Episode 20: Embracing Neuroqueer Identity: Queerness Explored Through the Lens of Autism and ADHD

Show Notes:

Statistically, 70% of Autistic individuals identify as non-heterosexual, and genderqueer people are 3 to 6 times more likely to be diagnosed as Autistic than cisgender adults.

In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, talk with Rebecca Minor, MSW, LICSW, a gender expansive therapist and advocate in the neuroqueer space, about genderqueer identity and neuroqueer identity—what they are, how they intersect, and how they are perceived versus present in society, relationships, and the mental health community.

Top 3 reasons to listen to the entire episode:

1. Understand what is genderqueer identity and neuroqueer identity, as well as delve into the misconceptions surrounding them.
2. See how neurodivergence and queerness overlap for both Autism and ADHD, including what studies have been done around this.
3. Understand the importance of self-disclosure in therapy, particularly for marginalized communities with intersectional identities, and how it can build connection and community, as well as offer emotional relief for clients.

There is still a lot to learn and unpack about queerness and neurodivergence, but research suggests a strong connection between neurodivergence and gender identity. We hope to shed light, give valuable insights, and broaden your understanding of these diverse identities.

More about Rebecca:

Rebecca Minor, MSW, LICSW is a neuroqueer femme, clinician, consultant, and educator specializing in the intersection of trauma, gender, and sexuality. As a Gender Specialist, Rebecca partners with trans and gender nonconforming youth through their journey of becoming, and is a guide to their parents in affirming it. Rebecca is part-time faculty at Boston University School of Social work and always works through a lens that is neurodiversity-affirming, trauma-informed, and resilience-oriented. In addition to her clinical work, Rebecca has provided cultural humility training and consultation to organizations, schools, and businesses for the past decade. You can follow her on Instagram, hire her for parent coaching, or check out her blog, and free guides and course for parents and caregivers!

• Rebecca’s Website: www.genderspecialist.com 
• Work with Rebecca: https://www.genderspecialist.com/coaching  
• Rebecca’s Instagram: http://instagram.com/gender.specialist  
• Rebecca’s Facebook: https://www.facebook.com/RebeccaMinorLICSW 

Resources

Neurodivergent Insights Masterclass Series: Exploring Neuroqueer Identities by Dr. Megan Anna Neff and Rebecca Minor: https://learn.neurodivergentinsights.com/exploring-neuroqueer-identities/

Neurodivergent Insights Infographic: https://neurodivergentinsights.com/autism-infographics/trans-autism

 

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Transcript

MEGAN NEFF: So, over the last two weeks we have been…

PATRICK CASALE: Did you forget your settings [INDISCERNIBLE 00:00:12] because-

MEGAN NEFF: [CROSSTALK 00:00:13] no, it takes me a second, Patrick. I don't have my process in this video. We should keep that in.

Okay, so, over the last few weeks, we've been exploring autistic identity and neurodivergent identity. And I can't think of a better guest to have on today than Rebecca Minor, who is neuro queer and does a lot in the neuro queer space. And so, we're going to dive a little bit deeper into talking about the intersection of queerness and neurodivergence, broadening it to autistic and ADHD identities.

Okay, Rebecca, I'm going to try to introduce you. I know I'm not going to do it justice. But here we go. So, we met on Instagram, which is a weird thing to say. I don't meet people on Instagram anymore. We met before-

REBECCA MINOR: No.

MEGAN NEFF: Yeah, I'm too, [CROSSTALK 00:01:04] and I get so overwhelmed. So, I'm so glad I met you like when I had a small following and when I actually spent time in the app because I've loved… How did we meet? I don't even know how we met. But I love that we did. And we've developed what I would say is a really wonderful friendship. And we've presented together on your neuro queerness. You are a gender-expansive therapist, but if I'm tracking right, you're kind of doing less clinical work, more speaking, more advocacy, lots of trainings. So, gender expansiveness in teens, this is your jam. Do I have that right?

REBECCA MINOR: You do, yeah, yeah. I'm still seeing too many clients for how much I'm doing the other things. But yes, I am.

MEGAN NEFF: Right? I am not surprised by that.

REBECCA MINOR: So, welcome.

MEGAN NEFF: What would you like to add about, like just giving our listeners some context for who you are.

REBECCA MINOR: So, I am a social worker by training. Some people care about that. I have been in private practice for about five years with a variety of settings, different experiences prior to that. And I work primarily with queer and trans youth and their journey of becoming. And most recently, I'm spending a bulk of my time working with parents and caregivers to really support them in being able to better support young people.

MEGAN NEFF: I love that. I've been so encouraged by how many parents are really showing up and they're doing their work to show up for their kids. And I love that you're coming alongside parents in that journey because it's a lot to unlearn, and then relearn, and just to address like, the fear that comes with parenting a queer kid.

REBECCA MINOR: You nailed that, yeah. And that's so often what it is, right? It's just like, because of a lack of information there's a lot of fear, and concern, and feeling like they should have all the answers. And so, then, there's a shutdown, right? And it's like not because they don't care, not because they don't want to support their kid, but they're stuck. And so, that shift can happen really quickly, which is also like an incredibly meaningful piece of the work that feels so different than sometimes longer-term clinical work or trauma-focused work that I've done, which goes on and on. This is much more like, "We can take care of this."

MEGAN NEFF: I like that kind of work. It's funny, I work long term as a therapist, but it can be really nice to then have those cases where it's like, "Oh, we can actually address this in five sessions and get you on your way."

REBECCA MINOR: Mm-hmm (affirmative.)

MEGAN NEFF: Which is very, like, I feel like a heretical thing to say when you come from the psychodynamic tradition, but I actually really like having a balance of the two, yeah.

REBECCA MINOR: Yeah.

MEGAN NEFF: So, I think how we met is kind of interesting because it goes back to this identity thing. So, I was working in the like, autism, ADHD space, primarily. You were working in the gender-expansive space primarily. I started seeing like, oh my gosh, there's so much overlap with queerness, and specifically, gender queerness among neurodivergent people. So, I started learning about queerness. You on the other hand, do you want to share what you were discovering in your practice?

REBECCA MINOR: Yeah, and I was going to say, I think I do remember how we met, which is mostly that I was like, "Hello, am I autistic?" Which is probably how you meet a lot of people. But I started noticing I was like, wait a minute, if I really sit down and think about it started with one client, right? Who came in and had seen something online and was like, "I think I might be autistic." And I was like, "That's markedly different, like what you're describing is markedly different than what my training had been."

And like in high school, I had volunteered in what? At that point, we were calling the special needs classroom and worked with autistic folks. And you know, the tropes that I had understood about that were so different than the clients I was working with. But once I started peeling back some of the layers and reading more of the current research, I was like, "Oh, oh, are all of my clients neurodivergent and I missed it?" Like, and so, it really set off this thing for me where I got hyper fixated and was researching like crazy, and taking all the self-measures, and trying to figure out not only what was going on for all of my clients, but also what was going on for me.

And so, I think that's when we started talking because I was like, this is just a fascinating clinical thing that I'm seeing. And also, I'm not clearly fitting into one of these categories, and I love your Venn diagrams for that reason because I'm like, you know, I've got a little bit of various things and the visuals made so much sense to my brain.

MEGAN NEFF: Yeah, yeah.

REBECCA MINOR: Yeah.

MEGAN NEFF: I love that. Yeah, we were having parallel process. And then, for me, in my process, I was unpacking queer identities, which for me came after the autism discovery, which you were further along in that journey. So, it was a really cool friendship where both clinically, but personally, we were kind of exploring, like, the other specialty which we had been led to by our home base… Okay, I have a visual of what I'm trying to say, but I'm not putting into words well. But yeah, I think that's, yeah, that we were able to kind of both explore each other's specialty in conversation.

REBECCA MINOR: Yeah. And that's when we were like, "Wait, why aren't people talking about this more?" And then I think that's when we got the idea for starting that, like, ask our followers questions about that intersection.

MEGAN NEFF: Yeah, yeah, yeah. And I think that'd be a helpful thing to get into, but we like to anchor in lived experience here. So, can you share a little bit more about your own neural queerness and your journey around that, or whatever you want to share around that?

REBECCA MINOR: Sure. So, I think one of, kind of, the place that I've comfortably settled is in using neuro queer as a label identity-wise. I'd gotten comfortable with the concept of queerness and that felt good to me, then I became aware of how inextricably linked I think my queerness is to my neurodivergence. And so, it just felt like it made so much sense and it's easier to say. That's one thing.

But I did go through a long process, and I'm still navigating the, like, "What exactly is going on here?" In terms of my own brain. I have a trauma history and a history of anxiety. And so, those things can confuse some of the, you know, they can present in some similar ways. And so, it's been a journey of kind of parsing out like, what's potentially autism? What's potentially ADHD? What's potentially trauma or anxiety? Or this or that? Or, you know, being burned out? Or just the combination of like being alive during a pandemic.

So, yeah, it's been interesting. At times, it's been pretty difficult and emotional. And you've been so lovely and gentle with me, which I appreciate, when I have weird questions, or I'm like, "Does this mean this?" And you're like, "Well, not always." But yeah, so I feel kind of like, I definitely meet criteria for ADHD, that feels solid. And I think-

MEGAN NEFF: Thank you too.

REBECCA MINOR: And I was going to say anyone in my life would also concur. And then I have like a sprinkling of other things that one might consider to be like-

MEGAN NEFF: I call it the neurodivergent potpourri bag.

REBECCA MINOR: Yes, yes. That's me. Got some family history in there. So, yeah, it's been interesting, and I think professionally, it's always a weird thing to navigate that like, personal/professional line of how much do I share? How much do I not share? Is it okay for me to talk about these different things if I don't feel like I can use the hashtag actually autistic because I don't have a diagnosis? Do I need formal diagnosis? And the thoughts go on, you know? So, that's kind of where I am. I'm happy to talk about it, it's a fine thing to say.

MEGAN NEFF: And yes, I think I know that about you from having seen you in public spaces. And that's something I like about your presentation style is how openly you talk about this.

I'm kind of diverging from where I initially thought we might go. And I do want to get back to talking about gender queerness. But I think this will wrap into it. Part of what you're talking about is being in process of your own identity as a clinician, but also, as a public clinician, I didn't mention this, but you also have a platform on Instagram, and you create content as well. I heard on a blog post a couple years ago, that's probably been the one that gets the most feedback from clinicians, and it's about being an identity-based practitioner, when our practice is based on our identity in the sense of, I am an autistic therapist, therefore, autistic clients come to me.

In our training, we're taught so much about like, blank slate, don't disclose. I'm just curious, both Patrick and Rebecca, your thoughts around exploring our identity while you're seeing clients. And then, also, while doing it publicly not just privately because there's a lot there.

REBECCA MINOR: Yeah.

PATRICK CASALE: See, we're doing a good job today. We're reading each other's facial expressions and all those things. I love that you just asked that question. I just want to also apologize for my voice today to everyone listening, it's struggling. I actually just had this conversation in our team meeting with our staff about using identity-based language, and especially, if they feel safe enough to do so because we are a practice that specializes in supporting the neurodivergent and queer communities in Western North Carolina.

I know we've talked about this, Megan, at length, but I do think it's nuanced. We always say that. I feel like that's going to just become incorporated into our fucking conversations on this podcast is the word nuance. But it is nuanced, and it is complex, and I think it's also advocacy at its truest form for our clients who are so desperately trying to find a landing spot, a place where they can feel safe and comfortable, a place where they don't have to, you know, explain everything over again, maybe their circumstances are different, but they don't have to say or explain everything in a clinical interview like they typically would. And I just think it's so powerful, and so much more humanizing when we use identity-based language, when we are able to show up in those spaces.

And I also think it's also really complicated, especially, for those of us who have audiences who have followings, as we're also unpacking our own identities, as we're also unpacking our own neurodivergent journeys. Like, for those of us who were diagnosed in adulthood, sometimes you get it wrong. And sometimes you're also unpacking your own internalized ableism that's existed throughout most of your life. And I think then you walk it back, and you learn, and you try, and you try again, and you continuously show up even when you get it wrong. And I think that's the most important piece here, for those of us who are showing up in public spaces.

But again, I just cannot say enough how much I think that speaking out openly, and disclosing, and using identity-based language is just so important in terms of advocacy across the board for people who just don't feel safe enough to be able to do the same things that we can do.

MEGAN NEFF: It certainly makes the countertransference more hot, is what I've noticed. Like, when your client is working through things that you're also working through.

REBECCA MINOR: That's true.

MEGAN NEFF: And Rebecca, I think you've experienced some of that or am I projecting?

REBECCA MINOR: No, no, that's totally fine. I've definitely experienced that because, in real-time, it was like I was working with clients who were like, "Wait, is this, you know, what's been going on all these years?" And it explains all these things. And like, there's the relief, and the like aha of that. But there's also the grief and the pain that comes with that, and holding that for clients in session, but also, navigating that myself, it's a lot.

And then, I also think about the parent audience, which I also have because I work with young people, right? So, like my teenage clients will be the first to tell you about my various neurodivergent tendencies because they have no problem with this or calling me out on them.

But with parents, then it raises those questions of like, "Will they doubt my competency? Like, what does that mean?" And it was the same thing for me as coming out as queer of like, "Will parents then think I'm like luring their children into this lifestyle?" Which is not a thing, but like, is a concern. And so, yeah, it's the potpourri.

MEGAN NEFF: It's going to be in the name of our episode, potpourri.

PATRICK CASALE: It's definitely going to be in the description somewhere, probably on the website, too. I think the grief relief process is something we talk about a lot. And I've experienced, you know, pretty often, especially, when I was formally diagnosed at 35. I'm 37 now, it's been a year and a half journey. But I think you're right, the countertransference is really intensified, and simultaneously, the relief for the client has gone up exponentially. So, I think both of those things, as my therapist thing is always like, "Both can be true." Those are both true. And like, the ability for the client to…

I also am someone who speaks openly about a former gambling addiction. When I've talked about that with clients, you see the immediate relief of like, "Oh, shit, someone gets it. Like, I'm not alone in this." And that has always been my driving force for disclosure. It's never been about like, what does it do for me? I always want to throw that asterisk in there for any clinicians who want to be like, "That's ethically not sound. Like, we don't disclose."

But when we are talking about people who are represented within marginalized communities with intersectional identities, then I think its disclosure is that much more important of a therapeutic intervention and I think that when you start to realize like, that's what it's about, it's not about what it does for my sense of self. It's more about like, what does it do for the person who feels like there is no glimmer of hope? Or that things will never change or be different?

REBECCA MINOR: Yes, yeah. And that's where that question of like, who is it for? It needs to be the guiding principle. One other thing you said earlier that I just didn't want to leave out was, oh, there goes brain processing, it was about getting it wrong. I was terrified of getting it wrong. And I still am, right? Like, there's still a part of me that's like, "Well, I don't know. Like, according to the data." And, you know, but in periods when I've been more burned out and gone back, and retaken some of the assessments, I'm like, "Oh, those numbers look a little different." But still, yeah, it's a thing.

MEGAN NEFF: We're going to talk about RSD soon. And I think getting it wrong, well, first of all getting it wrong because like, we are all very justice-oriented. So, I think, especially, when we get it wrong for our communities and for the most marginalized communities, like I know all of us feel that deeply. And then, also, the, like, aspect of RSD.

And I just read, like, social justice RSD. I hadn't heard that term before, but also, like a strong reaction to injustice. But because we've all had private conversations around this I know how much we care about not getting it wrong. And you can't be in public space and not step in it. Like, and it's good, right? It means we're… well, it's not good, but it's a sign that we are learning.

REBECCA MINOR: Yes. 

PATRICK CASALE: And there's a lot of unpacking to do even now and continuously. And I think that is important no matter what. But I think it's so important when you do have public space that you take up because people are following you, people are listening to you, people are sharing your stuff. So, I think there is even, it feels like almost this pressure to get it right. And that, for me is a struggle sometimes because then I get into like perfectionism mode. And I'm like, "I have to get it right. I can't post this because this could get picked apart in 100 different ways."

So, then I have to step back and think like, okay, what is the purpose of what I'm creating and posting because if it's informative, if it's supposed to be supportive, encouraging, etc, then I want to put it out there regardless of the fact that someone may say, "Next time you do this you should probably use this for vernacular, or this word, or this verbiage.'

And that's okay because then it's like, "Okay, I get that and I will do that the next time." But I don't want that to take away from the message either that can often be missed if we are unwilling to put ourselves out there. And that's why we all have platforms because we're willing to put ourselves out there and talk about stuff that a lot of people shy away from.

REBECCA MINOR: Absolutely, yeah, and I think the more self-disclosure I've done online, in appropriate and boundaried ways, for the therapists listening, has, like you said, right? Has shocked me in its traction, right? It's the stuff where I'm like, "Oh, this is what the people want." That gets like nothing. But when I'm like, "Look, I'm messy just like you." People are like, "Awesome." And it's like shared all over the place, right?

Or recently, in terms of unpacking identity and Megan Anna, you and I have talked about this as the reality of moving through the world as a queer person who holds a lot of privilege because I'm married to a cis man and how navigating that has been tricky and interesting. And so, I was so afraid of sharing about that and losing some of my queer followers who would be like, "You're another one of those, like next." And I forgot, or, you know, wasn't prioritizing the thousands of people who have reached out, and liked, and commented when I've shared like, "Hey, this is actually what my life looks like."

And just in the last month I have like, built this small but growing community of women who are in straight passing relationships and navigating their queerness. And it's just been really fascinating to see. But I think I absolutely get stuck in that feedback loop of like, I was doing it yesterday with a post where I was like, writing about protected time. And then I was like, all I could hear was people being like, "Oh, nice that you have protected time, what a privilege?" You know, and then I archived the post because I was like, "Urrgh." So, yeah, it's…

MEGAN NEFF: Yeah, I love that. I've definitely been there, done that. First of all, I just want to say, I love how you have, like, talked so openly about the complexity around queer identity. And how, yeah, like our marriage setup or partnership setup doesn't make an identity. And that was actually really empowering for me.

I also remember, we talked the weekend before you made the post of like, kind of, revealing that you were married to a cis man. And I remember the anxiety of that. And I totally understood that. But I love how you have come into that space. That's actually partly what gave me permission because it was that question of like, okay, I am queer, our family is very queer as like, but I'm also like, not in a queer partnership. So, what do I do with that?

And so, the work you've done around identity, I think, is so helpful because identity is so much bigger than the structure of our partnerships.

REBECCA MINOR: Absolutely. Yeah, thank you.

MEGAN NEFF: Should we shift to talk about identity and kind of gender queer identity and neuro queer identity? I know that we've done a lot of work at that intersection. And I wonder if it'd be helpful to do some of, like, a bird's eye view of some of the things that we discovered when we were asking our audience and what we've presented on, the speaker time to shift.

REBECCA MINOR: Sounds good to me.

MEGAN NEFF: Rebecca, do you want to do the bird eye view? Like…

REBECCA MINOR: Oh, I feel like you're better at that?

MEGAN NEFF: …intersection. What did you say?

REBECCA MINOR: I said, "Oh, I feel like you're better at that."

MEGAN NEFF: Okay, I will try and then, you will [CROSSTALK 00:23:30].

REBECCA MINOR: … yeah.

MEGAN NEFF: Yeah, so, okay. So, I mean, we know that there's a huge overlap of queerness and neurodivergence, both for autism and ADHD. It's a little bit more pronounced in autism than ADHD. So, first of all, talking about sexual queerness. There's one study, and as a disclaimer, it was a smaller study, but the study found that 70% of autistic people identified as non-heterosexual. And the language non-heterosexual they use that because it also included people who were asexual and [INDISCERNIBLE 00:24:12]. But essentially, 70% identified as some form of queer. That's huge.

The research also found it's more common among people assigned female at birth. So, cis autistic men. So, people like you, Patrick, are more likely to identify as heteronormative and heterosexual than everyone else. So, this gets, I think even more pronounced when we start looking at gender queerness, and particularly, autism, but also, ADHD. There's a pretty big study done in 2021 that found that gender queer people were three to six times more likely to be diagnosed as autistic than cisgender adults. What's really interesting about that statistic is that only include people who are medically diagnosed, and so, we would suspect that number would actually be significantly higher.

Other studies have found that autistic children are like four times more likely than allistic children to be genderqueer. There's other studies out there, I'll link the infographic in our podcast so people can go see the research.

But essentially, it's a significant overlap between gender queerness and neurodivergence, particularly, autism and ADHD. We also see similar rates in ADHD not quite as high but also, higher than in neurotypical children and adults. That's the bird eye view. How did I do Rebecca?

REBECCA MINOR: That was good. It just made me think do you have like a gut instinct as to why that is?

MEGAN NEFF:

Oh, gosh, I get that question so often. And I've heard some really interesting speculations. I think there are some studies around like, neuroanatomy, but I don't know those well enough to try and say at the moment. I think the idea of like, how we relate to social norms, I think is part of it. I think we're much more, you know, social norms are constructs, and I think we see them as constructs. I think-

REBECCA MINOR: That's always been my thought, too.

MEGAN NEFF: Yeah. So, I think we know they're there. But like I described as like, I analytically know they're there. I think RSD people experience them. Like, they experience the social norms as real things. So, I think we're much more likely to queer in the sense of query and social norms and explore.

I heard a really interesting theory, recently, about sensory. Because of heightened sensory someone was experiencing gender dysphoria, particularly. That would be a more intense experience because of the body experience around that, which, that was really interesting to me as well. There's a few other kind of ideas out there, but I don't know, what about you? What do you make of the overlap?

REBECCA MINOR: Well, I just, I mean, so often I think about gender, the whole concept of the binary as being its own construct, and if you're not led to constructs and you feel somewhat of a freedom to move in or out of them, it might give people an opportunity to consider possibility, right? Like, so often, I feel like when I work with people who are cisgender and allistic they've never considered any other possibilities around their gender. They're just like, "Oh, well, this is what I got handed and this is what I still am."

And like, it's never been called into question, not even know, like, passing thought. Whereas, you know, obviously, I spend a bulk of my time talking with trans and gender-expansive folks, but I mean, I talk to anyone who will talk to me about gender, which also made me be like, "Oh, is that a special interest? Are people a special interest?" Like, because I've been so, so social my whole life. But anyway, sidebar.

MEGAN NEFF: For sure autistics exist.

REBECCA MINOR: And I know you told me that. And I still need to read that like, lipstick… I don't remember the name of that book, but like outgoing one.

MEGAN NEFF: Yes, I also forget the name of the book. But yeah, she is like a very extroverted autistic.

REBECCA MINOR: Yeah. But I think just being even curious enough to consider otherwise feels more available to folks who are neurodivergent. Like, they're like, "Well, I just want to see what's over here, or like, try this on, and see how that feels." And just a willingness to play, I think that feels different.

MEGAN NEFF: I love that, a willingness to play. There's the soundbite now that… I'm looking at you Patrick like you maybe have a thought, but I can't tell if you do.

PATRICK CASALE: I like that we all… it feels like this is set up, though, like everyone has a thought at the same time was what my experience was just happening. Like, I was looking at Megan's face, I was looking at your face, Rebecca, and I was also thinking. So, I didn't have words to put into my thoughts. I honestly agree with everything you're saying. So, I'm just nodding, and like thinking, and just thinking about things differently because as someone who honestly, has never really questioned my gender or identity, honestly, I always am curious about that in general, because I'm like, I'm just processing what you're both saying right now. I'm like, this was Megan, your stat about what you say 70% of cishet autistic men don't ever question or did I get that wrong?

MEGAN NEFF: Oh, it's 70% of autistic people identified as non-heterosexual. But like the most likely autistic population to identify as heterosexual are cis men.

PATRICK CASALE: Yeah, that's what I was thinking about. And I was like, "Huh, this in interesting."

MEGAN NEFF: So, the autistic stereotype, yeah.

PATRICK CASALE: Sure, yeah. So, that's where my brain went. But then I was thinking, like, it makes a lot of sense about just playfulness and curiosity, and being willing to break out of construct, and just being like, "Yeah, this is fucking stupid. Like, who told us we were supposed to live this way?" I think that makes a lot of sense in all areas when I'm thinking about a lot of just neurodivergent people, in general.

REBECCA MINOR: Absolutely. And I think Megan Anna and I are great examples of the way in which that can happen and in various orders for folks, right? Like, a lot of times people will realize one of these things, and then it frees them up to realize another.

MEGAN NEFF: I did a story on my Instagram, but then the results didn't show. I don't think I am, like, enough tech savvy to try to do, like, polls on my Instagram stories and show results, which is ridiculous, but-

REBECCA MINOR: I can help you.

MEGAN NEFF: Thank you, I need help. But the poll I did was like if one identity discovery led to the other which identity came first? And so, was it the queer identity? And did that lead to a neurodivergent discovery or vice versa? And the results in the comments were really interesting. I really wish I knew how to show them better in a way that people could see them. But yeah, I see that all the time, where often discovery of one will open the door to the discovery of another.

PATRICK CASALE: Yeah, and I think that-

REBECCA MINOR: [CROSSTALK 00:33:02] language?

PATRICK CASALE: Sorry.

REBECCA MINOR: No, it's okay. I was saying I think that even about language and pronouns, right? Like, the idea that someone could use they/them pronouns doesn't often feel available to folks who feel really bound by linguistic rules, which can get really tricky for folks who are navigating gender expansive identity, and also, autistic, depending on kind of how their autism shows up, right? For some people, they're like, "I can dance around some of these rules." And other people are so bound by those rules. And so, it can get tricky.

PATRICK CASALE: Right, yeah. I agree with that. What I was thinking, Megan, about your poll, do you think that any of this has to do with the fact that regardless of which "identity" comes first, or is discovered first, that it just feels freeing to have it discovered and see the world through a completely different lens? Because so many of us, and I cannot speak for any of the queer identity perspective, but so many of us who are neurodivergent, who are seeking something all of our lives, and seeking like this landing place, and this place to just feel home, I'm using a lot of air quotes right now as if we don't record the video, feels freeing in a lot of ways. And I think that's just where my mind goes when you start to think about like, where does that one go, lead into another perspective, or identity, or realization, or aha moment?

REBECCA MINOR: I think that's a similar experience for folks who come out later in life too, of there's been this long-standing like, "Something's not quite fitting here. Like, why do I feel just a little bit different?" And you know, people who then in their 30s, 40s, but you know, whatever we're considering later in life diagnosed then recognize like, "Oh, maybe that's what it is."

And I think I see that fascinating. I'm fully side-baring now, so feel free to cut this. But I see that happening with people who are also recognizing… either finding out their autistic later because of their own child being diagnosed, and then having that aha, or for parents whose kids come out, and then they're like, "Oh, that's actually something that I never thought about for myself." And really kind of pull back the curtain on that and get to explore like, and that's where I see, whether it's people who are exploring their neurodivergence, or their gender identity, I see it as an opportunity for the whole family and everyone in their lives, really, to get curious about the ways in which that might be showing up for them too.

MEGAN NEFF: I have certainly lived that, where I think the first person to come out in my, like, extended family was one of my children at a youngish age. And then, like, that just kind of, yeah, it's like it opened up a conversation that wasn't a conversation before. And not just in our immediate family, but like beyond that.

And it makes me so proud of these kids who, like, are owning who they are, and then, like, empowering the adults to do that. And like, I'm cringing as I say that because it sounds kind of like parentified to be like, the kids are empowering the adults. But I also think there's like generational movements and pieces in there, where a lot of us just grew up, especially, if we grew up religious, in spaces where, like, it just, like, how comfortably my family, like, with our kids, we talk about queerness, and we talk about identity, and like the fact that from a young age, we never defaulted to like, "When you grow up and marry a man." It was like, "When you grow up and have a partner." Like, that just wasn't accessible to so many of us who are in our 30s, and 40s, and beyond.

REBECCA MINOR: Absolutely not. Yeah, and adding the religious piece is a whole other element of that, which you and I have talked about, too, of like, part of why I am so comfortable talking about gender and sexuality is I never got that messaging. Like, sex was talked about in a really positive, just normal, kind of, like, it's okay to mention it at the dinner table kind of attitude, which is baffling to other people.

And so, I think, yeah, there are real shifts happening generationally, which is like, what we really want to see, right? I feel like that's my, like, life's work is, is working towards that generational change where kids can be exactly who they are and we all need to catch up.

PATRICK CASALE: That is a really good point that you both made. But that's exactly what I was saying before in terms of advocacy and having an audience because when we're talking about movements, that's where this stuff comes from is advocacy efforts from people who are willing to show up and share their own stories.

And my brain is diverging because Rebecca, you mentioned something before about like, not wanting to post the messy side of life, but then those are the things people are always like, "Oh, yeah, that's exactly what I need." It's just because as people, I just think we're wired for connection, and we want relatability, and we want to know that we're not alone. So, that's the content, too. That's like, you throw something up there, you don't perfect it, and you're just like, yeah, take a glimpse at like what this is like for me on a day-to-day and people are like, "Holy shit, this is my life too."

MEGAN NEFF: And I think it adds a layer when we're therapists. I can't remember the name, but there's a New York Times bestseller a few years back now of a therapist who is maybe one of the first to like, the book is about her own mental health. And it was a really a breakthrough moment of like therapists talking about their imperfections because in traditional therapy, it's like you go to the therapist, they're supposed to have it all together, all figured out. But I think people are really responding to… it makes us more human as therapists if, you know, we also have messy kitchens, we also are in process around identities. Now, we know how to contain that, we now have boundaries so that like what's coming into that therapeutic space is intentional. But there's something really powerful that I've seen happening in the last five years, particularly, where therapists are becoming more humanized.

PATRICK CASALE: Yeah.

REBECCA MINOR: And I think it had to happen. Like, the model of the blank slate, like, barely says anything just like furiously takes notes therapist doesn't work for people. It certainly wouldn't work for my clients.

MEGAN NEFF: Particularly, not neurodivergent clients or many queer clients.

REBECCA MINOR: No.

MEGAN NEFF: It doesn't create safety.

REBECCA MINOR: No. And now when I think about retention, I'm like, "Oh, no wonder people are still here." Because like, you can see what's all over my face all the time. Like, there's no… it was feedback I got in grad school, right? Like, you should tone it down. And like, the thing that the feedback I get from clients is like, it's so comforting to me because I always know what you're thinking, or how you're responding to something, or like that you're with me. And it's not intentional, it's just my face.

PATRICK CASALE: Yeah, if it wasn't your face it would be a lot of effort and energy into masking that expression or that reaction.

REBECCA MINOR: Right, right.

PATRICK CASALE: And I think clients, they really resonate with that of like, "Oh, my God." Like, my wife will sometimes tell me I need to fix my face because my reactions are my reactions. And she's like, "Don't react that way in this environment." I'm like, "Ooh."

But in the therapy room, it's really helpful, it's really therapeutic because like, it takes away from that guessing game that clients sometimes have to play of like, that [INDISCERNIBLE 00:41:24] the way I needed it to, "Are you taken aback by what I said? Are you uncomfortable with what I just told you?"

And I like the new era of psychotherapy that we're moving into a blank relatability because I strongly believe this. And I say this all the freaking time that relatability is accessibility. And I believe that wholeheartedly.

REBECCA MINOR: I like that.

PATRICK CASALE: And on our webpage for our group practice says like, "No head nodding, how does it make you feel? We're therapists here?" And like, we get so many calls from people who are like, "Yeah, you're our people." And my marketing person last year, when we were creating the website was like, "You're going to turn off a lot of clients who are uncomfortable with using the F-bomb and saying it this way." And I'm like, "Good, those are not our clients anyway, we don't want those people to call us."

REBECCA MINOR: Right, yeah, that's not your fit. Absolutely. I love that you say no head nodding, how does that make you feel? Because that's the thing, right? Like, that's why people don't want to go to therapy. I hated therapy, initially, when I was forced to go as a child. And like, that poor woman, she tried to have me do art therapy and I scribbled with a black marker all over a piece of paper and was like, [CROSSTALK 00:42:36]-

PATRICK CASALE: [CROSSTALK 00:42:40].

REBECCA MINOR: Yeah.

MEGAN NEFF: That's sassy. I love it.

REBECCA MINOR: Was very sassy. She called my mom in and was like, "I'm not sure that this is going to work."

PATRICK CASALE: We can't fix her. But what happened to me early on in similar environments is like, the sterile nature of like, how can I ever open up, and be myself, and feel comfortable enough to actually share what's happening for me if it's just sterile, and it's just head nodding, and there's no response.

And, you know, I just struggled with that so much growing up as someone who has been in and out of therapy since I was five, and just the reality and realization of like, you can be the best therapist in the world clinically, and use every technique and intervention under the sun, but if there's no relatability, and no ability to build relationship, rapport, and connection, I'm not even listening to you. Like, I'm already thinking about when I leave this place, I'm never coming back here. And that's just the reality.

REBECCA MINOR: Yeah. I just had a question pop into my head as you were sharing that and I don't know if it feels okay to go here or not. But again, feel free to skip this. But I just wonder what it was like for you having been in and out of therapy since five to not be diagnosed for another 30 years?

PATRICK CASALE: Well, to answer your first question first, which is, is it okay to go there? And we encourage all the divergent pathways on this podcast. So, absolutely. I think there's two answers here. I'm doing this [INDISCERNIBLE 00:44:12] Jesus.

But there are two answers, right? Like, there's the answer here of me sitting here today who can like zoom out, look at life, and be like, "Wow, that was really hard." And then there's the answer of like, if I can drop into that life at five and onwards, it was really hard, which is what made me seek out diagnosis because I kept, I've told Megan this a million times, I was seeking that like, "What the fuck is happening?" Like, why is this happening to me? Like, why do I feel every second of every day, of every experience, and every situation so intensely? Why is it so hard for me to connect? Like, all of the questions that we ask ourselves, that has been constant for 35 years of life?

So, I think it's also this… And I've said this publicly, too, and I know my parents listen to this podcast, but there's almost this, and I think, for a lot of people who are my age, and in this age group who were not diagnosed until later on in life were like, "What the hell is happening here? Like, where did this get missed?"

And my mom's response, initially, to my diagnosis was like, "Well, that wasn't my experience of how your childhood was. You were really social and you really do not stop centering, right? Like, let's make it more about what's happening today. Here's the information that I'm sharing with you." But that's what it was.

And my mom was an LCSW in private practice, like, how do these things get missed? And I think it's because my parents are divorced, have been divorced since I was five, very messy stuff. I spent a lot of time alone. A lot of times they'll see that I played soccer. I was like, that's what I was supposed to do. And that's just how reality was for me.

And I think to sum up your question, the answer is hard, but in different ways. Like, hard now cognitively, to think about it from a therapeutic perspective and as someone who's done a lot of work, and then, hard as like, "Damn, it was really hard just existing."

REBECCA MINOR: Yeah, yeah. Thank you for sharing that. I think, as part of my searching for answers, I went and reviewed some of my report cards. And was like, "Hello." Like, it felt so clear. It's like she's so chatty, like, really smart, getting stuff done, but like real peaks and valleys of like, gravely struggling in some subjects, and like, off the charts in others.

But again, there are just so many questions where I'm like, "Where were the grownups?" Like, and it's also what information they have, right? Like, I wasn't a boy who was obsessed with trans. Or I wasn't my sibling who was assigned male at birth, who did get an ADHD diagnosis. So, you know, there are a lot of factors at play.

But I just think about that, like, holding that reality of having been in various care settings for so long and still feeling like this didn't get picked up.

MEGAN NEFF: Diversion two now, but that reminds me… There's an interesting emotional experience that happens and I don't know your sibling, if this tracks, but an example of let's say one child has like level two or level three autism or what would be, I guess, I hear clinicians talk about like more severe ADHD. I don't obviously like that language, but like, more impacted, more evident ADHD, when that child gets diagnosed, the child that perhaps maybe they're level one autism, or maybe they internalize, that sibling often gets missed because so much of the resources is going to the child who's struggling more. Like, that's a unique experience as a sibling. And then when that sibling later in life discovers this identity, I have seen that be a really complex experience of like, the word misattunement comes to mind, like when you're asking Patrick about, yes, 30 years of therapy, especially, 30 years in misattunement when we're discovering that much of our life was happening in this context of misattunement, either from therapists or from our families, that's painful.

REBECCA MINOR: Yeah. And much like Patrick, I had, you know, the context of very messy divorce and a whole… You know, there were so many things happening, that it wasn't the focal point. And I was doing well in school. So, it just didn't really matter because there weren't, you know, and I didn't have behavioral issues besides being chatty.

MEGAN NEFF: Did you have mental health issues.

REBECCA MINOR: Oh, yeah. Oh, yeah.

MEGAN NEFF: Right, that's the classic story, right? Like, we internalize.

REBECCA MINOR: I am like the queen of having a panic attack in the bathroom and coming back to class and looking like everything's fine. So, yeah, totally, it came out in other ways and physical ways too that I'm now tracking. I'm like, "Oh, it's not normal for eight-year-olds to have migraines." Or like, you know, so consistently. Or other, you know, various stomach stuff like GI is so often connected to. I missed so much high school for like, what no one could figure out GI symptoms. They were just like, "Take some Prilosec, good luck." But it wasn't until I started managing my anxiety better that, that made sense, right?

So, yeah, there's so many… I think misattunement is a useful frame for that. And I think feels really validating to think about it through that lens. And I also have a mother who's a LICSW.

MEGAN NEFF: Wait, and I have a dad who's a psychologist.

REBECCA MINOR: Oh, wow.

MEGAN NEFF: [CROSSTALK 00:50:34] like family systems was that we all became. Fascinating.

REBECCA MINOR: It is fascinating. And it's been fascinating to unpack some of that too. Like being, like, it's not just my sibling to have it, but like I have it, and also, like, mom, you might have it too.

PATRICK CASALE: Absolutely, those are good conversations to have when you're able to have them. I was telling Megan that I had one with my dad while I took him to Spain for his birthday a couple of months ago. And I was like, we're drinking, which I knew this conversation was going to come from that. But I was like, "Yeah, so I don't know, if you've been listening to my podcast. I'm autistic, you've never asked me about it. I think you're autistic too. And here are all the reasons why I think you're autistic."

And instead of, like, this rebuttal or reaction, just like, "Yeah, that makes sense." And I was like, "I don't know what to do with this information now." I was expecting a very different conversation.

But this is why I like and I've talked about this on here too, like, IFS work and re-parenting work, and inner child work so much because even though it's still a struggle for me when my therapist is like, "What would you do with five-year-old Patrick? And how would you comfort him?" And I'm like, "I don't fucking know. I have no idea how to answer that."

But the parts work and the ability to piece that together, and like stress it out, and like look at it from a million different perspectives is super useful for me. And it's honestly, the first modality that I've been like, yeah, this is my jam. Like, everything else I don't care about anymore. This is the only way I'll do therapy going forward.

REBECCA MINOR: Same.

MEGAN NEFF: That's true.

REBECCA MINOR: I do like EMDR, but IFS…

MEGAN NEFF: Oh, yeah, you do EMDR, don't you?

REBECCA MINOR: Yeah, not as much anymore, but it was useful.

MEGAN NEFF: I'm feeling a collective like, is this our collective conversations coming to an end? Or is this a collective-like, sigh of the heaviness of what we've just been talking about? What is this energy I'm feeling?

REBECCA MINOR: It felt more like the latter to me.

MEGAN NEFF: Yeah, yeah. Me too.

PATRICK CASALE: Yes, me too. Yeah, I actually feel like we could have this like a five-hour podcast episode right now, which feels really good. It feels like it's been a good conversation. I have no idea how long we've been talking. So, to everyone listening, if you're still listening, we appreciate it. We've been talking for over an hour. So, I think we can continue on, I think we can do a lot of different things right now.

MEGAN NEFF: Rebecca, do you have a hard stop at 1:00 your time? Okay.

REBECCA MINOR: I do. I actually for one of the very first times in my life, I put a buffer between this and my next. Actually, I'm going to be on another podcast. I'm having a podcast day. But now that's something that I'm learning to do for myself. It's been really hard, and it's still hard. But I am trying to put space between things and not push myself past my limits. It's really revolutionary.

MEGAN NEFF: I'm going to check in on you on that in like a month. I'm going to be like, "How are the buffers?" Because, yeah, I've noticed that about your schedule.

REBECCA MINOR: Right, yeah, yeah. And while we're on an IFS kick, I explored that kind of urgency in IFS and that's been really interesting working with that, and also, like, as a legacy burden, that something that we inherit, but also, how much of that has to do with my neurodivergence and that I have so many ideas, and I'm afraid I'll lose something or something's falling through the cracks, or I'll forget if I don't hurry and do it right now. Or I'm like, "Oh, I need to empty the dishwasher." And then, I'm halfway through that when something else comes up, and yeah.

PATRICK CASALE: [CROSSTALK 00:54:55] head nodding right now.

MEGAN NEFF: Yeah, like the inability to trust my energy. And what I mean by that. So, like, if I have an interest in a project, I have to pounce, even if it means I'm staying up to 1:00 and I'm not doing any of the sleep hygiene stuff I always talk about because it's, I don't know that this interest, therefore, this energy will be reliable and available to me tomorrow.

So, there is that like, sense of urgency because I don't trust my mind or I don't trust my energy. And that's it. Like, that's a hard aspect of being ADHD is the difficulty trusting will my mind hold this? Will my energy be there? Will my interest be there? And not being able to predict therefore schedule. I think that's why non-ADHDers when they're like, "Let's do a planner, and let's schedule." What they don't realize of part of why that's so hard for the ADHD brain not just breaking up tasks, but like, I don't know what kind of energy I'm going to wake up with on to Wednesday. So, how do I schedule out? Like, am I going to have a lot of cognitive energy, but not much body energy, or flipped? Yeah.

REBECCA MINOR: Did your camera just move?

MEGAN NEFF: It did, yes. When I do hand motions it moves.

REBECCA MINOR: It's not making things up.

MEGAN NEFF: No, that happened.

PATRICK CASALE: Now, it feels like we're in an ending place. That's at least how I'm picking up on what we're experiencing.

REBECCA MINOR: You know, what I realized, though? We never talked about the thing we said we were going to talk about, with like the polls and stuff, which we don't need to.

MEGAN NEFF: Oh, like getting into the detailed experience of when these identities intersect. Yeah, yeah, we can link to our masterclass that we have where we do like, and I think that's probably better because that's more of a kind of content lecture-based presentation. And it's probably, a more helpful way to absorb all that kind of high-up information.

But yeah, basically, when the identities intersect, it's really complicated. It complicates both identities. You and I have talked about that a lot from like, sensory to executive functioning, to navigating medical systems. And yes, we have a whole masterclass, it's an hour-long that's available. Oh, we should make a coupon code for people who listened so they can get it at a lower rate? I'll do that. And we'll put it in the notes.

But is there anything that we didn't talk about around the intersection that you feel like is important?

REBECCA MINOR: I think probably just acknowledging that some of the challenges will be a little bit different. And to try your best, as hard as it can be to find a provider who will understand both of those experiences, which is tricky.

MEGAN NEFF: It's tricky.

REBECCA MINOR: And if not, you made that helpful flowchart of kind of like, which one is harder right now? And focusing on that. Like, if it feels like the autism is like the key piece, then find someone who really knows their stuff about autism, and hopefully, is decent about gender. And kind of fill in the gaps where you can and vice versa because there aren't a lot of us who are, you know, equally is hyper fixated on this intersection.

MEGAN NEFF: Oh, sorry.

REBECCA MINOR: No, go ahead.

MEGAN NEFF: I was just going to say we should also do a shout-out to FINN's work. We're both Finn's consultation group, Finn Gratton. They have Supporting Autistic Youth, I think is the title. I have it back here. I'll link that in the show notes as well.

But that's for clinicians listening, please go buy that book. It's amazing. And I think also for parents, it's a great resource. And even for individuals. I think it's a really validating read. It's more intended for parents and therapists, but I think for individuals it's also a great read. So, there are some wonderful resources available at this intersection. And we will point to some of those.

REBECCA MINOR: Yeah, and I think it's a danger to assume that you're never going to need to know that or it's not your population that you work with. Like, I didn't focus a lot on autism because I was like, "I'm in the gender world." And then I was like, "Wait a minute, you literally cannot be in the gender world without also understanding autism."

MEGAN NEFF: And same ways you cannot be working with neurodivergent clients and not understand gender queerness, yeah, yeah.

REBECCA MINOR: And that's one thing that's also been really nice with the parent coaching is being able to work with parents who are navigating both of those pieces and they do present with different concerns around their kid less so like, are they really trans or do they really know? But more just that, I think they've been very hands-on parents a lot of the time because what's often-

MEGAN NEFF: Often the neurodivergence, yeah, absolutely, yeah.

REBECCA MINOR: So, that, and like that kind of like autism mom trope, and like, needing to be on top of every detail, and like, it really blindsides them because they're like, "No, I know, my kid and I know what they need." And navigating that combination can be really tricky and…

MEGAN NEFF: Especially, medically because medical providers might see that and be like, "Is the parent pushing this kid's identity piece? The kid needs to be more involved." But maybe the child cannot speak in those medical settings, maybe. And so, the parent often becomes more of an advocate, and that gets complicated when navigating gender affirming medical care.

REBECCA MINOR: Absolutely.

MEGAN NEFF: Yeah.

REBECCA MINOR: It's really pieces too of like, "Oh, well, they're saying they want us to call them this new name and these new pronouns, but they're not changing their clothes." I'm like, "Well, have you considered that those are the clothes that are familiar, and they're comfortable, and that…"

Like, frankly, a lot of what we consider women's clothing is not comfortable. So, you know, maybe they're not wanting to like shimmy themselves into something that's so tight they can't breathe. And that's not an indicator of whether or not they're exploring their gender. So, yeah, that's what I'm happy to help people with.

MEGAN NEFF: Yeah, can you share a little bit about where people can find you? I know, you've got several resources for parents. And yeah, can you share a little bit about that.

REBECCA MINOR: My website is genderspecialist.com. And on there, I have a course called How to Talk to Kids About Gender, that's for all parents. It's not specific to folks who have trans or gender-expansive kids, but just if you know or care about kids, here are some helpful ways to talk about gender with them.

And then, also, information about [PH 01:02:20] peer coaching, which is great because it's not bound by licensure. So, I can work with folks wherever they are. So, I've actually been able to do some of that internationally, lately, which is really cool.

And otherwise, I have lots of free downloads and like a glossary of terms because there's a lot of language to learn and some basics like Now What guides of like, "Okay, so my kid just came out like… Now what?" So, I've got you covered there, and lots of blogs. And then, as you mentioned earlier, I'm also on Instagram @gender.specialist. So, yeah.

MEGAN NEFF: Awesome, awesome. Thank you so much for taking the time. I know your schedule is wildly busy. So, thank you. Oh, my gosh, my voice. Thank you so much for taking the time out of your schedule to talk with us. This has been a fun conversation.

REBECCA MINOR: Thank you so much. It was so nice to finally meet you, Patrick.

PATRICK CASALE: Yeah, you too. This was great. So, really awesome conversation. Thank you so much for being on here.

REBECCA MINOR: Thanks, guys.

PATRICK CASALE: And to everyone listening to the Divergent Conversations Podcast, all of Rebecca's information will be in the show notes, links, all of the things we talked about today, and all the things that Megan mentioned, as well. And new episodes are out on every single Friday. Like, download, subscribe, and share.