Living in the Crossfire: Chronic Pain, Neurodivergence, and a System That Fails Us

Chronic pain is not just a nuisance or inconvenience—it’s a constant force that dominates every aspect of life. When paired with neurodivergence, it creates a profound and often invisible struggle. As a trans woman who is autistic and lives with debilitating chronic pain, I know firsthand how systemic failures compound this burden. This article explores the harsh realities of living in a world that lacks the infrastructure to support us, along with the emotional toll of being misunderstood and marginalized.

“Invisible Shackles”: The Relentless Nature of Chronic Pain

Chronic pain doesn’t clock out at the end of the day; it’s a 24/7 experience that infiltrates sleep, focus, relationships, and basic self-care. Every movement becomes a calculation: Will this worsen the pain? Is this worth the risk?

For those of us who are neurodivergent, the effects are magnified. Sensory sensitivities make pain even harder to bear, and the fatigue of masking or navigating social norms drains already limited energy. It’s like trying to navigate life with invisible shackles—everything takes more effort, and yet no one sees the weight you carry.

“No Place in the Machine”: A Workforce That Leaves Us Behind

The modern workforce is optimized for efficiency, not accessibility. Flexible hours or remote work might seem like solutions, but they rarely address the deep, systemic barriers faced by people with chronic pain and neurodivergence.

Employers often view accommodations as liabilities rather than necessities, and disclosure can lead to stigmatization. The “hustle culture” mindset only deepens the divide, treating those of us who can’t maintain relentless productivity as disposable. In today’s economy, where inflation outpaces wages and the safety net is full of holes, living with chronic pain and neurodivergence becomes an almost impossible balancing act.

“A Lonely Battle”: Misunderstood by Family and Friends

Living with chronic pain is isolating, but the misunderstanding of loved ones can make it even lonelier. Comments like, “But you don’t look sick” or “Have you tried yoga?” reveal a lack of awareness about the complexity of invisible disabilities.

The emotional toll is twofold: dealing with dismissive attitudes while also rejecting pity. Pity reduces us to objects of tragedy, while true understanding and empathy are rare. For me, being a trans autistic woman adds another layer—my struggles are often seen as part of my identity rather than independent challenges, which invalidates the reality of my pain.

“Systemic Gaps, Personal Costs”: Healthcare and Economic Barriers

The healthcare system is ill-equipped to handle the intersection of chronic pain and neurodivergence. Pain management is often treated as a one-size-fits-all problem, ignoring how neurodivergent brains process pain differently or how executive dysfunction complicates self-care.

Even when help is available, it’s rarely affordable. Disability benefits are hard to qualify for and provide insufficient support. Therapies, assistive devices, and even transportation are out of reach for many. The result is a cycle of poverty that traps people who are already fighting just to survive.

“Resilience Without Choice”: Living Despite the Odds

Resilience is often romanticized, but for those of us with chronic pain and neurodivergence, it’s not a choice—it’s survival. We adapt, advocate, and find ways to live despite the odds. But resilience shouldn’t be an excuse for systemic inaction. We deserve workplaces that value inclusion, healthcare systems that prioritize holistic care, and communities that support us without judgment.

References

1. American Psychological Association. (2023). The mental health toll of chronic pain and online harassment. Retrieved from apa.org

2. Disability Rights Organization. (2025). Systemic failures in accommodating chronic pain and neurodivergence. Retrieved from dro.org

3. National Pain Foundation. (2024). Barriers to chronic pain treatment in marginalized communities. Retrieved from painfoundation.org

4. Them. (2025). The intersection of gender identity and healthcare discrimination. Retrieved from them.us

5. Forbes. (2025). How the workforce excludes disabled individuals in the modern economy. Retrieved from forbes.com

Let’s push for change, not just for ourselves but for everyone left behind by a system that wasn’t built for us. We deserve better, and we’ll keep fighting until we have it.