If you exist at the intersection of being Neurodivergent (Autistic, ADHD, AuDHD, Plural) and LGBTQIA+ (Trans, Non-Binary, Queer, Ace), you might feel like you are constantly translating yourself.
In traditional medical settings, you are split into pieces. The gender clinic asks you to prove you are “stable” enough for hormones, ignoring that your meltdowns are caused by sensory dysphoria. The autism specialist ignores your gender identity, focusing solely on “social skills” that feel like performance art. And society tells you that you are “too much”—too sensitive, too loud, too rigid, too fluid.
We don’t view these identities as separate issues to be treated. We view them as a singular, beautiful, and complex lived experience. We call this being Neuroqueer.
This guide is the first of its kind in North Carolina: a comprehensive roadmap to understanding the Neuroqueer experience, why standard therapy often fails this population, and how to find care that honors both your neurology and your gender without asking you to compromise either.
What Does “Neuroqueer” Mean?
“Neuroqueer” is more than just a label; it is a verb. Coined by neurodiversity scholars like Dr. Nick Walker, it describes the act of “queering” (subverting) social norms of behavior and cognition.
Statistically, the overlap is undeniable. Research indicates that Autistic people are 3 to 6 times more likely to be gender diverse than the neurotypical population. But why?
The “Social Construct” Theory
Neurotypical brains are wired to absorb social rules—like “boys wear blue” or “eye contact is polite”—often without questioning them. Autistic brains are wired for logic and authenticity. We process the world bottom-up (details first). When an Autistic person looks at the arbitrary rules of gender, they often ask, “Why?” When the answer is “Because I said so,” the Autistic brain rejects it.
This isn’t “confusion.” It is clarity. Neuroqueer people often have a more expansive, custom-built understanding of gender because they are less bound by the social performance of it.
The “Double Closet”: Why Standard Therapy Fails
For decades, North Carolina’s mental health system has operated on the Medical Model, which views both Autism and Transness as “problems” to be fixed or gated. This creates a “Double Closet” for Neuroqueer clients.
1. The Trauma of Compliance (ABA and Conversion)
There is a dark history where Applied Behavior Analysis (ABA) and Conversion Therapy overlap. Both are compliance-based therapies.
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ABA teaches: “Quiet hands. Look me in the eye. Act normal.”
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Conversion Therapy teaches: “Act masculine. Act feminine. Don’t be different.”
If you grew up exposed to either (or both), your nervous system has likely learned that authenticity is dangerous. Standard CBT (Cognitive Behavioral Therapy) can sometimes make this worse by focusing on “correcting” thoughts rather than validating the safety of your body.
2. Medical Gatekeeping
We frequently see clients who have been denied Gender Affirming Care (HRT or Surgery) by doctors who claim their Autism makes them “incompetent” to consent. This is infantilization. Being Autistic does not mean you don’t know who you are. In fact, Autistic people often have a hyper-awareness of their internal states (or a specific struggle with interoception that requires patience, not denial).
Neuroqueer Therapy flips the script. We operate on an Informed Consent model. We believe you are the expert on your own body.
Core Pillars of Neuroqueer Therapy
So, what does it actually look like to work with a Neuroqueer-affirming therapist? It looks like a room where you don’t have to explain why the fluorescent lights hurt.
1. Sensory Safety as the Foundation
You cannot process trauma if your tag is scratching you or the lights are buzzing.
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In Session: We keep lights low. We welcome sunglasses and noise-canceling headphones. We don’t demand eye contact (which uses up cognitive bandwidth).
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Stimming is Encouraged: If you need to rock, flap, or pace to think, do it. We know that stimming is regulation, not a symptom to be extinguished.
2. Unmasking the “Double Mask”
Neuroqueer people wear two heavy masks:
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The Neurotypical Mask: Faking social interest, suppressing fidgets, scripting conversations.
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The Cis-Het Mask: Performing the gender assigned at birth to avoid violence or rejection.
Therapy is the laboratory where we practice taking these off. We ask: Who are you when no one is watching?
3. Validating “Non-Standard” Communication
We don’t try to teach you neurotypical social skills. We celebrate Neurodivergent communication styles, such as:
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Info-Dumping: Sharing deep knowledge as a love language.
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Directness: Valuing honesty over social hierarchy.
Navigating Transition as a Neurodivergent Person
Medical and social transition brings specific hurdles for the neurodivergent brain.
The Sensory Battles of Transition
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Binders: For someone with tactile defensiveness, the compression of a binder can feel like a panic attack. We help you explore sensory-friendly alternatives like Trans Tape or high-compression sports bras, or advocate for top surgery sooner to relieve the sensory burden.
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Hormones: “Second Puberty” can be a sensory nightmare. Testosterone changes your smell and skin texture (oiler). Estrogen changes your temperature regulation and skin softness. We prepare you for these shifts so they don’t trigger sensory meltdowns.
Executive Dysfunction and HRT
Managing a weekly injection schedule or daily pills is a nightmare for the ADHD brain.
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The Strategy: We don’t shame you for forgetting. We build “scaffolding.”
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Body Doubling: Facetime a friend while you do your shot.
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Visual Cues: Keeping meds in a visible spot (not in a drawer).
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Gamification: Pairing the shot with a dopamine reward (a favorite treat or video game).
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Neuroqueer Resources in North Carolina
You are not alone. North Carolina has a thriving, underground, and increasingly visible network of Neuroqueer support.
Affirming Therapy Practices
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Bluebird Avenue Art Therapy (Charlotte): Specializes in “AuDHD” and uses art to bypass the pressure of verbal speech.
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Be BOLD Psychology (Durham/Telehealth): A leader in writing GALAP letters and providing “cradle-to-grave” queer care.
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Resilient Mind Counseling (Asheville): Known for “Queer Celebratory” care and a high density of neurodivergent staff.
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Neuro-Abundance Counseling (Asheville): Explicitly focuses on the “Neuroqueer” lived experience.
Community Support
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LiNC-IT: A specific NC program helping early-career Autistic professionals find employment that respects their neurotype.
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The GALAP: Use this directory to find NC providers who write surgery letters for free (pro bono), removing the financial gatekeeping of transition.
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Campus Groups: NC State’s Autistic Students Alliance and Duke’s Neurodiversity Connections are creating safe harbors for students.
Conclusion: You Are Not “Broken”
If there is one thing we want you to take away from this page, it is this: Your brain and your gender are not mistakes.
The way you experience gender—freed from arbitrary rules, rooted in your unique sensory experience—is a gift. The way your brain processes the world is valid.
You do not need to be “fixed.” You need to be supported, accommodated, and celebrated. Whether you are seeking a diagnosis, a letter for surgery, or just a place to unmask for an hour a week, Neuroqueer therapy is here to help you build a life that fits you, not the other way around.
Ready to Unmask?
Finding a therapist who speaks your language (literally and neurologically) changes everything. Contact us to match with a clinician who understands the Neuroqueer experience from the inside out.
