Gatekeeping Neuro-Affirming Practice: Who Gets to Decide?

Written by: Jasmine K. Y. Loo (NAPAA Director • Autistic ADHDer • Fellow Human)

The neurodivergent community deserves choice, autonomy, and access to affirming care — not self-appointed advocates policing who’s “allowed” to exist under the neuro-affirming umbrella. Kassiane Asasumasu, who coined the term “neurodivergent” said,

“Neurodivergent is a term of inclusion NOT a term of exclusion.”

But you know what’s ironic? The fact that NAPAA finds ourselves in a position to repeat our key message: “The way we understand neuro-affirming care cannot be any less inclusive than how we understand neurodivergence.”

Because otherwise, how on earth could we possibly meet our clients wherever they are in their journey of discovering their own neurodivergence, let alone support them through it?

The Rise of Gatekeeping in Neuro-Affirming Spaces

In recent years, we’ve seen a concerning shift in the neurodivergent advocacy space. What once felt like a beacon of hope — pushing for true understanding and inclusivity — has, in some circles, devolved into gatekeeping, exclusion and purity politics. The loudest voices, often self-elected, have begun drawing strict and rigid lines around who “qualifies” as neuro-affirming. Any professional who doesn’t adhere to their specific set of expectations are dismissed, vilified or deemed dangerous.

This creates two serious problems:

1. It removes the autonomy of neurodivergent individuals. The assumption that NDs cannot determine for ourselves what affirming care looks like infantilises us. It replaces our own judgment and agency with the opinions of a self-appointed few.

2. It shuts out professionals who are learning and evolving. Instead of fostering an environment where professionals can grow in their understanding of neurodivergence, gatekeeping shuts the door on those who don’t “get it right” immediately. The result? Fewer professionals feel safe enough to engage in these conversations, leading to less access for ND clients.

The Reality: Neuro-Affirming Care is Not One-Size-Fits-All

Neuro-affirming practice is not a single ideology, or simply using all the “right” terms and never using the “wrong” terms — it is an evolving, evidence-informed, person-centred approach that meets the neurodivergent person where they are.

We understand that many neurodivergent individuals are deeply invested in the semantics of language—whether it’s preferring identity-first over person-first language or rejecting the term “disorder” altogether. This isn’t about mere preference; it’s about a profound fear of being pathologised. This struggle with semantics often stems from the fear that society and even professionals may continue to see neurodivergent individuals through a pathologising lens, rather than as whole, multifaceted people. How neurodivergence is discussed often determines how we are treated — and whether we will be understood or dismissed.

We empathise with these concerns. We know that language is a battleground where the stakes are high: it’s about dignity, respect, and the very way neurodivergent people are viewed in the world. However, despite the importance of these discussions, a healthy discourse cannot be achieved through rigid language policing, which does the opposite of honouring the diversity of neurodivergence.

Being neuro-affirming does not mean rejecting every existing framework outright. It does not mean vilifying professionals who operate under regulated, evidence-based systems. It does not mean silencing professionals who use language that is still recognised within their industries (e.g., referring to ADHD as a “neurodevelopmental condition”).

Most importantly, it does not mean that only any one group gets to decide what’s affirming (yes, that includes us, or NAPAA as a whole).

Setting the Record Straight

NAPAA is built on a foundation of inclusion, integrity, and professional accountability. Our resources are dedicated to providing educational and informational content, alongside lived experience perspectives. This article is an exception — our only opinion-based piece — written to clarify key points and ensure transparency about what we stand for.

We recognise that discussions around neuro-affirming care can be passionate, and while we welcome constructive conversations, we also respect that our values may not align with everyone’s. Maintaining a healthy discourse is necessary for continued progress, but that is not at all synonymous to gate-keeping. Here are some questions we've been asked:

1. “Traditional governing bodies aren’t affirming, so why require professionals to be registered?”

   Because basic professional accountability matters. Neuro-affirming does not mean abandoning ethical and professional standards. Registration ensures that professionals adhere to an ethical code, maintain their training, and can be held accountable if they cause harm. Having a governing body does not mean someone is inherently non-affirming.

   
   

2. “How do you ensure practitioners are actually neuro-affirming?”

   By creating a community-driven approach to accountability, not a gatekeeping hierarchy. NAPAA exists to empower neurodivergent individuals to make informed choices about their care. Members must align with core neuro-affirming principles — but we do not claim to be the ultimate authority on neuro-affirming practice. We trust ND people to assess their own experiences and share feedback accordingly. We’re here to empower, not disempower NDs by telling them what/how to think.

   
   

3. “This is just another way for non-affirming professionals to use ‘neuro-affirming’ as a marketing tactic.”

   We get it. We are ND ourselves. We have also experienced professionals who claim to be affirming but don’t understand the basics. That’s exactly why we built this — to increase visibility for professionals who are genuinely committed to neuro-affirming care. But let’s be clear: gatekeeping doesn’t protect us from this problem. Education and community-driven accountability do.

   
   

4. “Are you saying there’s no one else who can be genuinely neuro-affirming outside of your accepted professions?”

   Absolutely not. There are many neuro-affirming professionals and individuals out there, and we’re not claiming exclusivity or elitism. But here’s the thing — NAPAA is not a governing body. We can only operate within clear, structured parameters — accepting professions that have existing industry standards, ethical frameworks, and accountability structures in place.

   
   

   That doesn’t mean we believe those outside our accepted professions aren’t neuro-affirming, nor are we deliberately excluding them. It's just like how we aren't trying to imply no professionals outside of Australia is truly affirming - we are just Australian-based, is all. All this simply means we do not have the legal authority to investigate or govern anyone’s practice. We will never claim to be something we’re not — or pretend to hold authority we don’t have. That’s a promise.

The Danger of Gatekeeping

• It drives professionals away from learning. The fear of being “cancelled” discourages professionals from engaging in necessary conversations about improving their practice.

• It reinforces an all-or-nothing mindset. There’s no space for growth — only the illusion of “perfection” or total rejection.

• It creates a false dichotomy: Either you fit into this rigidly defined idea of what’s neuro-affirming, or you are a danger to the community. When have we seen sustained progress working this way?

• It alienates neurodivergent people who don’t conform to the ‘approved’ ND experience. Gatekeeping assumes that all ND people have identical needs, preferences and values. We don’t. Period.

NAPAA's Approach: Choice, Accountability and Transparency

At NAPAA, we believe that neurodivergent individuals deserve to choose their own professionals based on clear, transparent information.

Instead of dictating who is or isn’t “affirming enough,” we create a platform where professionals are visible, accountable, and encouraged to engage in ongoing learning. We do not gatekeep; we provide resources, community support, and transparency.

Our goal is simple: Empower neurodivergent individuals to make informed choices.

Final Thoughts

Neuro-affirming care is not a personal brand or a trend to police. It is an evolving approach that prioritises understanding, autonomy, and dignity. We are here to build bridges, not walls. If you care about neuro-affirming practice, we invite you to engage, contribute, and keep these conversations open.

We will not let rigid gatekeeping undermine the autonomy of neurodivergent people.

We trust our own ND community to define what is right for them.

And we will not be silent about it.

Ultimately, there’s work that needs to be done, voices and lived experiences that need to be heard, knowledge to be acquired. NAPAA welcomes all those who are committed to doing the work, to listening to the voices of NDs, and to the continuous learning to better serve the community. Are you that person?