From ‘othered’ to ‘embodied’: neuroqueer art therapy with autistic, gender-expansive young people

Abstract

Background: This paper examines art therapy for autistic and gender-expansive (those whose gender expression is not defined by the binary of male or female) youth. Gender identity is explored through the wider lens of the LGBTQIA+ community (that is, lesbian, gay, bisexual, transgender, queer, intersex, asexual and persons holding other gender and sexual identities), while autism is understood as part of neurodivergence (neurological functioning that diverges from the societal ‘norm’). Context: Experiences of marginalisation are contextualised within a medical model and in relation to the client’s lived experiences. The sessions were attended by an adolescent and delivered by a trainee art psychotherapist, at a Child and Adolescent Mental Health Service (CAMHS) in North West England. Approach: Neuroqueer-affirming practice, such as in making environmental changes, validating experiences and recognising both strengths and challenges of neurodivergence, is explored intersectionally. Sensory-integrative practice that supports the organisation of sensory information underpins the theoretical framework. Outcomes: These approaches in art therapy may support sensory integration, communication and self-discovery and mitigate the impacts of traumatic experiences for this client group. Conclusions: Where youth mental health services are not adapted to best meet autistic, gender-expansive clients’ needs, these clients may experience additional marginalisation, furthering existing mental health difficulties. Implications for research: Sensory-integrative and neuroqueer-affirming practice may be of particular benefit for autistic gender-expansive youth, highlighting the lack of current and co-created research. Bodily experiences of countertransference (the therapist’s emotional or physical response to the client) and the impact of the art therapy setting may be especially useful to consider. Plain-language summary: Research about gender-expansive autistic young people has traditionally ignored their life experiences, wishes and opinions. These young people experience high levels of mental distress, which is made worse by societal prejudices. This highlights the need for mental health interventions, such as art therapy, to be tailored to the needs of these clients. This paper includes elements of art therapy sessions with a young person I worked with as part of my trainee placement, who identified both as non-binary and autistic. These sessions explore this young person’s experience within the context of Child and Adolescent Mental Health Services (CAMHS) in the National Health Service (NHS). The paper explores intersecting themes that are present in art therapy with autistic gender-expansive young people and the wider LGBTQIA+ community. Additionally presented are ways in which art therapy may be beneficial to address the specific mental health needs of this client group.