Creating Safe Spaces in Pediatric Therapy: The Intersection of LGBTQ Identities and Neurodiversity
In the world of pediatric therapy, we often focus on milestones, goals, and treatment plans. But underneath every strategy lies something even more powerful: the relationship between a child and the adult supporting them. For neurodivergent and queer kids, that relationship can either be a place of quiet invalidation—or a safe, affirming space to fully be themselves.
The Intersection of Neurodiversity and Queer Identities
Neurodivergent kids—those with autism, ADHD, sensory processing differences, and more—are statistically more likely to identify as LGBTQ+. Research and lived experience both show that neurodivergent individuals may explore gender and sexuality in unique, nontraditional ways. Yet these kids are often misunderstood, misgendered, or encouraged (explicitly or subtly) to conform to rigid norms in educational and clinical settings.
When a child feels pressure to mask who they are—whether that’s their communication style, their sensory needs, or their gender identity—it can lead to anxiety, shutdowns, and deep emotional harm. As therapists, we have the privilege and responsibility to do better.
Why Inclusive Pronouns Matter
Pronouns may seem like a small part of language, but for many kids, they are a huge part of being seen. Teaching and using inclusive pronouns—like they/them—within speech therapy isn’t about grammar drills. It’s about affirming identity.
When we model pronoun flexibility, include diverse characters in our materials, and normalize asking and sharing pronouns, we send a clear message: You belong here exactly as you are.
Child-Led, Neurodiversity-Affirming Care
The core of neurodiversity-affirming care is simple: respect the child as the expert of their own experience.
That means:
Letting kids lead play, communication, and conversation
Honoring body autonomy and sensory preferences
Supporting stimming and nontraditional communication
Valuing all communication—not just verbal speech
Listening when a child tells you who they are (even if it’s through behavior, AAC, or identity exploration)
When a child says their name or their pronouns, it’s not a trend or a phase—it’s an invitation to connect with them authentically.
How Providers Can Be Allies
🛠 Create Space, Not Pressure
Allow for open-ended expression. Don’t correct or dismiss a child’s chosen name, interests, or identity.
📚 Include Representation
Books, visuals, and toys should reflect a wide range of gender expressions, family structures, and communication styles.
🗣 Model Inclusive Language
Use they/them pronouns as a default if unsure. Respect pronouns across all communication platforms—therapy notes, AAC programming, and casual conversation.
🤝 Collaborate With Families
Many families want to support their child but don’t always have the tools. Offer gentle education and frame inclusion as an act of care, not correction.
💬 Be Open to Learning
Allyship is a practice, not a checklist. Stay curious. Be willing to make mistakes and model humility and repair.
Empowering Kids to Be Themselves
The most powerful therapy doesn’t always happen in goal sheets or behavior plans. It happens in the moments a child feels safe enough to unmask, to laugh freely, to speak in their own way, or to say, “This is who I am.”
When we commit to inclusive, neurodiversity-affirming, and child-led practices, we’re not just teaching kids how to communicate. We’re teaching them they’re worth listening to—exactly as they are.
Ready to affirm every child in your care?
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