Inextricably tied: Nonbinary autistic individuals’ views on how their gender identity and autism are connected

Abstract

This study explores the experiences and identities of nonbinary autistic people, an under-researched population. While past studies have posited a co-occurrence of autism and transgender identity, little research focuses specifically on nonbinary autistic adults. This community-based study draws on interview data from 44 nonbinary participants. Participants expressed nuanced and informed understandings of their gender identities, highlighting fluidity and a rejection traditional binary gender roles. Participants discussed the connection of their autistic and nonbinary identities and how their identity is shaped by external forces such as politics, community, and interpersonal relationships. Findings highlight the need for the inclusion of nonbinary autistic people in autism research and for autism services and programming to be affirming of various gender identities.

Lay abstract

This study explores the experiences and identities of nonbinary autistic people. The relationship between autistic and nonbinary identities has not been researched in detail. Few studies focus specifically on nonbinary autistic adults. We interviewed 44 nonbinary individuals for this study. Participants had thought-out opinions on gender identity and emphasized identifying with fluidity rather than traditional gender roles. Participants discussed the connection of their autistic and nonbinary identities and how it affected how people saw them and how they saw themselves. We have recommendations for programming, policy, and research from these findings.

Keywords

adults autism spectrum disorders LGBT qualitative research transgender

Introduction

There is a documented high co-occurrence of autism and transgender identity (Cooper et al., 2018; Warrier et al., 2020), but only one (fairly new) study has examined the nonbinary autistic experience specifically (Peachey & Crane, 2024), and few studies include nonbinary participants (Gratton, 2020; Gratton et al., 2023; McAuliffe et al., 2023; Steinberg et al., 2023). Over the past decade, there has been scant but growing literature on this co-occurrence of transgender identity and autism (de Vries et al., 2010; Van Der Miesen et al., 2016; Warrier et al., 2020). Until recently, these studies used limited datasets of a few hundred individuals in clinical and institutionalized settings undergoing medical transition (Gratton et al., 2023; Jones et al., 2012; Pasterski et al., 2014; Walsh et al., 2018). Many theories attempting to understand this trend emerged, mainly focused on biological hypotheses or skill deficits among autistic people which have been harmful and stigmatizing to this under-researched population (George & Stokes, 2018; Strang, Janssen, et al., 2018; Strang, Powers, et al., 2018). So far, few scholars have incorporated the viewpoints of autistic transgender people with a holistic, affirming, and destigmatizing lens (Cooper et al., 2022; Gratton et al., 2023; Strang, Powers, et al., 2018). This study is one of the first to collect data from nonbinary autistic people to better understand how they see themselves and their communities.

Sex and gender are distinct concepts. Social scientists for the past 50 years have conceptualized gender as a social construction that extends beyond the body (Butler, 1990; Fausto-Sterling, 2000). Within this theory, gender is fluid, dynamic, and embedded in social structure. It exists on a continuum rather than a binary, and individuals perform gender in their interactions (West & Zimmerman, 1987).¹

While nonbinary individuals have always existed (Schilt & Lagos, 2017), many nonbinary and transgender individuals have lacked language to explain their experiences, especially as authority has moved from medicine to community spaces (Shanker, 2020). Gender identity is proven to be a multifaceted and intricate inner experience that varies greatly within individuals (Jacobsen et al., 2022). Thus, many nonbinary individuals did not understand themselves as such until the cultural means to do so became accessible in the past 10 years. Furthermore, the language broadly used to describe gender is community driven and not accessible to everyone (Menne et al., 2020). Thus, it cannot be fully captured in categorical labels alone (Gratton et al., 2023). Although there are many nuanced identities beyond the “nonbinary” moniker, we use this term to encompass gender identities that are not completely aligned with gender binary concepts of “man” and “woman.” This is including but not limited to nonbinary, agender, genderqueer, and genderfluid individuals. In this particular historical moment, as the lives of transgender individuals are politicized, legislating transgender people (including nonbinary people) overlaps with state control of autistic individuals (Ballentine, 2023; Demillo, 2023).

Nonbinary identities are more prevalent in recent years, as evidenced by the precipitous increase in Americans identifying as such (Brown et al., 2022). A little over a million Americans, and about 11% of the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and more) community, identifies as nonbinary, with most nonbinary people being under 29 years old, urban, and White (Wilson & Meyer, 2021). Based on knowledge from activist circles and first-person narratives (Dale, 2019; Sparrow, 2020), as well as some scholars, including nonbinary participants in autism research (Cooper et al., 2022; Gratton, 2020; Gratton et al., 2023), it appears that nonbinary autistic individuals not only exist, but may be more common than researchers realize. Critical disability and gender scholars have been addressing the connections between neurodivergence and gender fluidity. Neuroqueer theories, for example, are an arm of neurodiversity frameworks that emphasize the inherent fluidity outside the binary of both disability and gender (Walker, 2021). This means that queer and fluid gender identities upend how we think about rigid heteronormative standards and cross boundaries in similar ways to neurodivergent identities; they are connected. Calls for more community-based studies to better represent this fluidity have been specifically targeted for transgender autistic populations (Gratton et al., 2023; Strang et al., 2019).

Despite more people identifying as nonbinary, nonbinary people experience discrimination and a lack of understanding from others. In particular, nonbinary autistic people may experience more discrimination and difficulty navigating institutions (Peachey & Crane, 2024). Autistic and gender minority stress (e.g. discrimination, perceived stigma, prejudice, and exclusion) experienced daily by this community can amplify depression and suicidal thoughts and behaviors (Testa et al., 2015). This pressure on a person’s everyday life is a significant contributor to physical and mental health disparities (Hillier et al., 2020), and is proven to be keen for autistic individuals, leading to poorer mental health outcomes (Botha & Frost, 2020). Given that masking and other forms of stress for autistic people have gendered patterns (Pearson & Rose, 2021), we focus on queer autistic individuals (and specifically nonbinary autistic individuals) in the hopes that better inclusion will lead to better wellbeing.

In an effort to repair the harms of past research and center systematically excluded individuals, the purpose of this article is to focus on the viewpoints and narratives of the nonbinary autistic adults who participated in our larger study and share how they understand themselves as nonbinary and autistic people. This is one of the first studies of its kind to focus on nonbinary autistic individuals. Our community-based approach and interviews with nonbinary autistic people themselves situate us to understand how nonbinary autistic people describe their identities and what shapes them. We ask the following research questions:

How do nonbinary autistic people understand their identities?

Do they feel these identities are connected?

How do external forces shape their experiences?

Methods

The data come from a larger community-based study on 65 queer and transgender autistic adults who live in a large metro area in the mid-Atlantic region of the United States. For this article, we focus on the 44 nonbinary participants.

Qualitative work is primarily used to understand the opinions, motivations, and processes that make up social life (Lamont & Swidler, 2014; Rinaldo and Guhin, 2022; Small & Cook, 2023). This is especially true that interview data are good at uncovering narrative (here defined as the personal and cultural stories that individuals use to understand themselves) and what people think of themselves and their environments (Frank, 1995; Hydén & Antelius, 2011; Irvine et al., 2019; Miller et al., 2020). As such, our study does not aim for generalizability, causal inference, or any other statistical measure. Instead, this study looks to understand how queer and transgender autistic adults think and feel about themselves and community. Such methods are important to capturing individuals’ opinions and understanding the daily lives of disabled individuals (Liddiard et al., 2019; McDonald & Kidney, 2012; Stafford, 2017; Stone & Priestley, 1996) and queer people (Compton et al., 2018; Pascoe, 2018).

Interviews here resembled life history interviews, meaning they highlight autobiographical elements in the lives of individuals from marginalized groups (Goodson, 2001). Participants had not been able to talk about this topic before, and they covered much narrative ground.

Participant recruitment

The larger study received Institutional Review Board (IRB) approval at Drexel University. To participate in the larger study, participants had to communicate in and/or understand English, live within 100 miles of Philadelphia, and identify as LGBTQ. Our research team partnered with 19 community organizations serving either LGBTQ individuals or disabled community members in the local area. Participants were recruited through these organizations, as well as through social media from the researchers’ academic department and snowball sampling. Participant recruitment involved a sign-up process through which potential interviewees could share their preferences for how they wanted their interviews to be conducted. This can be found in Supplementary Appendix B. This sign-up process was housed on Qualtrics, and also was used to cull any scam sign ups (Pellicano et al., 2024).

Procedures

For the mode of interview, participants could choose between in person, virtual, audio only, text via Zoom chat or Google docs, or asynchronous email. Of the 44 interviewees featured in this article, 14% of the sample chose audio only, 12% Zoom chat or Google docs, 12% email, 4% in person, and 58% virtual. We allowed participants to bring other people to their interviews to increase their comfortability and sense of support, but no one chose this option. We also allowed participants to specify if they wanted a certain type of interviewer. A few requested an autistic interviewer, and one requested a person of color. We accommodated all requests. We did not require a formal autism diagnosis and made this clear in our recruitment. We guided participants through extensive consent processes at the stages of signups, presentation of formal consent forms and during and after the interviews. We reminded participants that they were in a study (Khan, 2013), allowed them to strike any information from the study, allowed them to skip answers or end the interview, and generally gave them control of the flow of the interview.

The first five authors interviewed participants. Most interviews lasted around an hour and a half, with the longest going over two and a half hours. Interviews covered the participants’ feelings on their gender and autistic identities, their general biography, and feelings and recommendations on building community. Our interview guide can be found in Supplementary Appendix A. Participants were compensated with a US$50 gift card to Amazon, Target, or Walmart. Interviews were transcribed by a third party and de-identified. We engaged in member checking, and sent participants a version of this article, including how they were featured, before submitting for publication. All names used in this article are pseudonyms chosen by participants unless they declined to choose, in which case the interviewer selected a name.

Sample characteristics

The sample of nonbinary individuals featured in this article was comprised of self-identified queer and transgender autistic adults who could understand English. Most lived independently or with found families (an emic colloquialism in the queer community that describes families of choice). While we did not ask participants explicitly if they were nonspeaking, they had the option to request written interviews, and five participants described periods or experiences where they were nonspeaking. The mean age was 28, with the youngest participant being 19, and the oldest being 44.

Emphasis was placed on recruiting participants of color, who made up 22% of the sample, while 78% identified as White (see Table 1). Of people of color, four were Black (including multiracial), three were Latino (including multiracial), two were Indigenous (including multiracial). Of those who gave sexual orientations, 44% were queer/fluid, 32% were bisexual or pansexual, 21% were gay/lesbian, and 29% were on the asexuality spectrum. Educational attainment is often used as a proxy for socioeconomic class, but given the high rates of educational attainment of millennials (Fry & Bialik, 2019), we note that many of our participants described experiencing poverty (receiving public benefits, earning income under the federal poverty line, and so on). Many of the participants received autism diagnoses in adulthood.

Table 1.

Demographics of the sample of nonbinary participants.

Demographic characteristics	Participants (n = 44)
Age
Mean in years	28
Diagnostic timing
In childhood	5 (12%)
In adulthood	19 (43%)
Not diagnosed	20 (45%)
Race
White participants	34 (77%)
Participants of color	10 (23%)
Level of education
Some high school	1 (2%)
High school/GED	7 (16%)
Some college	7 (16%)
College	22 (50%)
Graduate degree	4 (9%)
No answer	3 (7%)
Sexual orientation
Queer/Fluid	20 (44%)
Bisexual/Pansexual	14 (32%)
Gay/Lesbian	9 (21%)
Asexual	13 (29%)

“Some college” designates current students. Participants could report more than one sexual orientation.

Analysis

Interview studies allowed for flexibility, and we engaged in active, collaborative memoing during the data collection period (Rubin & Rubin, 2012). We identified early that nonbinary individuals were an important group, and that the two themes (the interconnectedness of autistic and nonbinary identity, and how external forces shaped sense of self) were important to those interviews. We sought out disconfirming evidence (Lareau, 2012; Tavory & Timmermans, 2013), meaning we looked for cases or counterfactuals that posed challenges to the patterns in our data. Thus, we engaged in the constant comparative method, contrasting each new case we added with the previous interviews (Glaser, 1965). With the above themes in mind, we used thematic and line-by-line coding (Braun & Clarke, 2022) in NVivo (Deterding & Waters, 2021), with the first author leading the analysis. The analysis was inductive, in that the research team focused on a population of interest but did not have defined hypotheses (Fereday & Muir-Cochrane, 2006). The research was also abductive in that the research team was familiar with the literature but let patterns and themes emerge organically (Timmermans & Tavory, 2012).

Autistic and queer community involvement statement

Our research team consisted of scholars representing queer, autistic, and nonbinary identities committed to emancipatory research with the study population.² The first five authors interviewed participants. The first two authors coded the interviews for this study. All the authors shaped each stage of research. We chose a qualitative community-based approach due to recognition that this population has been historically underrepresented in autism research (Gratton et al., 2023; Putnam et al., 2023). We also wanted to ensure that future directions would include community feedback and involvement. Although the methods used in this study emphasized a community-based approach, they were not fully participatory, in that community partners and participants did not have a formal role in shaping the goals and methods of the project. Before submitting for publication, we engaged in member checking, and sent participants a version of this article, including how they were featured.

Findings

We begin this section by giving an overview of general findings, and then describing two main themes that we identified. The nonbinary participants in this study held well-informed, nuanced, and varied opinions about their gender identities and were deliberate in the conclusion that they held a nonbinary gender identity. Furthermore, nonbinary participants emphasized fluidity and a lack of identification with traditional binary gender roles as important to understanding their gender identities. Nonbinary participants explained that their autistic identities and gender identities impacted each other. Many said that they did not feel it was necessary to apply rules related to gender roles/expression, and many felt that existing gender norms were arbitrary. They perceived gender binaries as less applicable to them.

Some said that they were unlikely to see gender as binary, so they valued the flexibility that a fluid view offered. Some brought up neuroqueer framings. Nonbinary participants also discussed how the ties between their autistic and nonbinary identities affected their relationships with others, their connections to their bodies, and how they saw themselves. We present the two salient themes, “queering autism” and “shaped by social forces” in Table 2.

Table 2.

A list of salient themes, descriptions and examples.

Theme	Description	Quote
Queering Autism	The experience of autism and queer identity affecting each other, creating room for individuals to explore gender	“I definitely think about [nonbinary and autistic identities] together, and I do think they’re intertwined.”—Blake
Shaped by Social Forces	External forces such as community, politics, family, and peers shaped how interviewees saw their autistic and nonbinary identities	“Things could be different based on your race or your cultural upbringing or whatever could affect being queer and how that comes to be, and also discovering gender divergence.”—Crystal

Queering autism

Several of our participants discussed the connection they felt between being autistic and identifying as queer, be it queer in their sexual orientation or gender. One participant, Frank (28 years old, White), detailed that “each one effects” the “flavor of the other” meaning that how “I present my queerness is sort of through the lens of autism, and how I present my autism is through the lens of being queer.” Similarly, Vi (31, White), shared how their queerness and autism were “definitely complicated, but they feel very intertwined” and that the way they approach the world “through an autistic lens impacts how [they] navigate that being a queer individual as well.” Mercury (26, White) commented on how their experiences as an autistic person “feels also specifically queer,” drawing connections between their experience as a teenager dealing with bullying and subsequent “masking,” that is, the conscious or subconscious act of hiding and/or suppressing parts of oneself and/or behaviors in order to blend in with allistic (non-autistic) society (Miller et al., 2021). Mercury expanded on this, stating:

I think that there’s a lot of ways I’ve worked to-well, when I was younger- really worked to hide both my queerness and being autistic. And I think because of that experience, they seem linked in a common theme of being worried about what people would think if I presented myself or knowing very clearly. I mean, I think that a lot of my masking or hiding being came from really intense bullying that I experienced. I would say from elementary school into high school, I was really bullied a lot and I learned exactly what I couldn’t do.

For Mercury, their response to their childhood experiences as a queer autistic adult “has been to reclaim those things and in that reclamation, there’s some sort of an interaction between both of those identities.” Many participants felt that their autism was inherently queer, and vice versa, and did not explicitly separate these identities. Rather, they found them intimately connected.

Participants also viewed being autistic as connected inextricably to gender expansiveness, that is, expressing gender outside of the binary of “man” or “woman.” This showed up for participants in a myriad of ways, ranging from connecting to autistic traits to autism facilitating acceptance of their gender. Blake (26, White) stated, “I don’t feel like a girl and I don’t feel like a boy. And I think part of that is, because I’m autistic. I don’t feel like those things. I don’t feel like anything. I feel like a little alien. I don’t know. I definitely think about them together, and I do think they’re intertwined.” DJ (26, White Latine) shared a similar sentiment regarding how their being autistic influenced their gender being outside of the gender binary. Particularly, that “trying to fit myself to a binary is just, of any kind, is so difficult. And in some ways I feel like that has to do with something about me being autistic. I just have a harder time trying to fit myself in this maybe a box that I’m being expected to.” Despite the difficulties of trying to fit into a binary, participants expressed an ease in gender exploration. Jack (26, White) shared how being autistic facilitated greater acceptance of their nonbinary identity. They said:

I think that being autistic, for me, has partly just been about feeling different. It has allowed me to not feel the same as other people. I don’t know. It makes me, I want to say almost like an independent thinker. I’m much more comfortable with the feeling of not belonging and the feeling of being different and experiencing a different reality than people. I think that, while I didn’t know I was autistic when I figured out I was trans, that feeling, like, “I was never going to be the same as you all anyway, and I literally perceive everything slightly differently than you all do anyway,” gave me the space to perceive my own gender differently. Not that neurotypical people can’t be trans. But I think it’s easier to remove yourself from what you assumed, and be different, and experience the pain of being trans in some ways, if you’ve already felt that, if you already have those feelings in other ways. That’s one thing, which sounds bad, but it’s also just freeing.

The intersectional position of being on the margins both as neurodivergent and queer allowed space to consider nonbinary gender identities.

Some participants expressed broader views about how they perceived that autistic people in general were more likely to reject the gender binary. Many professed seeing gender as a social construct without our prompting and dislodged this identity from the biological definitions of sex. Chloe (30, White) believed that autistic people were not more likely to be transgender, but rather more likely to express and state that they were transgender. Chloe stated, “It makes a lot of sense because gender is one of those societal roles that doesn’t make sense” and “I don’t see why a lot of autistic people who aren’t cisgender would just go along with it.” Other participants drew specific attention to the tendency for autistic people to reject societal norms. In this case, the societal norms being rejected were gender norms.

Similar to the neuroqueer identity and framework, some of our participants expressed the idea of an autistic gender, “autigender,” particularly because their understanding of gender was inextricably tied to being autistic. Clara (24, White), brought up the term and described the ways in which gender and autism were “linked together the same way” their “autism and everything else” are “linked together.” Chloe explained how the concept of autigender and experiences of gender for autistic people overall differs from allistic understandings of gender, stating that it is:

Hard to understand if you’re not autistic, but basically it’s your concept of what a girl is, your concept of what a boy is, your concept of what neither is. It’s just really affected by the fact that you’re autistic because you just don’t understand it in the same way as people who grow up more with more simple understandings of gender like boys do this and girls do that, and that kind of stuff.

These framings often reflected informed and nuanced opinions on gender identity and disability, and connected on an individual level to how participants saw themselves.

Shaped by social forces

External structures, such as politics, communities and interpersonal interactions, shaped how interviewees saw their gender and autistic identities. Several participants expressed their thoughts on the politicization of their identities. Sylvia (30, White) brought up how “[t]here’s a lot of politics around it that is not relevant” to them “on a day-to-day basis” but that for them, “it’s just about living my life as I am.” Mason (27, race not reported), brought up the juxtaposition of being willing to discuss their trans identity with others but being met with pushback while being labeled as “too political”:

So a lot of times I do just get questions for, what does transgender mean? And I’ve been told that I’m too political by one of my brother’s friends because somebody brought up a non-binary joke in a restaurant and I explained to them what non-binary actually meant. They were appreciative of the information. But my brother’s one friend was like, she hated my guts after that because I’m just too political. And I’m like, I would love to live in a world where my gender and sexual identity is considered political and not my everyday nightmare.

Beyond a personal view of autism and transgender identity, participants were aware of how both were politicized, and how this impacted their own experiences.

Some of our participants focused on the experiences of queer autistic people of color. Crystal (27, Black) noted how the experience of being autistic and nonbinary were also affected by race and ethnicity and wished more attention was called to this during the interview process, and within the autism field and queer spaces in general. They said:

it seems like we already always have to bring that up ourselves and note those things . . . it would be nice to acknowledge how those things could be different based on your race or your cultural upbringing or whatever could affect being queer and how that comes to be, and also discovering gender divergence.

Josephine (age not reported, Indigenous) identified as two-spirit, which is a distinct, indigenous identity that often denotes a third-gender role (Angelino & Bell, 2023; Elm et al., 2016). They noted that their race impacted their experiences more than any other identity that they held, stating that race and ethnicity “is really important” and “probably my primary struggle even more than being thinking of dealing with autism. I deal with it 24/7.” For these participants and several others, race and ethnicity was just as inextricably tied to their nonbinary identity.

Many participants reported that families and clinicians did not affirm or talk about their queer and/or autistic identities. This led to suppression and disconnection from aspects of their identities earlier in life. In contrast, friends and members of the autistic and/or queer community played an important role in exploring and validating their experience of gender and autistic identities in adulthood. Lexi (21, White) shared “I often talk about being queer/autistic with my queer autistic friends.” Jack shared how living with and developing a close friendship with a trans masculine roommate helped them accept their own trans/nonbinary identity.

As expressed by many of our participants, living in a cis-heterosexual, binary dominated society with narrow autism stereotypes meant that they were not aware of the existence of trans/nonbinary identities or the diversity of ways that people can experience autism. Connecting with queer and autistic people allowed some participants to understand their experiences and identities in new, meaningful ways. Some reported learning about nonbinary identities from others, and this helped them put words to experiences in a way they had not been able to before. Others talked about discovering their autistic identity through connecting with people they could relate to. Ky (age and race not reported) discussed how their nonbinary friend helped them realize that they too were nonbinary and that a connection existed between nonbinary and autistic identities. Ky expressed how this provided “a unique outlook on things, especially regarding gender.” The ability to identify this outlook started with community and connecting with others.

Participants voiced a desire for opportunities to connect with and learn from autistic people. Crystal expressed that there could be “more programs for people to just understand themselves, because I think a lot of information has to be filtered through understanding how a child moves through the world a lot.” As DJ noted, raising awareness about autism in queer spaces could help more undiagnosed autistic people understand themselves:

I think in general, there’s a lot of people in the LGBT community that are on the autism spectrum, and I feel like if there was a way to, and maybe they’re not diagnosed or something, and maybe they don’t even know, but I wish there was just maybe more awareness or ways to go about getting some sort of evaluation or resources without having to be afraid of being discriminated or misgendered.

This could address the “lost generations” of autistic people from groups in the LGBT community that experience disparities in access to diagnosis. Such focus helps autistic people who do not feel affirmed or comfortable in autism spaces. According to Mercury, who had worked in LGBT organizing, those spaces focused on “cisgender men and not really a lot of support for anybody else.” In this way, the power of the autistic community could be harnessed to provide access to neurodiversity-affirming information about autistic identity and intersections with other identities.

Discussion

Our study, one of the first of its kind, utilizes interviews with nonbinary autistic adults to understand their daily lives and identities. The strength of our community-based approach yielded a diverse sample of many individuals with varied experiences. Despite this variety, we found overwhelmingly that these participants emphasized two themes around meaning and identity: that their nonbinary and autistic identities were inextricably tied, and that how they saw themselves was shaped by social forces.

The experiences and perspectives of autistic nonbinary individuals hold value, and their absence within much of the existing literature impedes the pursuit for true understanding of what it means to be autistic and queer. This study seeks to join the turn in research focused on the views of autistic individuals. Emerging studies now not only incorporate lived experience, but also actively involve individuals who identify as autistic, nonbinary, or both as members of the research team (Gratton et al., 2023; Strang et al., 2019). This approach yields more accurate and holistically reflective findings that hold significant relevance in addressing the very real challenges faced by autistic nonbinary individuals. This study contributes meaningfully to that process by creating space for autistic nonbinary individuals to explain the interaction between autism and gender identity and present the autistic nonbinary experience.

Some queer-affirming spaces have taken the first step in addressing the uptick in neurodivergent identification, such as gathering resources and creating affinity groups. We call for the onus of inclusivity to be on institutions, rather than individuals. Queer-affirming spaces should go beyond sharing pronouns and engage in more nuanced discussion about the gender identity spectrum and gender fluidity to be inclusive of autistic people. Autistic identity is often intertwined with gender identity and sexuality. Many participants in our study had gender identities outside of the gender binary or existing nonbinary labels. While such labels cannot fully capture the complicated feelings on identity, neurodiversity-affirming, and queer-affirming community spaces should be equally multifaceted.

While identifying as queer relies on personal experiences of sexuality and gender, queerness overall is political. Queer identity has become a political battleground for state policies and public opinion (American Civil Liberties Union [ACLU], 2024; Funakoshi & Raychaudhuri, 2023; Parker et al., 2022). Autism and autistic identity have and continue to experience similar parallels. In research and in mainstream portrayals, there is a long history in the United States of pathologizing marginalized communities, rather than identifying the systemic and root causes of their suffering. Autistic individuals who also identify as nonbinary are subjected to a dual form of “otherness” due to their gender diversity and neurodivergence. Our study begins to uncover the impact of such othering. The development of culturally relevant, strength-based personalized care is critically needed to improve the health outcomes of this historically under-supported group (McQuaid et al., 2023). Care approaches that are designed in collaboration with and endorsed by autistic nonbinary people will effectively meet this group’s most pressing needs (Keenan et al., 2024; Strang et al., 2019).

In addition, it is vital to name and act upon the need for awareness and training on queer autistic identities and their intersection with racial and ethnic identities for clinicians, service providers, and allies of nonbinary autistic people. As reinforced by commentary from our study participants who are people of color, for nonbinary autistic individuals of color, experiences of gender, autism, and race are linked. This connectedness informs their interactions, how they move within society and how they are affected socio-politically. A commitment to understanding intersectionality, that is, the way in which systems and structures of oppression and privilege overlap to impact individuals and groups (Crenshaw, 1991; Mallipeddi & VanDaalen, 2022), is critical to practicing affirmingly while actively mitigating harm to a population that has historically experienced harm on multiple fronts.

While we have concerns about the wellbeing of this population, we do not believe this is a story of despair. Nonbinary autistic participants described pride in their identities and their relationships with others. Connection with a community where members share similar identities can provide a layer of protection against minority stress (Kaniuka et al., 2019; Kleiman & Mournet, 2023; Meyer, 2015). Community not only offers support, validation, and a sense of belonging but also fosters a culture that strengthens collective resolve, and ability to challenge systemic injustices and barriers, and push for social and structural change.

Participants in our study also expressed a need and desire to be a part of communities that embrace both their autism and gender diversity. These environments would enable individuals to fully participate, express themselves authentically and experience support from others navigating similar joys and hardships. This counters the prevailing narrative that parents and families know autistic people best. Peer mentors and social spaces may be more appropriate, especially as adults come to understand that autistic people need opportunities to connect with others with shared experiences and identities (Finke, 2023; O’Connor et al., 2022; Sosnowy et al., 2019).

Limitations

There are several limitations to this study. Due to the use of convenience and snowball sampling, we may have been more likely to interview autistic people with more connections to people and organizations. It may also be that these individuals were the most excited to participate in our study and talk about their identities, especially because many had received late diagnoses recently. Queer and transgender autistic people who are less connected or have less of an opportunity to explore or embrace their identities might be underrepresented in this study and in autism research generally. This includes institutionalized queer and transgender autistic adults. We were unable to purposively sample autistic adults in institutional settings, and those who are primarily non-speaking. We also collected data in a city with robust infrastructure for autistic and queer people. There are likely geographic differences in access to resources, and acceptance, so we urge researchers to focus on nonbinary autistic individuals in rural settings. Given that the majority of individuals identifying nonbinary are currently adolescents (Wilson & Meyer, 2021), we look forward to future research focusing on youth. Similarly, we are eager for quantitative work to complement existing qualitative insights.

Conclusion

Our study used an innovative community-based approach, which allowed for representation of diverse perspectives of nonbinary identity. We find that nonbinary autistic adults see their gender identities as tied to their autistic identities, and that these meanings are situated in structure. Our findings have theoretical implications for how we conceptualize nonbinary identities as being tied to other identities, including disability. It complicates how we see gender identity, and what nonbinary identities mean for individuals, especially those on the margins. Furthermore, it encourages autism researchers to think of how to better serve this population in ways that avoid pathology or oppression. From a programming and policy standpoint, we foremost recommend the creation of more social spaces for autistic people, by autistic people, that are explicitly queer-friendly.

Supplemental Material

sj-docx-1-aut-10.1177_13623613241257600 – Supplemental material for Inextricably tied: Nonbinary autistic individuals’ views on how their gender identity and autism are connected

Supplemental material, sj-docx-1-aut-10.1177_13623613241257600 for Inextricably tied: Nonbinary autistic individuals’ views on how their gender identity and autism are connected by Samuelle Voltaire, Hillary Steinberg, Tamara Garfield, Kyle Chvasta, Katherine Ardeleanu, Maci Brown and Lindsay Shea in Autism

Footnotes

Acknowledgements

We foremost thank the interviewees who contributed to this work for their care and time, and for sharing their viewpoints with us. We also thank the community organizations who believed in this work and partnered with us. Thanks to Anne Roux for her support and feedback.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The Eagles Autism Foundation provided funding for this research. This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under cooperative agreement UT6MC45902 Autism Transitions Research Project. The information, content, and/or conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Institutional review board approval

Drexel University #2205009268.

ORCID iDs

Samuelle Voltaire

Katherine Ardeleanu

Lindsay Shea

Supplemental material

Supplemental material for this article is available online.

Notes

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