Speaking the Truth About Autism, Gender, and Suicide: My UN Experience
Bridgette Hamstead
Earlier this year, I had the privilege of representing the United States on an expert panel for the United Nations’ World Autism Day. The panel posed a critical question: What challenges do autistic individuals face due to societal norms and gender roles enforced by culture and tradition? As an autistic woman, parent, and advocate, I was deeply committed to answering this question with the honesty and urgency it deserved.
In my response, I spoke about the unique barriers faced by autistic girls, women, and gender-diverse individuals. I highlighted the ways underdiagnosis, masking, and societal expectations contribute to higher rates of anxiety and depression. I also addressed how healthcare systems often fail to provide gender-affirming care for autistic trans, non-binary, and gender non-conforming individuals, exacerbating their mental health struggles. Finally, I touched on a topic that is often avoided in public conversations: the prevalence of suicide within these marginalized groups.
When the United Nations released the panel discussion to the public, I discovered that my mention of autistic suicide had been removed. At first, I was heartbroken. Suicide is a critical issue in the autistic community, and ignoring it perpetuates the silence that allows the crisis to continue. The decision to censor this part of my response felt like a dismissal of the very lives I was trying to advocate for.
But I realized something else: censorship is often a reaction to discomfort. My words named a painful but necessary truth—one that challenges systems and narratives that prioritize convenience over justice. While my statement may have been erased in that moment, the issues I raised are too urgent to be ignored.
This article delves into my answer to the panel question, including the censored portion. It explores the systemic challenges faced by autistic girls, women, and gender-diverse individuals and examines the broader impact of these barriers on mental health, including suicide. It also highlights the changes we need across healthcare, education, and society to address these inequities and create a safer, more inclusive world for autistic people.
These conversations are uncomfortable, but they are vital. Let’s break the silence and confront the systemic failures that harm autistic individuals—and commit to building a world that values and supports every one of us.
Understanding Autism Through the Lens of Gender
Autism is often misunderstood, with societal perceptions shaped by neurotypical, male-dominated perspectives. Diagnostic criteria and public narratives about autism have historically focused on behaviors observed in boys and men, creating a narrow and incomplete understanding of what it means to be autistic. As a result, the unique experiences of autistic girls, women, and gender-diverse individuals are frequently overlooked, leaving them underdiagnosed, misunderstood, and unsupported. These gaps in understanding perpetuate systemic inequities that deeply impact mental health, social inclusion, and quality of life.
One pressing question demands our attention: What challenges do autistic individuals face due to societal norms and gender roles enforced by culture and tradition? The answer reveals a complex interplay of biases and barriers. For autistic girls and women, the societal expectation to conform to traditional gender roles compounds the stress of masking, often leading to higher rates of anxiety and depression. For autistic trans, non-binary, and gender non-conforming individuals, the intersection of autism and gender diversity creates additional layers of discrimination, limiting access to essential care and exacerbating feelings of isolation and misunderstanding.
This article explores how gender intersects with autism to create these unique challenges. We’ll examine the systemic factors that perpetuate these inequities and the urgent need for change across education, healthcare, and social systems. From the underdiagnosis of autistic girls to the barriers faced by gender-diverse individuals seeking affirming care, this is a story of marginalization—but also one of resilience and the potential for transformation.
By confronting these inequities head-on, we can begin to dismantle the harmful norms and structures that exclude so many autistic individuals. This is not just about addressing gaps in support; it is about reimagining a world where every autistic person, regardless of gender, is valued, empowered, and celebrated for who they are.
The Overlooked Experiences of Autistic Girls and Women
Underdiagnosis and Misdiagnosis
For decades, autism diagnostic criteria have been based primarily on research conducted with boys, creating a framework that often fails to recognize how autism manifests in girls. Traits commonly associated with autism—such as difficulty with social communication or repetitive behaviors—may present differently in girls, who are often better at mimicking social norms or masking their challenges. This discrepancy leads to significant underdiagnosis or misdiagnosis, with many autistic girls being incorrectly labeled with anxiety, depression, or even personality disorders rather than receiving the correct diagnosis. Without this recognition, they are denied access to the supports and accommodations that could help them thrive.
Adding to this challenge, societal expectations often socialize girls to suppress their autistic traits. From a young age, they are taught to be nurturing, agreeable, and socially adept—qualities that may not come naturally to many autistic individuals. This socialization can make their autism less visible to clinicians and educators, further complicating the diagnostic process and leaving countless autistic girls to navigate their challenges alone.
The Burden of Masking
Masking, or the deliberate suppression of autistic traits to blend into neurotypical social environments, is a survival strategy that many autistic girls and women adopt. This might involve forcing eye contact, stifling stimming behaviors, or carefully rehearsing social interactions to appear “normal.” While masking can help autistic individuals avoid bullying or social exclusion, it comes at a steep cost.
The chronic effort required to mask can lead to profound emotional and physical exhaustion, often referred to as autistic burnout. Over time, masking can contribute to serious mental health challenges, including anxiety, depression, and a diminished sense of self. Many autistic women describe masking as living a double life, one that forces them to suppress their authenticity to gain acceptance. This relentless burden highlights the urgent need for societal change to create spaces where autistic individuals can exist without fear of judgment or rejection.
Social and Educational Challenges
In social and educational settings, autistic girls often face unique challenges that are dismissed or misunderstood due to stereotypes about gender and behavior. Unlike boys, who may exhibit more visible traits like hyperactivity or difficulty with transitions, autistic girls are often perceived as “shy,” “quiet,” or “well-behaved.” These assumptions mask their struggles, leading teachers and administrators to overlook their need for accommodations or support.
For instance, an autistic girl who struggles with sensory overload in a noisy classroom might be seen as withdrawn or unengaged rather than overwhelmed. Similarly, difficulties with group projects or peer interactions may be attributed to shyness rather than recognized as social communication challenges. Without proper recognition and intervention, these girls are left to navigate environments that are neither understanding nor supportive, exacerbating feelings of isolation and hindering their academic success.
Workplace Discrimination
The challenges faced by autistic women do not end in childhood; they follow them into the workplace. Gender biases and neurodivergent stigma often intersect to create significant barriers in hiring, career progression, and workplace inclusion. Employers may misinterpret the traits of an autistic woman—such as a preference for direct communication or difficulty with small talk—as a lack of social skills or enthusiasm.
Once hired, many autistic women encounter workplaces that are ill-equipped to accommodate their needs. Sensory-unfriendly environments, rigid schedules, and unspoken social expectations make it difficult for them to succeed. This lack of support often leads to financial instability and reduced career satisfaction, as autistic women are either underemployed or pushed out of roles that fail to recognize their potential.
Lack of Representation
One of the most pervasive challenges for autistic girls and women is their lack of representation in research, advocacy, and media. For much of history, autism has been portrayed through the lens of neurotypical boys, leaving the experiences of women and girls invisible. This erasure perpetuates harmful stereotypes and limits public understanding of how autism manifests across genders.
In advocacy spaces, autistic women are underrepresented, leaving their needs and perspectives overshadowed by male-centric narratives. Similarly, the absence of diverse autistic women in media and popular culture reinforces the misconception that autism is primarily a male experience. This invisibility not only denies autistic women the resources and recognition they deserve but also limits opportunities for others to see themselves reflected and validated.
Intersectional Challenges for Autistic Trans, Non-Binary, and Gender Non-Conforming Individuals
The Intersection of Autism and Gender Diversity
Autistic individuals are significantly more likely to identify as trans, non-binary, or gender non-conforming compared to the general population. Research consistently highlights this higher prevalence, yet the intersection between autism and gender diversity remains poorly understood. This lack of awareness leaves many autistic gender-diverse individuals navigating a world that is not only uninformed but actively dismissive of their experiences.
One of the primary challenges is the absence of robust research on this intersection. Much of the medical and psychological understanding of gender diversity is rooted in neurotypical experiences, failing to account for how autism might shape or inform a person’s understanding and expression of their gender identity. This gap in knowledge contributes to widespread misunderstandings among healthcare providers, educators, and even families, leaving autistic gender-diverse individuals without the support they need to thrive.
Barriers to Gender-Affirming and Neuro-Affirming Care
For autistic trans, non-binary, and gender non-conforming individuals, accessing affirming care is often a fraught and frustrating process. Healthcare systems frequently fail to provide both gender-affirming and neuro-affirming services, forcing individuals to navigate a patchwork of resources that may not fully meet their needs.
One significant barrier is the skepticism many healthcare providers express about the validity of gender identities in autistic individuals. Some providers wrongly attribute gender diversity to autism itself, assuming that autistic individuals are "confused" or "unable to understand" their gender identity. This prejudice can lead to delays or outright denial of gender-affirming treatments, exacerbating gender dysphoria and increasing feelings of invalidation and distress.
The impact of these healthcare failures is profound. Without access to affirming care, autistic gender-diverse individuals often experience heightened isolation and stress. Dysphoria may worsen in the absence of support, and the constant fight for recognition and treatment can take a toll on mental and emotional well-being.
Stigma and Societal Discrimination
Autistic trans, non-binary, and gender non-conforming individuals face compounded stigma at the intersection of their identities. In a world that already marginalizes autistic people and gender-diverse individuals separately, those who inhabit both identities often encounter amplified rejection and misunderstanding.
In social spaces, they may face exclusion from peers who struggle to accept their gender identity or dismiss their autism as a legitimate part of who they are. Within medical and family contexts, they may be pressured to conform to societal norms, with their gender diversity dismissed as a “phase” or blamed on their autism. This pervasive invalidation can make it difficult to find safe and supportive environments, leaving many feeling isolated and misunderstood.
Mental Health Outcomes
The combination of autism, gender dysphoria, and societal discrimination has devastating effects on mental health. Autistic trans and gender-diverse individuals experience significantly higher rates of anxiety, depression, and stress-related disorders compared to neurotypical and cisgender peers. The chronic stress of navigating a world that invalidates their identities can lead to burnout and a sense of hopelessness.
For many, these mental health challenges are exacerbated by the lack of accessible, affirming care and the constant need to advocate for their right to exist authentically. Without systemic change, these individuals will continue to face barriers that compromise their well-being and limit their ability to live fulfilling lives.
The Silent Crisis: Autistic Suicide Among Women and Gender Minorities
One of the most devastating consequences of the systemic barriers faced by autistic individuals—particularly women and gender minorities—is the alarmingly high rate of suicide within these communities. Research indicates that autistic individuals are significantly more likely to experience suicidal thoughts and behaviors than the general population, with autistic women and gender-diverse individuals at even higher risk. This crisis is deeply intertwined with the challenges discussed in this article, including underdiagnosis, masking, societal discrimination, and a lack of affirming supports.
For autistic women, the constant pressure to mask their traits and conform to societal expectations can lead to profound exhaustion and a sense of invisibility. Many autistic women describe feeling trapped in a world that dismisses their struggles as mere shyness or sensitivity, leaving them without validation or support. The emotional toll of living inauthentically, combined with a lack of accommodations in school, work, and healthcare, often results in feelings of hopelessness and despair.
For autistic trans, non-binary, and gender non-conforming individuals, the intersection of autism and gender diversity creates additional vulnerabilities. These individuals frequently encounter skepticism or outright rejection of their identities, both as autistic people and as members of the gender-diverse community. The compounded stigma they face in healthcare, education, and social spaces can lead to isolation and a lack of access to gender-affirming care. Gender dysphoria, when combined with the sensory and social challenges of autism, can exacerbate mental health struggles, increasing the risk of self-harm and suicide.
A lack of awareness and understanding among healthcare providers further worsens this crisis. Many mental health professionals are untrained in recognizing how autism affects emotional regulation or in understanding the unique needs of autistic individuals who are also gender-diverse. This gap in care leaves many without the support they need, forcing them to navigate these overwhelming challenges alone.
To address this silent crisis, society must take a multifaceted approach. First, we need to expand mental health services that are both neuro-affirming and gender-affirming, ensuring that autistic women and gender-diverse individuals have access to therapists and programs tailored to their needs. Additionally, increasing research into the unique mental health experiences of autistic women and gender minorities is critical to developing interventions that work.
Just as important is creating inclusive environments where autistic individuals feel valued and supported. Schools, workplaces, and community spaces must adopt policies and practices that prioritize mental health and provide safe spaces for autistic people to express themselves authentically. Efforts to dismantle societal stigma and improve representation in media and advocacy will also play a crucial role in reducing feelings of isolation and validating the experiences of autistic women and gender-diverse individuals.
The high rates of suicide among autistic women and gender minorities are a stark reminder of the urgent need for systemic change. This issue cannot remain in the shadows. By addressing the interconnected barriers discussed in this article—healthcare gaps, educational inequities, workplace discrimination, and cultural stigma—we can create a society that not only reduces these risks but also fosters hope, belonging, and a sense of purpose for all autistic individuals.
The Systemic Failures Behind These Challenges
The challenges faced by autistic girls, women, and gender-diverse individuals are not isolated incidents but symptoms of systemic failures across healthcare, education, employment, and cultural narratives. These failures perpetuate inequities that leave many without the support and opportunities they need to thrive. Addressing these systemic issues is critical to creating a more equitable society.
Healthcare Gaps
A significant barrier for autistic girls, women, and gender-diverse individuals is the lack of training among healthcare providers to address the intersection of autism and gender diversity. Many providers lack an understanding of how autism presents differently across genders, leading to missed or inaccurate diagnoses. When gender diversity intersects with autism, the challenges become even more pronounced, with many providers questioning or invalidating the gender identities of autistic individuals.
Compounding this issue is the healthcare system’s failure to address co-occurring conditions that disproportionately affect autistic individuals, such as anxiety, depression, and sensory processing challenges. Mental health services are often ill-equipped to provide tailored care for autistic individuals, and even fewer providers understand the unique needs of autistic individuals who are also gender-diverse. This lack of comprehensive care leaves many struggling to navigate a healthcare system that feels unwelcoming or outright hostile.
Educational Inequities
Education systems also fail to meet the needs of autistic girls and gender-diverse students. Many teachers are not trained to recognize how autism manifests differently in girls, leading to significant underdiagnosis and a lack of accommodations. Gender-diverse students face similar challenges, with educators often unaware of how to create inclusive environments that respect both neurodivergent and gender-diverse identities.
Curriculum design often excludes neurodivergent perspectives entirely, further marginalizing autistic students by failing to validate their experiences or celebrate their contributions. The absence of representation in educational materials sends a clear message to autistic girls and gender-diverse students: you don’t belong here. This exclusion not only impacts their academic outcomes but also undermines their confidence and sense of self-worth.
Employment Discrimination
The workplace presents another critical arena where systemic failures are evident. Gender and neurodivergent biases are pervasive in recruitment practices, which often prioritize traditional social and communication skills over actual qualifications or job performance. For example, job interviews frequently emphasize eye contact, quick responses, and small talk—traits that may be challenging for many autistic individuals and irrelevant to their ability to perform the job.
Once hired, the lack of accommodations for both autism and gender-related needs creates further barriers. Sensory-unfriendly environments, rigid schedules, and a lack of understanding about gender diversity leave many autistic employees feeling unsupported and undervalued. These systemic issues contribute to high rates of underemployment and financial instability among autistic individuals, particularly those who are also women or gender-diverse.
Cultural Narratives and Stereotypes
Cultural narratives and stereotypes play a significant role in perpetuating the marginalization of autistic girls, women, and gender-diverse individuals. Traditional gender roles often dictate how people are expected to behave, communicate, and engage with the world. Autistic individuals who do not conform to these expectations—such as girls who struggle with social cues or gender-diverse individuals who reject binary norms—are frequently misunderstood or ostracized.
Media portrayals further reinforce these harmful narratives. Autism is often depicted as a male-dominated experience, erasing the existence of autistic girls and women. Gender-diverse autistic individuals are almost entirely absent from media representation, further marginalizing their identities and perpetuating a lack of understanding among the public. This erasure not only invalidates their experiences but also limits the opportunities for broader societal acceptance and inclusion.
Paths Toward Inclusion and Equity
Building a more inclusive and equitable world for autistic girls, women, and gender-diverse individuals requires systemic change across multiple sectors. From research and advocacy to education and policy, a comprehensive approach is needed to dismantle barriers and create supportive environments where every individual can thrive.
Increased Representation in Research and Advocacy
One of the most pressing needs is to prioritize research on autism in girls, women, and gender-diverse individuals. Historically, autism research has focused disproportionately on boys, leaving significant gaps in understanding how autism manifests across genders. Addressing these gaps would not only improve diagnostic tools but also ensure that interventions and supports are tailored to meet the needs of all autistic individuals.
Equally important is the inclusion of diverse autistic voices in advocacy and policy-making. Decisions about autism-related programs, services, and policies should not be made without input from the very people they affect. Autistic individuals bring invaluable lived experience and expertise that can shape more effective and inclusive solutions. Advocacy efforts that center these voices can help challenge stereotypes and drive meaningful change.
Training and Awareness for Professionals
Healthcare, educational, and workplace professionals must be educated on autism and its intersection with gender diversity. Training programs should address the unique needs of autistic girls and gender-diverse individuals, equipping professionals to provide neuro-affirming and gender-affirming care. For healthcare providers, this means recognizing the validity of gender identities in autistic individuals and understanding how autism may shape their experiences of gender.
In schools and workplaces, training should focus on identifying and supporting autistic individuals without defaulting to harmful stereotypes or deficit-based approaches. Developing accessible resources and ongoing professional development opportunities can help educators, employers, and healthcare providers foster environments where autistic and gender-diverse individuals feel seen, respected, and supported.
Creating Inclusive Spaces
Inclusive spaces are essential to creating a society that values and celebrates neurodivergent and gender-diverse identities. In healthcare, this means implementing neuro-affirming and gender-affirming practices that respect autonomy and prioritize mental health. For example, clinics should offer flexible appointment structures and sensory-friendly environments, ensuring that autistic patients feel comfortable and understood.
In education, inclusive spaces might include classrooms designed with neurodivergent learners in mind, as well as curricula that reflect diverse perspectives, including those of autistic and gender-diverse individuals. Workplaces can foster inclusion by creating policies that accommodate both neurodivergent and gender-related needs, such as flexible schedules, quiet workspaces, and comprehensive anti-discrimination protections.
Social environments must also embrace inclusion by challenging traditional norms and celebrating diversity. Community spaces, organizations, and events can actively work to ensure that autistic and gender-diverse individuals feel welcomed and valued, fostering a sense of belonging.
Policy and Systemic Change
Achieving equity requires systemic change, starting with policies that mandate accommodations and protections for autistic girls, women, and gender-diverse individuals. Governments should establish and enforce anti-discrimination laws that address the unique challenges faced by these groups. Policies must also require educational institutions, workplaces, and healthcare providers to provide necessary accommodations and create inclusive practices.
Funding is another critical component of systemic change. Governments and institutions must invest in accessible mental health and social services tailored to the needs of autistic and gender-diverse individuals. This includes expanding access to neuro-affirming therapies, peer support groups, and gender-affirming care.
Empowering All Autistic Voices
Autistic girls, women, and gender-diverse individuals face unique and intersecting challenges that arise from societal norms and rigid gender roles. These barriers—ranging from underdiagnosis and masking to stigma and a lack of accommodations—stem from systems that were never designed with their experiences in mind. Cultural expectations about how girls should behave, compounded by the limited representation of autistic individuals beyond a male-centric lens, have led to generations of misunderstanding, exclusion, and harm. For autistic gender-diverse individuals, the compounded stigma of navigating both neurodivergence and gender identity creates even greater vulnerabilities.
The challenges explored in this article are not inevitable; they are the product of systemic inequities that can and must be addressed. Healthcare systems must evolve to provide neuro-affirming and gender-affirming care that respects the unique needs of all autistic individuals. Educational institutions must adopt inclusive practices that recognize and accommodate the diverse ways autism manifests across genders. Workplaces and communities must challenge stereotypes, create supportive environments, and celebrate neurodivergent and gender-diverse contributions. At every level, systemic change is essential to dismantling the barriers that hold autistic individuals back and replacing them with systems that uplift and empower.
To create this change, advocacy is essential—and it begins with all of us. Readers have the power to challenge harmful norms and push for better representation, education, and policies. Advocate for autism research that includes the voices and experiences of girls, women, and gender-diverse individuals. Support education initiatives that train professionals to recognize and meet the needs of neurodivergent people without relying on stereotypes or deficit-based frameworks. Call for policies that mandate accommodations and protections in schools, workplaces, and healthcare systems.
Empowering autistic voices means creating a world where everyone is valued for who they are, not who society expects them to be. It is about ensuring that no one has to mask their authenticity or fight for basic rights and recognition. Together, we can build systems that allow autistic girls, women, and gender-diverse individuals to live authentically and thrive. The path forward requires courage, collaboration, and unwavering commitment, but the result—a more inclusive and equitable society—is worth every effort.