Why More Teens Are Questioning Gender
- Celeste Carolin - LMFTA, ADHD-CCSP
- 5 days ago
- 6 min read
A therapist’s perspective on neurodivergence, mental health, and slowing things down
If you spend time with teens, whether as a parent, educator, or therapist, you’ve probably noticed a shift. More adolescents are talking openly about gender. They’re questioning labels, exploring identity, and wondering whether they might be transgender or nonbinary.
Some of this makes sense. When language becomes available and stigma eases, people finally have words for experiences that were always there.
At the same time, teens are dealing with a lot. Anxiety and depression rates are high. Social pressure is relentless. Comparison is constant, and understanding how they feel and why feels like an impossible task. For neurodivergent teens, especially those with ADHD or autism, all of this often lands harder. Gender questions and mental health struggles can become tightly intertwined, especially when a teen is trying to understand why they feel disconnected, rejected, or chronically out of step with peers.
This post isn’t here to decide anyone’s identity. It’s here to slow the conversation down, particularly for neurodivergent teens, and to separate experiences that often get collapsed into one urgent question. I come to this work as a neurodivergent therapist with varied gender expression, working closely with neurodivergent transgender and gender-questioning teens, and I emphasize careful pacing, mental health support, and long-term well-being.
The Mental Health Piece That Often Gets Missed
Many teens who question gender are also dealing with anxiety, depression, shame, trauma, social isolation, or burnout. Naming that does not invalidate gender exploration. It adds context.
When a teen is hurting, their brain looks for meaning and relief. Sometimes a label feels like it might finally explain everything.
In therapy, I often hear some version of:
“If I figure this out, maybe I’ll finally feel okay.”
“If I transition, my anxiety will calm down.”
“This must be why I’ve always felt different.”
Those thoughts aren’t manipulative or confused. They’re human. They also deserve gentle reality-checking, because anxiety and depression usually need direct care alongside identity exploration.
The Neurodivergent Lens
Neurodivergent teens, particularly autistic and ADHD teens, show up disproportionately among youth questioning gender. This does not mean neurodivergence causes someone to be transgender. It does mean gender can feel more confusing, more urgent, or more important to sort out when a teen already experiences the social world differently.
A few patterns tend to overlap:
Gender norms are largely unspoken rules. Many neurodivergent teens don’t absorb social expectations automatically. They have to study them. Gender comes with a lot of rules, and many of them are inconsistent or contradictory.
Not fitting in is often a long-standing experience. Many neurodivergent teens have felt “other” for years. When puberty hits and social hierarchies sharpen, gender can start to feel like the missing explanation.
Literal thinking can collapse stereotypes into identity conclusions. “I don’t relate to girls” can quietly become “I am not a girl,” even when the core issue is discomfort with stereotypes or expectations.
Sensory experiences matter. Puberty, grooming, clothing, body changes, and being perceived by others can be genuinely overwhelming. Sensory distress can look like dysphoria if no one slows down to sort it out.
Certainty can feel regulating. When anxiety is high, a clear identity narrative can feel stabilizing, even if it’s still evolving.
A Simple Way to Understand “Gender Is a Social Construct”
When people say gender is socially constructed, they usually mean that society attaches a lot of meaning and expectation to “boy” and “girl,” and those expectations change across cultures and time.
That idea can be freeing. It can also be very confusing, especially for teens.
Some teens hear messages like:
“If this doesn’t fit, something must be wrong.”
“If I don’t match the stereotype, I need a different label.”
“I’m supposed to figure this out now.”
Neurodivergent teens often take these ideas very literally and feel pressure to analyze gender rather than experience themselves over time. In therapy, I focus on:
What feels distressing? What feels grounding? What changes as anxiety settles? Those answers tend to matter more than abstract definitions.
Gender Identity vs Gender Expression
This distinction alone often lowers panic, but for my teens I work with is hard to grasp.
Gender identity is an internal sense of self that tends to persist over time. Gender expression is how someone dresses, moves, creates, and shows up in the world.
A teen can be a boy who feels beautiful in a skirt. A girl who rejects feminine expectations. Cisgender and strongly gender-nonconforming. Transgender and very gender-typical.
Clothes, colors, and interests don’t determine identity. Not fitting mainstream norms does not automatically mean someone is transgender.
Sidebar: A Story I See Often
I work with many teens who have ADHD and autism and want, very badly, to fit in. One teen, we will call Alex, tried hard to connect with peers but often felt rejected no matter what they did. Over time, Alex began to believe something was fundamentally wrong with them and was deeply depressed and angry.
Alex was creative and drawn to softer, feminine-identified colors. When they tried on a skirt, they felt expressive, something that felt rare and grounding. Alex also experienced very few symptoms typically associated with persistent gender dysphoria. They did not feel significant distress about their body, especially their masculine body parts, and there was little pressure at home to conform to any particular gender standard.
Still, being transgender began to feel like a possible explanation for not fitting in, with the conclusion that they needed hormones to fix the social expectations at school, and for years of social rejection.
In therapy, we slowed the process down. As anxiety and self-criticism eased, Alex was able to explore whether this pull was about gender identity, gender expression, or a longing to finally feel accepted, without pressure to decide.
When Being Transgender Feels Like It Will Fix Anxiety or Depression
This is delicate, but important to name.
Sometimes teens reach for a gender explanation because they are miserable and want relief. That doesn’t make them dishonest. It means they’re trying to survive.
In therapy, I’m often listening for two different questions underneath the same conversation:
Who are you, really, across time and settings?
What pain are you hoping will stop right now?
Both matter. Both deserve care.
Stories like Alex’s highlight why it’s important to distinguish between persistent, body-based gender dysphoria and distress rooted in anxiety, social rejection, sensory overwhelm, or relief from rigid expectations, especially for neurodivergent teens.
Is It Harmful to Pause Medical Transition Until Age 18?
Families ask this often. Teens ask it too. Fear-based answers don’t help.
The research from the last several years is mixed and still developing. Some studies show short-term mental health improvements for certain youth who receive medical interventions. Other reviews emphasize limits in the evidence and the need for careful assessment and safeguards.
What we can say responsibly:
Pausing is not automatically harmful, especially when teens are supported and their mental health is treated.
Pausing medical transition is not the same as denying care. Therapy, family support, school advocacy, and symptom treatment matter.
Some teens experience persistent dysphoria that needs close, individualized attention.
For many neurodivergent teens, slowing down helps clarify what gender dysphoria is and what is distress.
There is no single timeline that fits every teen. Ongoing support and flexibility matter more than speed.
Questions That Often Help
If my anxiety or depression improved, would this feeling stay the same?
Is my distress about my body, or about how people treat me?
Do I want different physical traits, or fewer expectations?
Do I feel calmer over time with this identity, or more urgent?
If I felt accepted as I am, would this question shift?
Why Slowing Down Works
Teen brains are still developing, especially around long-term decision-making. Neurodivergent teens often need extra time to sort signal from noise, particularly when rejection or sensory overload is loud.
Slowing down isn’t invalidating. It creates space for clarity to show up on its own.
Final Thought
Questioning gender isn’t a problem. Being neurodivergent isn’t a problem. Struggling with mental health doesn’t automatically explain identity away.
The goal isn’t a fast answer. The goal is a teen who feels supported enough to understand themselves over time, while also receiving care for anxiety, depression, or overwhelm that may be part of the picture.
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