By Mario Alvarez Serrano, MA, JD, LCPC, LMHC, NCC
For many LGBTQIA+ people, especially transgender, nonbinary, and gender-expansive individuals, daily life can involve constantly evaluating whether it is safe to be authentic. Many autistic and ADHD adults describe a similar process known as masking: consciously or unconsciously hiding parts of themselves to appear more socially acceptable. When someone is both neurodivergent and LGBTQIA+, these experiences often overlap. The result can be chronic stress, emotional exhaustion, and the feeling that acceptance depends on performing a version of oneself that feels safer for everyone else.
Stimming, short for self-stimulatory behavior, refers to repetitive movements, sounds, or sensory behaviors that help regulate the nervous system. Rocking, hand movements, fidgeting, pacing, humming, skin rubbing, using sensory tools, or repeating phrases can all be forms of stimming. Although stimming is often associated with autism, it is also common among people with ADHD and other neurodivergent experiences. Research suggests that stimming serves important functions, including emotional regulation, sensory processing, attention, and stress reduction. In many cases, it is an adaptive coping strategy rather than a behavior that needs to be eliminated.
Masking is something different. It involves suppressing natural behaviors in order to reduce the likelihood of judgment, bullying, discrimination, or rejection. A person may force eye contact, rehearse conversations, suppress stimming, copy social behaviors, or carefully monitor how they speak, dress, or move. LGBTQIA+ people often describe similar strategies around sexual orientation, gender identity, or gender expression. Whether someone is hiding autistic traits or avoiding being perceived as queer or transgender, the underlying goal is often the same: staying safe in environments where authenticity may feel risky.
Research has shown that prolonged masking is associated with increased anxiety, depression, burnout, emotional exhaustion, and lower psychological wellbeing among autistic adults. LGBTQIA+ communities also experience the effects of minority stress, a well-established psychological framework describing the chronic stress created by stigma, discrimination, prejudice, and expectations of rejection. When neurodivergence and LGBTQIA+ identities intersect, these stressors can compound one another, making it difficult to determine whether someone is masking because of autism, gender identity, sexual orientation, trauma, or years of adapting to environments that did not feel accepting.
Another growing area of research has explored the relationship between autism and gender diversity. Multiple studies have found that autistic people are more likely than the general population to identify as transgender, nonbinary, or gender-diverse, although researchers continue to study why this relationship exists. Importantly, autism does not cause someone to be transgender, nor does being transgender cause autism. Instead, clinicians are increasingly recognizing that these identities frequently coexist and deserve thoughtful, individualized, and affirming care rather than assumptions or stereotypes.
Affirming therapy does not begin with the assumption that stimming should stop or that masking is always unhealthy. Instead, therapy asks more useful questions. When is masking helping someone stay safe? When is it becoming emotionally costly? Which relationships allow someone to unmask without fear? How have experiences of rejection, discrimination, or misunderstanding shaped the way someone relates to themselves? Therapy can help clients understand the function of masking, strengthen self-awareness, develop sustainable coping strategies, and identify environments where authenticity becomes more possible.
Whether you identify as autistic, ADHD, neurodivergent, transgender, nonbinary, queer, or are still exploring your identity, you should not have to spend your life performing a version of yourself simply to feel accepted. LGBTQIA+-affirming and neurodivergent-affirming therapy recognizes that identity, nervous system regulation, relationships, and mental health are deeply connected. The goal is not to make you appear more "normal." The goal is to help you understand yourself more fully, reduce shame, build resilience, and create a life where authenticity and safety can exist together.
References
Both peer-reviewed and professional guidance informed this article.
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