The Hidden Link: Why We Need Better Education on Neurodiversity and Identity

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A Brief Explainer (from me, Troy) Before We Begin the Main Article

Throughout 2025, I found myself reflecting deeply on the intersection of identity and neurodivergence. I’m proud to share this led me to six months of psychotherapy: my own choice, my own investment (cost an absolute fortune). I enjoyed it so much I’ve signed up for another six monthly sessions in 2026. I highly recommend it to anyone, whether you think you need it, can afford it, or not. ;)

This white paper emerged from that reflection: unpacking memories from the 70s and 80s, revisiting joyful childhood moments and difficult ones, making peace with what the younger, undiagnosed version of me, my family, and those around us have navigated since.

Through this process, I’ve realised that questions of identity and neurodivergence aren’t abstract. Take my and Oscar’s ADHD diagnosis in 2023 (Oscar then 9, me 48). I knew very little about neurodiversity before then. Now I’m acutely aware of how it changes and morphs in just about every case. Some presentations resemble Bart Simpson (me as a 10-year-old), some Lisa, Marge, Homer, even Maggie, and every other resident of Springfield. Or Modern Family, Full House, Third Rock from the Sun, Friends. The list goes on.

Today, I’m seeing the same struggles persist, particularly around neurodivergence and identity, just wearing different shapes and sizes.

I want to be clear: my experiences don’t make me an authority on anyone else’s journey. Each person has their own story, timetable, and truth. Some may even question whether I should speak on this at all. But since my diagnosis, I’ve recognised that much of what we’ve inherited as “truth” came from an archaic age of narrow perspectives: binary categories imposed on a spectrum reality.

The younger generations are showing us a more evolved path forward, one that embraces complexity rather than accepting or forcing simplicity. I offer these words with humility, speaking to those living this reality in a world still learning to listen.

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The Missing Link - Why ( I think ) We Need Better Education on Neurodiversity and Identity

By Troy Lowndes

What happens when two misunderstood experiences intersect inside an overburdened, neglected system that nobody is equipped to understand, let alone support?

Take me: I stumbled into understanding neurodivergence the same way many parents do - through my son. Three years ago, in 2023, at age 48, I effectively received my ADHD diagnosis on the same day as my then 9‑year‑old, Oscar, even though mine wasn’t made official until six months later. With Oscar’s assessment, a lifetime of “different” finally made sense. But what if that understanding had come earlier? What if the systems meant to support young people actually understood how neurodivergence and identity can often intersect?

For instance: Recent research reveals something striking: young people exploring gender identity are 3-6 times more likely to be autistic than the general population (Warrier et al., 2020). The UK's Tavistock gender clinic reported 35% of referred youth had possible autism spectrum conditions, far above the typical 1-2% baseline.

But here's the question nobody's asking: Are we measuring real prevalence, or are we just seeing who gets diagnosed?

The Diagnostic Desert

Here's what we know about neurodivergence diagnosis rates:

•       Autism: Diagnosed in 1-2% of the population, but prevalence studies suggest the true rate is 2-3% or higher

•       ADHD: Diagnosed in 2-5%, but research indicates 5-8% prevalence

•       For women and girls: Diagnosis comes 5-10 years later than for men, if at all

•       For adults: Most remain completely undiagnosed

Think about that for a moment. We're missing at least half of neurodivergent people. They're navigating life (including major identity questions) without understanding their own wiring.

What If the Data Tells a Different Story?

Gender clinics often conduct far more comprehensive psychological assessments than most other healthcare settings, and for many young people a gender clinic referral becomes the first time anyone looks properly at their broader neuro developmental profile.

So when there’s "high rates" of autism reported in gender clinics, we might actually be seeing:

•       Diagnostic access, not true difference: Gender-diverse youth get assessed; their cisgender ND peers don't

•       Selection bias: Young people seeking specialist care already have high self-awareness and health engagement

•       The first room where someone finally notices: These aren't "complicated cases." They're undiagnosed ND people finally encountering thorough evaluation

The critical question shifts: Are gender-diverse people more neurodivergent, or just more likely to be in rooms where clinicians pay attention to it?

Why the Overlap Actually Makes Sense (And Why It’s So Hard to Accept)

As a late-diagnosed neurodivergent person, I can tell you something that the research confirms but many struggle to accept:

the overlap between neurodivergence and gender diversity isn’t a bug. It’s a feature.

The Neurodivergent Lens on Gender

Research shows that autistic individuals can offer novel insights into gender as a social process precisely because of their neurological differences and reduced social conformity pressure. When you don’t automatically absorb society’s gender scripts, something profound happens: you have space to figure out who you actually are.

Here’s what the lived experience looks like:

Pattern recognition over social performance: Autistic people excel at pattern recognition while often finding social scripts exhausting. When “doing gender” feels like an arbitrary performance rather than an authentic expression, you start questioning the entire framework.

Literal versus performative: Many autistic people describe how confusing and emotionally taxing “doing gender” is. The unspoken rules, the constant performance, the expectation to conform to stereotypes that don’t match internal experience. When you’re already struggling to understand why everyone else seems to know the rules you weren’t taught, gender becomes one more confusing script.

Reduced group identification: Research shows autistic adults, on average, identify less with gender groups compared to neurotypical adults. It’s not confusion. It’s clarity about what feels authentic versus what feels like social pressure.

The concept of “gendervague” captures this beautifully: neurodivergence doesn’t cause gender diversity, but it fundamentally shapes how we understand and experience gender. When you see through social constructs more readily, prioritize internal experience over external expectations, and don’t unconsciously perform neurotypical gender scripts, your relationship with gender looks different.

Why This Makes People Uncomfortable

The political stakes are massive. On one side, progressives fear acknowledging the link will fuel gatekeeping (which it has). On the other, conservatives use it as evidence that gender diversity isn’t “real,” just autism causing confusion.

But here’s the fundamental question: Do we trust neurodivergent people to know themselves?

If YES, the overlap makes perfect sense. Reduced social conformity pressure plus heightened self-awareness equals more authentic gender expression.

If NO, the overlap looks like “vulnerability” requiring protection from their own experiences.

The Data Supports Both… Depending on How You Frame It

Medical/deficit model: “Autism causes confusion about gender” (pathologizing both conditions)

Social/neurodiversity model: “Reduced conformity to arbitrary social norms enables authentic gender exploration” (celebrating both)

Same data. 180-degree different interpretation.

Recent research reveals it’s not autism diagnosis that correlates with gender diversity, it’s autistic traits. The way of experiencing the world. The dimensional characteristics, not the categorical label.

Gender-diverse people show, on average, higher autistic traits including sensory sensitivities, pattern-recognition skills, and different approaches to social connection. These aren’t deficits. They’re different ways of processing the world.

The Diagnostic Access Paradox

Here’s the irony: 24% of gender-diverse people in studies have autism diagnoses, versus 5% of cisgender people. Critics see this as proof of vulnerability.

But remember our diagnostic desert? Most neurodivergent people never get diagnosed. So this might actually show that gender services are one of the few places conducting thorough psychological assessments.

What looks like “high autism rates in gender clinics” might actually be “one of the few places ND people finally get properly assessed.”

Binary Thinking Can’t Handle This

Most people want either/or:

- Either ND OR gender-diverse (not both)

- Either “caused by” OR “unrelated to” (not “interrelated with”)

- Either “protect” OR “affirm” (not “support complexity”)

This is exactly where my Spectral Binary framework becomes essential. Things can be dimensional rather than categorical. Multiple factors can interact without one “causing” another. Coherence doesn’t require forcing simplicity.

My Triple Lens

As someone diagnosed at 48 after decades of navigating the world without a framework, then spending 2.5 years in therapeutic work understanding it, I bring three perspectives most people arguing about this don’t have:

1. **Decades of undiagnosed experience**: I know what it’s like without the framework

1. **Post-diagnosis reframing**: I can see the patterns retrospectively

1. **Therapeutic integration**: I’ve done the deep work to understand how it all connects

From this vantage point, the overlap isn’t controversial. It’s obvious.

When you don’t automatically absorb and perform social gender scripts, you have space to actually figure out who you are. That’s not confusion. That’s clarity emerging from reduced noise.

What This Means for Education

The resistance to accepting this link isn’t about the data. It’s about:

- Fear of political misuse

- Discomfort with complexity

- Distrust of neurodivergent self-knowledge

- Investment in binary thinking

- Lack of lived experience

This is why education is so critical.

Not education that chooses between “autism causes gender confusion” versus “they’re completely unrelated.” But education that understands: neurodivergence creates different pathways to authentic self-understanding, including about gender.

That’s the framework families need. That’s the lens clinicians need. That’s the support young people deserve.

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The Education Gap Nobody Talks About

Right now, families and medical teams are making high-stakes decisions about young people's wellbeing without fundamental literacy in the conditions they are navigating.

Parents Typically Receive:

•       A diagnosis label (if they're lucky)

•       Photocopied information sheets

•       Maybe a referral to services with 2-3 year waiting lists

•       Essentially zero framework for understanding how autism or ADHD intersects with gender exploration

Medical Teams Carry:

•       2-4 hours of autism training across their entire medical degree

•       Even less on ADHD

•       Minimal cross-training between neurodevelopment and gender specialties

•       No standardised tools for ND-adapted gender assessment

The result? Autistic communication styles get misread as clinical uncertainty. A detailed, chronological account of gender feelings gets interpreted as "intellectualising" rather than potentially recognised as autistic processing. Need for extra time becomes "evidence of doubt."

Real Consequences of Misunderstanding

Consider these scenarios:

Without ND education:

•       Parents can often struggle to distinguish sensory dysphoria from gender dysphoria

•       Clinicians interpret flat affect as ambivalence about gender (rather than autistic presentation)

•       Stimming gets read as "anxiety about transition" (rather than self-regulation)

•       Direct communication seems "too certain too quickly" (rather than autistic preference for clarity)

•       Young people wait years for sequential assessments while suffering without support for either condition

With integrated education:

•       Early ND identification alongside gender exploration

•       Accommodations that actually help (sensory-friendly appointments, written summaries, concrete questions)

•       Support for both experiences simultaneously, not one-at-a-time gatekeeping

•       Communication styles recognised and respected rather than pathologised

The Numbers Tell a Stark Story

From the Cass Review and recent UK practice:

•       Gender clinic waiting times: 3-5 years in many regions (globally).

•       Post-Cass policy requiring autism assessment before gender care progresses

•       Young people left without adequate support for either condition during assessment limbo

•       35% of gender-referred youth with ND traits, but services designed for neurotypical presentation

And the research gaps are massive:

•       Most assessment tools never validated with neurodivergent populations

•       We don't know long-term outcomes for ND individuals who transition vs. those who don't

•       No consensus on what "persistent gender identity" looks like in autistic communication styles

•       Minimal understanding of how ADHD affects gender exploration (far less studied than autism)

What Actually Needs to Happen (My View)

The solution isn't more gatekeeping. It's better understanding. We need:

For Parents:

Integrated psychoeducation covering:

•       How sensory sensitivity affects body awareness and clothing choices

•       Why special interests might intensify around identity exploration

•       The difference between masking ND traits and managing gender presentation

•       How to distinguish overlapping distress sources

•       Advocacy skills for systems that pathologize both conditions

For Clinicians:

Cross-training that includes:

•       Recognising ND communication patterns without penalising them

•       Understanding that processing time ≠ uncertainty

•       Differentiating sensory dysphoria from gender dysphoria from social rejection

•       Providing accommodations (longer appointments, written materials, concrete questions)

•       Capacity assessment that doesn't pathologise neurodivergence

For Young People:

Self-advocacy tools that help them:

•       Understand their own ND profile

•       Build vocabulary for internal experiences (especially with alexithymia)

•       Prepare for clinical appointments

•       Communicate effectively despite communication differences

•       Access peer support from the intersection community

The Research We're Missing

Here's what MN many don't know, and desperately need to understand:

When actively screening for autism in gender-diverse youth: prevalence 22.5%. When screening age-matched controls: prevalence 5.2%. But controls received brief screening, not comprehensive clinical assessment.

Strang et al., 2018

If we gave cisgender youth the same assessment depth, would we find similar "hidden" neurodivergence?

We need:

•       Longitudinal studies tracking ND individuals' wellbeing across different support pathways

•       Research on how ADHD (not just autism) intersects with gender identity

•       Validation of assessment tools with ND populations

•       Studies examining diagnostic access patterns, not just clinical prevalence

What This Means for Me (Troy) and My Ongoing Work at ToneThread

My evolving work on emotional tone analysis through the Spectral Binary framework (Warmth, Certainty, Intensity, Coherence) suddenly becomes critically relevant here.

Traditional clinical assessment relies on neurotypical communication patterns. When clinicians can't accurately read an autistic person's emotional coherence or certainty, they:

•       Misinterpret flat affect as ambivalence

•       Read stimming as anxiety rather than regulation

•       Mistake direct communication as "too certain"

•       Confuse processing time needs with doubt

Communication translation tools could provide the layer these assessments desperately need.

Why This Matters Now

Millions of undiagnosed neurodivergent people are making major life decisions (about identity, relationships, careers, health) without understanding their own wiring. Some are exploring gender. Many aren't. All deserve better.

The overlap between neurodivergence and gender diversity isn't a problem to solve. It's an intersection to understand and support.

The question isn't whether someone is "really" autistic or "really" trans. It's whether we can provide literate, compassionate support for the full complexity of who they are.

For the young people currently in gender services, for their families navigating without frameworks, for clinicians practicing beyond their training: education is the intervention that makes everything else possible.

Key Statistics at a Glance

•       3-6x: Higher autism rates in gender-diverse populations (Warrier et al., 2020)

•       35%: Youth in Tavistock gender clinic with possible autism (Carmichael et al., 2021)

•       60%+: Estimated percentage of autistic individuals undiagnosed globally (Zeidan et al., 2022)

•       2-4 hours: Total autism training in typical medical degree (Gillberg et al., 2010)

•       3-5 years: Current gender clinic waiting times in many regions (Globally).

•       40%: Reduced assessment time with ND-adapted protocols (Strang et al., 2018)

Further Reading

Full white paper: Bridging the Diagnostic Gap: Integrated Neurodivergence and Gender Identity Education for Families and Clinical Teams - linked here.

Key research:

•       Warrier et al. (2020) - Large-scale study, Nature Communications

•       Strang et al. (2018) - ND youth gender trajectories, Journal of Autism and Developmental Disorders

•       Cooper et al. (2020) - Systematic review, European Child & Adolescent Psychiatry

•       Cass Review (2024) - Independent review of UK gender services.

About the Author

Troy Lowndes is a neurodivergent systems analyst and creator of ToneThread, developing emotional tone analysis tools through a Noval Spectral Binary framework. Diagnosed with ADHD at 48 alongside his son Oscar, Troy brings 25+ years of technology experience and 2.5 years of focussed therapeutic collaboration to understanding communication at the intersection of neurodivergence and identity.

Connect: www.tonethread.com

This blog post summarises research and recommendations from a comprehensive white paper on neurodivergence and gender identity education. All statistics cited from peer-reviewed sources. Full references available in the complete white paper.