Neurodiversity and Sexual and Gender Diversity: Toward a Neuroqueer Science of Identity, Health, and Care

Neurodiversity and sexual and gender diversity have usually been investigated as separate domains of human difference. A growing literature reports substantial intersections, most clearly for autism and, to a lesser extent, attention-deficit/hyperactivity disorder, across sexual orientations, gender identities, gender expressions, and relationship configurations. These intersections have frequently been approached through a clinical language of co-occurrence, risk, diagnostic complexity, or presumed etiological association. Population and clinical studies report that autistic people are more likely than comparison groups to describe non-heterosexual or gender-diverse identities, but these observational findings do not resolve causation, and the evidence remains disproportionately focused on autism, transgender identity, and gender dysphoria. This conceptual narrative essay develops a neuroqueer framework centered on human variation, intersectionality, sexual well-being, self-determination, epistemic justice, and structural determinants of health. Neurodivergence should not be used to invalidate sexual or gender self-knowledge, while sexual and gender diversity should not obscure neurodevelopmental support needs. Research should distinguish identity from distress, broaden coverage beyond autism, improve measurement and sampling, investigate sexuality across the life course, and include neurodivergent sexual- and gender-minority people as knowledge producers. This essay proposes that clinical services cultivate neurodiversity-affirming and sexuality- and gender-affirming competence. A neuroqueer sexual science redirects attention from explaining why identities coexist toward examining the conditions associated with safe, self-determined, pleasurable, and socially connected lives.