings are too overwhelming for autistic women and gender-diverse people to access (Lockwood-Estrin et al., 2022).

Autistic women and gender-diverse people may also encounter service access barriers if they present in a way that deviates from normative constructions of distress (Ridout, 2022). For instance, literature capturing autistic women's experiences with healthcare highlights how they felt that their pain was dismissed by practitioners because of their “blunted” presentation in these settings (Tint & Weiss, 2018). Women's experiences of having their pain disregarded in healthcare settings are underpinned by an entrenched history of medical misogyny and androcentrism (Hoffmann & Tarzian, 2001). For instance, despite experiencing elevated rates of chronic pain compared to men, healthcare providers are more likely to classify women's pain as an emotional overreaction, rather than physiological in nature (Samulowitz et al., 2018). Autistic women and gender-diverse people likely experience compounded intersectional biases within healthcare settings, similar to those experienced by other multiply marginalised populations (Bastos et al., 2018). Gender-diverse populations also experience unique forms of gender bias linked to cisnormativity and transphobia within healthcare settings, resulting in stark inequalities in health outcomes (Clune et al., 2023; Rosenberg et al., 2021).

Responding to these systemic biases, a neuro-queer feminist approach involves challenging neuro-normative assumptions about how neurodivergent survivors should present and express distress. In doing so, neuro-queer feminism creates space for diverse, intersectional experiences of gendered oppression and violence. In line with this, a neuro-queer feminist approach is useful for understanding the gender- and neuro-minority-based oppression faced by autistic women, and how it creates barriers to accessing and engaging with support services around their experiences of gendered violence (Ridout, 2020). Neuro-queer feminism involves adopting a neurodiversity-affirming approach to feminist practice with neurodivergent survivors of gendered violence. In practice, this involves fostering resistance to normalisation, ensuring service delivery centres on affirming neurodivergent ways of being and doing rather than enforcing conformity to the status quo (Dallman et al., 2022).

Another essential part of neuro-queer feminism is fostering an antioppressive approach to praxis within psychology and related disciplines to dismantle the intersectional matrix of domination of autistic gender minorities. An antioppressive approach requires that practitioners develop a critical consciousness of power differentials both in their working relationships with marginalised individuals and at systemic and structural levels (Gupta, 2022). Integral to antioppressive praxis in the context of neurodivergence is using a critically reflective approach to practice that challenge neuro-normative stigma when working with autistic and other neurodivergent service users in all contexts (Pickard et al., 2020). In doing so, practitioners should examine their own constructions of neurodivergence and the degree to which these may be informed by the pathology paradigm and/or neuro-normative assumptions (Davies, 2022).