What's the link between autism and the LGBTQ+ community? A Highland campaign group discusses why we should be talking about it more
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Talking to people in either autistic or LGBTQ+ spaces, it may come as a surprise to find that few bat an eyelid if the topic of an overlap between the two communities is broached.
Many LGBTQ+ people will have stories of either being diagnosed or self-identifying with some form of neurodivergence.
With estimates of between one and two per cent of the population being specifically autistic, and latest census data showing that just over three per cent of the population identifies as LGBTQ+, it seems statistically unlikely that there would be a big crossover.
However, academic studies show that there is a connection. The University of Cambridge published a study in 2021 that showed significantly higher rates of asexuality (more than 6.5x), bisexual men (2.7x), gay women (more than 3x), other sexualities (6.8x) and gender diversity (6x) among autistic people compared to non-autistic people.
In fact, compared to 83 per cent of non-autistic people who described themselves as straight, the figure amongst autistic people was just 63 per cent.
The study’s authors concluded that: “Our findings bolster previous evidence that autistic individuals identify with a wider range of sexual orientations than others… suggesting that autistic adults do not conform to the same sex-specific patterns of sexual orientation observed in the general population.”
Similarly, datasets gathered for the 2018 television documentary "Are You Autistic?" showed that gender diverse people are between three-and-a-half and six times more likely to have an autism diagnosis compared to the rest of the population.
Scholars admit it is difficult to pinpoint exactly why this is the case. Autistic people may be less influenced by social norms and cues and so may present more authentically, or they may think differently about their gender and sexual identity.
Biological factors for both neurodivergence and gender and sexuality are much debated, but no consensus has been drawn. The most likely "reason" is a combination of all of those factors.
At a more accessible level, though, anecdotal evidence supports what those studies have found, as LGBTQ+ members of the Autism Rights Group Highland (ARGH) committee discuss.
"I think if I went into an autistic space and there were no other people from the LGBTQ+ community there, I would be wondering where they dug these people out from," Kabie Brook said.
"It's kind of just the typical thing. Autscape is an annual gathering of autistic people in the UK, and when you go you see people of all genders and sexualities.
"It would be really odd to be in an autistic space where there were just straight people."
SJ Groenewegen continued: "I have read some people theorising, particularly with gender fluidity, that autistic people can find it a bit easier to throw off what society expects.
"It's an enormous topic. You could devote lifetimes to trying to work through it, but anecdotally it's astonishing how many people I worked with in the LGBTQ+ sector who have also subsequently discovered that the chance of them being autistic is quite high."
Kabie added: "For me, and for some other people that I've spoken to, when you're autistic you know you're different from birth.
"It's really obvious because of how you're doing things 'wrong' in peoples' minds. Sometimes you think that if you're getting all these things wrong then all these other 'norms' are wrong too.
"If you don't fit into a box with neurology, maybe it's more okay to not fit into a box at all. If you're going to be persecuted for being different anyway, you might as well be yourself."
While the root of the overlap is not understood well, there are also strong parallels in the experience of realising and embracing you are autistic and LGBTQ+.
Both are stigmatised, with practices in place to try and force LGBTQ+ and autistic people to become more “normal”. In fact, early research and developments of LGBTQ+ conversion therapy and applied behavioural therapy for autistic people share a common name which led to crossover in some of the abusive practices used.
Both have been pathologised, with homosexuality only being declassified as a mental disorder in the 1990s and being trans only being declassified in 2019.
Both groups are targets of bullying while growing up, both require introspection by people in those communities, and both come in for criticism due to rising numbers – in autism's case of diagnoses, and for the LGBTQ+ community of people identifying with part of the acronym.
That criticism has even been seen in Holyrood, with equalities, migration and refugees minister in the Scottish Government Emma Roddick recalling: "I found over the GRR debate in particular that there were a few comments about autistic people identifying as trans, and suggestions that they don't know their own minds because they are autistic.
"It was quite difficult to listen to at times, and there were a few comments that got some traction on Twitter because people were offended at that suggestion."
Such negativity also speaks to the importance of talking about them both individually and the intersections between the two communities.
"A lot of people probably still think they know what autism is when they don't," Graeme Thomson-Gold explained.
"People aren't necessarily being over-diagnosed. It's becoming more widely understood, and therefore more is known about it, which means that people are starting to put two and two together more often.
"I got bullied all the way through school, and at that time I thought it was because I was gay. It's only now I realise that being autistic was probably a big part of it.
"Even I'm seeing how my understanding has been opened up by realising I'm autistic."
SJ said: "In autistic circles there is masking and suppression, and staying in the closet is obviously a thing in the LGBTQ+ community, so there is all sorts of similar terminology for different things. That opens up conversation so that we can talk about these things."
Kabie reasoned: "Some people say that you can't know what you are until you have a name for it, which is a bit simplistic, but I do think that knowing there are other people out there like you is really helpful.
"It's not an explosion in people deciding they are this or that, it's an explosion in people having the language to describe how they feel. That has really helped people's mental health to know that they can be pansexual or asexual, and that that's a real and totally legitimate thing."
While knowing, understanding and embracing autism diagnoses and LGBTQ+ identities can literally be life-savers with the impact it has on mental health, issues can crop up in simply accessing healthcare.
This was acknowledged by the authors of the University of Cambridge study referenced earlier, who wrote: “The sexuality and experiences of autistic individuals may have significant implications for healthcare, as studies suggest that intersectionality of autism and being LGBTQ+ may result in worse mental health symptoms, worse overall health, and lack of adequate healthcare (even including being refused healthcare) likely due to institutionalised sources of marginalisation (eg inadequate insurance coverage for healthcare needs) and minority stress."
That ties into the work that ARGH do, in particular around obtaining a diagnosis of autism.
"Being able to create a sense of identity is really important – that's one of the reasons we're so fixed on people being able to get an assessment for autism, to understand who they are," Kabie stressed.
"When we go to an autistic space, it is quite normal to have gender diversity and lots of different sexualities. Unfortunately, when you move to the medical community or diagnostic services they just don't understand it.
"It's like their mind is blown if you're not out of the textbook, so talking about it is very important because there's a lot of catching up to do.
"I know a trans woman who went to get an assessment for autism and was told they don't deal with trans people. Then there are people presenting to gender clinics who are being told that they just think they are trans because they are autistic.
"The underlying core to both of those things is equity of access to services.
"The autistic population does die younger, we are more likely to have a disability and we are more likely to be LGBTQ+. Intersectionality is really important, and that gets forgotten by services who don't want to deal with you if you're too much of a real person.
"It's all part of societal prejudice and misunderstanding. We're discriminated against all the time."
SJ said: "I ended up going private and I found a place that was specifically for adults and was very actively inclusive of LGBTQ+ identities, which was really important to me.
"Across the services, I'll be lucky if I get people who are okay with it, but the default is a really strange, fictional version of reality.
"It lifted such a huge weight off my shoulders knowing I didn't have to worry because they were more than capable of asking me to explain, instead of everyone working on assumptions and getting things wrong.
"The word that keeps cropping up in my mind is the tendency to infantilise autistic people in particular. That does also overlap with particularly the gender side of the queer rainbow.
"It's like it's impossible for us to make up our own minds, and that's a really strong undercurrent that actually comes to the surface quite often. It's been politically weaponised."
Graeme added: "Not knowing who you are, or why you are in some ways, is linked to understanding why you feel and behave in certain ways and processing that.
"Like a lot of autistic people, my anxiety is constant. I've looked to get help previously with different types of therapy, but because we were missing the fact that I am autistic the way they were approaching it didn't work.
"There are lots of bits that make up me. If I start to understand those bits, at least I have a better understanding of what I'm working with.
"It's not a magic bullet, but being able to articulate what you are and who you are is fundamentally important and it does make a huge difference."
That is something that Emma is conscious of too, as she added: "No experience negates your identity, so it's just about letting people have the opportunity to realise that. You're never going to be as happy as you could be if you don't know who you are.
"We're getting quite good now at talking about disability competence and embedding that into systems so that people aren't being treated like they're the weird ones. It's about getting that for LGBTQ+ people as well, because you will be LGBTQ+ and need to access services and have other challenges, like being disabled or seeking refuge.
"Folk have to be aware that it's possible that the person you're speaking to isn't straight and cisgender, and not assuming that or making people feel like the service isn't for them because of it.
"That's really what we're trying to do with mainstreaming and the public sector equality duty – it's making sure that these aren't add-on tick boxes at the end, but that equality is normal and something you don't have to put much effort into. It can just be part of the process of designing any policy or any service."
Those concerns over access and quality of healthcare were also echoed by the University of Cambridge’s study, whose authors wrote: “Currently, autistic individuals overall report lower satisfaction and self-efficacy within healthcare, as well as higher odds of unmet healthcare needs than others; and LGBTQA+ autistic individuals may be particularly vulnerable to worse mental and physical health, as well as inadequate healthcare.
“Providers should also be aware that autistic individuals may be more likely to identify with a wider spectrum of genders and sexualities, and their language should be affirming and inclusive of all these identities, particularly when discussing sexual education, sexual health, and consent. Psychiatrists should also be aware of possible intersectionality between gender, sexual orientation, and/or disability, as their autistic patients may be particularly likely to experience mental or physical health problems due to discrimination and minority stress.”
While there is fledgling research into the overlap between autism and being LGBTQ+, it is still a very much developing topic.
That is helped by some of the work ARGH does, like webinars and conferences and crossover work with local authorities and the Scottish Government.
With feet in both camps, then, the committee members are perhaps uniquely placed to advise on what future steps should be taken to improve things for LGBTQ+ people with autism.
"I've had a good experience, which proves that it can be done – to the rest, it just requires communication," SJ noted.
"For me, it's about not shutting down conversations that have opened up, which is what is happening particularly in the United States but in the UK as well.
"Closing off all of that suppresses what is a really healthy thing – uncomfortable, but in a really healthy way – to be talking about it and trying to work stuff out.
"When a label emerges, and it's not quite the right one, that's okay as long as we can have conversations about it and work out what a good way is. None of this is neat and tidy, but that's just the way humans are."
Kabie suggested: "Sometimes you do hear people talking about intersectionality, but it's just words.
"We need to be able to access services, say who we are and be believed. We need to have people work with us, instead of saying we don't fit in here or we should go to this specialist service which is actually a very narrow thing."
Graeme added: "Nobody really has an understanding, especially in healthcare places.
"It would be useful for LGBTQ+ people to know a bit about autism as well so that it can become more accessible and people can talk about it.
"There are spaces where people should know more about this, and it's where these things overlap."
