The Erasure of Women & Nonbinary People in Autism & ADHD Research
Bridgette Hamstead
For decades, autism and ADHD research has been overwhelmingly centered on cisgender boys, leading to a systemic erasure of women and nonbinary people within neurodiversity discourse. From diagnostic criteria built around male-centric presentations to deeply ingrained biases in both medical and psychological fields, this exclusion has resulted in generations of women and nonbinary individuals being overlooked, misunderstood, and denied access to support. The consequences are profound, ranging from late or missed diagnoses to increased mental health struggles, social alienation, and structural barriers that continue to marginalize those whose neurodivergence does not align with the outdated, male-centered model.
The Origins of the Male-Centric Model
Autism and ADHD research have long been shaped by a fundamental bias: the assumption that neurodivergence is primarily a "male condition." The earliest studies on autism were conducted on boys, particularly those displaying highly externalized behaviors such as repetitive movements, speech delays, and overt social struggles. Similarly, ADHD was historically defined by hyperactivity and impulsivity, traits most commonly observed in young boys. This narrow understanding led to diagnostic criteria that failed to account for the different ways that autism and ADHD manifest in other genders.
Because of this bias, many autistic and ADHD women and nonbinary individuals have spent their lives navigating a world that does not recognize their neurodivergence. Without the ability to fit neatly into diagnostic boxes designed for cisgender boys, they have often been misdiagnosed with anxiety, depression, borderline personality disorder, or other mental health conditions, while their core neurodivergent traits remain unacknowledged and unsupported.
The Masking Epidemic: Why Women and Nonbinary People Go Unnoticed
One of the most significant reasons women and nonbinary people are so often overlooked in autism and ADHD diagnoses is the phenomenon of masking. Masking refers to the conscious or subconscious suppression of neurodivergent traits to blend into neurotypical society. Many autistic and ADHD individuals—particularly those socialized as girls—learn from a young age that their natural ways of thinking, speaking, and behaving are "wrong" or "disruptive." As a survival mechanism, they develop the ability to camouflage their traits, mimicking neurotypical behavior at great personal cost.
For autistic women and nonbinary individuals, this often means forcing eye contact, scripting social interactions, and pushing themselves into social norms that feel unnatural. For those with ADHD, it may involve overcompensating for executive dysfunction by developing elaborate coping mechanisms or internalizing their struggles as personal failures. Because masking is so effective at concealing neurodivergence, many clinicians fail to recognize these individuals as autistic or ADHD, leading to late diagnoses or complete diagnostic neglect.
The emotional and psychological toll of masking is enormous. Constantly suppressing one's true self leads to exhaustion, burnout, and an increased risk of anxiety, depression, and suicidality. Many late-diagnosed autistic and ADHD women and nonbinary people describe a lifetime of feeling "broken" or "defective," only to later realize that their struggles were never due to personal failings, but rather to an unrecognized neurodivergence that had been invisible to a male-centric medical system.
The Harm of Gender Bias in Diagnosis and Treatment
Even when women and nonbinary people are able to receive a diagnosis, they frequently encounter medical professionals who minimize or invalidate their neurodivergence. The stereotype of autism as a "male disorder" and ADHD as a condition of "rowdy boys" means that many healthcare providers remain resistant to recognizing these conditions in individuals who do not fit the traditional profile.
In cases where autism or ADHD is acknowledged, treatment and support options are still largely designed with cisgender boys in mind. Many therapies focus on addressing externalized behaviors rather than the internal struggles that are more common in women and nonbinary individuals. Furthermore, the medical system often fails to account for the ways in which societal pressures—such as gender expectations and discrimination—shape the neurodivergent experiences of these individuals.
For instance, many autistic women and nonbinary people are misdiagnosed with personality disorders or dismissed as "too emotional" when they seek mental health support. Similarly, ADHD individuals who do not display hyperactivity but struggle with executive dysfunction, inattentiveness, or sensory sensitivities are often ignored or told they simply need to "try harder" or "be more disciplined."
The Intersection of Neurodivergence and Gender Identity
The erasure of women and nonbinary people in autism and ADHD research also intersects with larger issues of gender identity and societal expectations. Research has shown that autistic individuals are significantly more likely to be transgender or nonbinary than the general population. However, the lack of gender-inclusive studies and the continued focus on neurodivergence through a cisgender lens leave many trans and nonbinary neurodivergent individuals without the recognition or support they need.
Many trans and nonbinary neurodivergent people report that their neurodivergence and their gender identity are deeply intertwined. However, due to medical gatekeeping, many trans autistic individuals find themselves facing additional barriers to gender-affirming care, with some providers wrongfully assuming that their gender identity is a "symptom" of autism rather than a valid aspect of their selfhood. This further demonstrates the urgent need for a research model that does not rely on rigid gender binaries but instead reflects the full diversity of neurodivergent experiences.
The Need for Inclusive Research and Advocacy
To dismantle the systemic erasure of women and nonbinary people in autism and ADHD research, we must push for a radical shift in both medical and societal perceptions of neurodivergence. This includes:
Expanding Diagnostic Criteria: Medical professionals must update and expand diagnostic frameworks to recognize the full range of autistic and ADHD presentations, including those that are more common in women and nonbinary people.
Centering Lived Experience: Research and advocacy must prioritize the voices of autistic and ADHD women and nonbinary individuals, ensuring that their experiences shape the future of neurodivergence discourse.
Training Healthcare Professionals: Doctors, therapists, and educators must be trained to recognize the diverse ways that neurodivergence manifests across different genders, rather than relying on outdated, male-centric stereotypes.
Addressing the Intersection of Gender and Neurodivergence: Neurodiversity advocacy must actively include trans and nonbinary voices, acknowledging the ways that gender identity and neurodivergence interact.
Conclusion: A Future Without Erasure
The ongoing erasure of women and nonbinary people in autism and ADHD research is not just an academic issue—it is a profound injustice that has left countless neurodivergent individuals struggling without recognition, support, or community. The current diagnostic and medical models are failing those who do not fit the outdated mold of what autism and ADHD "should" look like. It is time to move beyond these limited perspectives and embrace a future where all neurodivergent individuals—regardless of gender—are seen, understood, and supported.
By demanding more inclusive research, better diagnostic frameworks, and a fundamental shift in how we talk about neurodivergence, we can work toward a world where no one is left behind simply because they do not fit a historically narrow and exclusionary definition of what it means to be autistic or ADHD. The future of neurodiversity advocacy depends on ensuring that all voices are heard—not just those that have traditionally dominated the conversation.