Why Queer and Neurodivergent People Have More Chronic Health Issues
Queer people are more likely to have poorer health. We see it over and over again in research studies and national census data. Maybe you see it in yourself and your friends too.
Likewise, autistic people are more likely than allistics to have epilepsy, sleep disorders, digestive issues, and connective tissue disorders. Folks with ADHD are more likely to have metabolic conditions, migraine, allergic conditions, and gut health concerns.
Many queer and neurodivergent people have received the message, their whole lives, that something is wrong with them, and having chronic illness, especially unexplained symptoms, can easily feel like a confirmation of this.
So let me say, in no uncertain terms: your identity does not make you unhealthy. There is nothing wrong with you. There are real life reasons why chronic illness impacts our communities more, and none of them are your fault.
Minority Stress and Its Impact on Physical Health
Being queer and neurodivergent in a cisheteronormative world built for one particular type of brain is stressful.
When you spend years monitoring how you’re perceived, suppressing part of yourself to avoid negative consequences, and experiencing rejection and discrimination because of your identity or how your brain works, your body’s stress response moves from helpful-problem-solver to chronic drag.
Researchers refer to this as minority stress: the chronic, identity-based stress that comes from living in a world that was not built for you. The body responds to persistent hostility the same way it responds to any threat, and over time, that response becomes its own burden.
And chronic stress has been, robustly, repeatedly shown to worsen health. Stress directly impacts the body in so many ways:
Sleep disturbance messes with your ability to heal and recover.
Stress hormones can change your metabolic settings and immune function.
Nervous system changes impact your unconscious bodily functions, like digestion and blood flow.
Increased pain sensitivity can worsen everything from cramps to joint pain.
Over time, these factors can impact health in profound ways.
There’s also a much more practical way that stress can impact health: when you’re more stressed, you end up leaning on tools that ease stress or make life easier, like cigarettes or convenience foods, which can in turn affect your health.
Access Barriers to Healthcare for Queer and Neurodivergent People
Being queer and neurodivergent can change the opportunities available to you.
For example, your housing or work situation may be influenced by your identity. In turn, these impact the money and time you have available to care for yourself, buy and cook fresh food, and get good sleep.
Even more relevant to health, your experience with healthcare may be more fraught.
Queer people, especially trans folks, are way more likely than straight, cis folks to report negative experiences in health care. When we do reach out, there’s a risk of getting poorer quality care, for a variety of reasons:
Practitioners hold unconscious biases
Practitioners don’t have the training to provide good quality queer sexual and reproductive health or care for trans and intersex bodies
Explicit discrimination, harassment, or refusal of care unfortunately still happens.
All of these experiences make us way less likely to seek healthcare in the first place, which means you might not be getting the screening, assessment, and treatment that would help you.
Similarly, neurodivergent folks experience lots of barriers to healthcare access:
Communication barriers
Sensory barriers
Difficulty navigating complex health systems
Your neurotype being pathologized or blamed for all of your health concerns
Being labelled “difficult” or “noncompliant” because of your differing needs
These barriers are documented, systemic and have major consequences for the health of queer and neurodivergent communities across Canada.
Executive Dysfunction and the Challenge of Self-Care
Executive dysfunction makes it harder to care for yourself. Establishing healthy habits, getting to bed on time, and feeding yourself are all particularly challenging when you have ADHD or another neurotype that affects executive functions.
And the lifestyle advice that proliferates online is particularly terrible for ADHD brains, which means when you inevitably struggle to implement it, you probably feel a sense of shame that makes you never want to try that again.
Something we hear from clients regularly: the exhaustion of trying to follow advice designed for neurotypical people, and the shame that tends to follow when it falls short. The advice was never designed for your brain in the first place.
How Do We Change This?
The solution to these challenges is NOT to change anything about yourself. You deserve wellness and healthcare exactly as you are.
These are fundamentally systemic problems, so the solutions are also systemic: ensuring affirming and accessible healthcare, and reversing disparities that cause stress for marginalized people.
But while we’re all fighting the good fight, there are ways you can personally reduce the impacts these larger issues have on your health.
1. Seek out affirming healthcare. Work with care providers who listen, believe you, and understand your experience.
2. Seek self-knowledge. Learn what your brain needs to be able to effectively care for yourself and be an advocate for your own healthcare. This may be through seeking a formal diagnosis or can be found through self-exploration in therapy or on your own.
3. Build an affirming life. There’s nothing you can do to prevent yourself from being discriminated against – that’s not your responsibility. However, you can work on unlearning internalized biases you may have, like internalized homophobia, transphobia, or ableism. You can set boundaries that reduce the impact of less affirming people in your life. You can create accommodations for yourself or advocate for accommodations at work that make your life easier. You can work on building self-esteem, confidence in your identity, and comfort with openly being yourself. This is all deep work that reduces the impact that minority stress has on your nervous system.
Your identity cannot make you sick. But your body responds to the environment you live in. When we create more supportive environments, you have more capacity to care for yourself, more confidence to reach out for help when you need it, and less stress messing with your insides.
Frequently Asked Questions
Why do queer people have more health problems?
Research consistently shows that queer people, including trans and non-binary folks, experience higher rates of certain chronic health conditions than their cisgender, heterosexual peers. The primary drivers are barriers to affirming healthcare and the physiological toll of dealing with discrimination and concealment over time. The causes are systemic, and the research is consistent.
What is minority stress and how does it affect the body?
Minority stress refers to the chronic, excess stress that comes from belonging to a stigmatized or marginalized group. Over time it contributes to dysregulation of the nervous system, immune function, metabolic processes and more, which can worsen or contribute to chronic illness. A well-documented phenomenon in public health research, and increasingly recognized by clinicians working with queer and neurodivergent populations.
Why do neurodivergent people struggle more with chronic illness?
Neurodivergent people, including autistic people and those with ADHD, face a combination of factors that increase chronic illness risk: co-occurring conditions that are more common in neurodivergent populations, executive dysfunction that makes self-care harder to sustain and significant barriers to navigating healthcare systems that were never designed with neurodivergent needs in mind.
How can therapy support queer and neurodivergent people living with chronic illness?
Therapy addresses several of the root contributors to chronic illness in marginalized communities. Working with a 2SLGBTQIA+ affirming therapist can help you process the impact of minority stress, build self-esteem and identity confidence, work through internalized biases and develop self-advocacy skills for healthcare needs. Blueprint Counselling offers affirming individual therapy in London, Toronto, and virtually across Ontario.
About the author: Our guest author, Dr. Arlie Millyard is a naturopathic doctor who treats digestive troubles and complex chronic illness with a queer and neuro-affirming, body-neutral approach. You can find more of her writing about navigating healthcare as a queer, neurodivergent or chronically ill person at arliemillyard.ca.
At Blueprint Counselling, we meet queer and neurodivergent clients at the intersection of identity, mental health and physical wellbeing. If this post resonated and you are looking for affirming support, we offer individual therapy in London and Toronto and virtual therapy across Ontario. Book a free consultation today!