Professional Dignity and Neurodiversity in Pharmaceutical Medicine

Posted on: Wednesday 17 June 2026

This blog article has been prepared by Dr Rachael Harlow, a member of the EDI Forum.

 

The article presents the views of the author and not necessarily those of the Faculty of Pharmaceutical Medicine.

Pharmaceutical medicine is a field defined by a reliance on scientific enquiry, complex problem-solving, and among many other pursuits, innovation. Indeed, as in other medical fields, divergent thinking is often an asset that is capitalised upon for scientific breakthroughs. And yet, despite our fundamental dependence on this virtue to develop life-changing therapeutics, corporate environments often cling to rigid and neurotypical behavioural expectations.

For neurodivergent professionals, this creates a “Personality Gap” – a space between how a neurodivergent individual naturally processes the world and the unwritten social contracts of the corporate workplace. In this article, we discuss what is needed to bridge that gap by advocating for professional dignity and authentic integration, without requiring conformity.

The Clash of Styles in Pharma

Pharmaceutical development is highly matrixed. Cross-functional collaboration permeates every pore of medicines development, and we rely heavily on constant and consistent stakeholder engagement. There are vanishingly few roles (and indeed perhaps there are none) that don’t require professionals to build and maintain relationships on a daily basis with a great many people, of great many professional backgrounds. In this environment, colleagues who work, communicate, or socialise differently often find themselves undervalued, regardless of the quality of their output.

Though interpersonal relationship difficulties are by no means exclusive to the neurodivergent community, and the vast spectrum of neurodiversity means that not every individual will experience interpersonal difficulties, it is nonetheless a common issue. Many neurodivergent employees experience feelings of isolation due to difficulties navigating workplace dynamics or being misunderstood by peers, which often stems from differences in social communication styles and a preference for explicit instructions over ambiguous, unwritten workplace norms (1, 2). Those who find themselves struggling with the nuanced political manoeuvring of a cross functional team, or who find networking exhausting and stressful, may be unfairly labelled as “difficult” or “not a team player”(3-5).

Cross-functional collaboration permeates every pore of medicines development, and we rely heavily on constant and consistent stakeholder engagement.

Similarly, neurodivergent individuals may experience dissonance between their ways of working, compared to their team. Utilising periods of hyperfocus to deliver significant work packages ahead of deadlines may feel like a wonderful trait to possess, but unconventional and non-linear working styles may clash with expectations from leadership to deliver more steady and paced outputs.

In both of these scenarios, individuals who may be delivering their professional work streams exceptionally well may still be encouraged by their people leaders to “improve” aspects of their personality or aspects of their person that are heavily driven by their neurodivergence. When this means that person is overlooked for development opportunities, promotion, or even penalised for these traits, this creates a problem. The 2024 Buckland Report found that autistic graduates are the most likely to be overqualified for the jobs they hold, and autistic individuals face the largest pay gap of all disability groups, earning on average a third less than non-disabled people (6). The reality of this resistance with leadership is stark, with a study of nearly 1,000 neurodivergent employees found that 65% fear discrimination specifically from their management (7).

This disconnect is often glaringly obvious during the annual performance review cycle. In the pharmaceutical industry, performance evaluation typically relies on a dual-axis system: employees are graded both on objective deliverables and subjective behavioural competencies. It is here that a trap is sprung for neurodivergent professionals. An employee might achieve exceptional ratings on objective metrics, but their overall performance rating is dragged down by the subjective behavioural axis. Rubrics assessing “leadership behaviours,” “stakeholder agility,” or “executive presence” implicitly measure how well an individual adheres to neurotypical communication and socialisation standards. Consequently, a neurodivergent employee’s direct communication style or preference for asynchronous collaboration may be documented as a “development area” under the guise of lacking “soft skills.” When promotions and leadership development programs are gatekept behind these subjective, neurotypically-biased behavioural scores, the organisation systematically filters out diverse cognitive talent, mistaking a difference in operating style for a deficit in leadership potential.

unconventional and non-linear working styles may clash with expectations from leadership to deliver more steady and paced outputs.

The Exhaustion of Masking

To navigate this personality gap, many neurodivergent professionals engage in “masking”. Masking is the conscious or unconscious suppression of natural neurodivergent traits in order to pass as neurotypical, and is highly prevalent. It functions as a deliberate, exhausting survival strategy to safeguard neurodivergent individuals against the threat of negative social and employment outcomes (8). In whatever guise masking presents itself, it is often a necessary survival mechanism used to avoid professional discord.

To add to this, the cognitive energy that masking requires is vast, and shouldn’t be underestimated. While a masked employee might seamlessly blend into the corporate culture, they are often doing so at the cost of invisible burnout and spending energy that could be used for scientific innovation on simply pretending to be someone else. This constant suppression of natural behaviours to appear “socially acceptable” leads to severe psychological consequences, with a 2023 study of 225 autistic doctors revealing that 77% had experienced suicidal ideation, 49% had self-harmed, and 24% had attempted suicide due to the pressures of fitting into unsupported environments (9).

While a masked employee might seamlessly blend into the corporate culture, they are often doing so at the cost of invisible burnout…

Double-Bind: Intersectionality in the Workplace

As pharmaceutical medicine professionals we look for “clean” signals in our trials, carefully selecting inclusion and exclusion criteria to lay bare the effects of our therapeutics and ensuring that we minimise the effect of confounding factors. In real-life however, neurodivergence does not exist in a vacuum. When neurodivergence intersects with gender, race, or any protected characteristic, the challenges are exponentially magnified. For instance, neurodivergent individuals who identify as LGBTQIA+ often experience a “double marginalisation” where they carry a dual burden (10). Indeed there is a pointed statistical overlap between neurodivergent and LGBTQIA+ communities; with over half of autistic women in one study reporting falling on the asexual spectrum, and only 8% identified as strictly heterosexual (11).

Neurotypical corporate models often implicitly penalise women (12),  but neurodivergent women face compounded barriers. When neurodivergence intersects with other marginalised identities like gender, the compounded stigma often results in deeper concealment of their condition at work (13). This is exacerbated by historical biases in medical research mean that ADHD and autism are diagnosed two to four times more frequently in males than in females, often leaving neurodivergent women without formal recognition, accommodations, or support until much later in life (14, 15). Because women are not expected to be neurodivergent, their colleagues and managers frequently miss the underlying context of their behaviour. Instead of recognising a difference in neurocognition, a neurodivergent woman’s traits may well be judged as a character flaw, being perceived poorly simply for failing to meet deeply ingrained gender expectations. Research demonstrates that sexist expectations requiring women to interact and display emotions in a neurotypical manner often cause their need for support to be entirely overlooked, which directly and unfairly restricts their career progression (16). Moreover, evidence shows that women are heavily disadvantaged by rigid gender-related office expectations such as specific standards for appearance and social interaction, placing a disproportionate burden on neurodivergent women and leads to significantly higher rates of workplace stress (17).

Intersectional stereotyping may likewise play a devastating role for ethnic minority neurodivergent employees. A neurodivergent trait, such as blunt communication or differences in eye contact, can be unfairly weaponised against them through the lens of racial bias – resulting in them being labelled in a way that a non-minoritised peer may not be. For example, Black autistic women frequently face “misogynoir”: a specific blend of anti-Black racism and misogyny where their atypical neurodivergent behaviours are wrongfully misinterpreted as aggression (18). This is complicated further by the fact that Black and Brown people in the UK already face significant systemic biases within the autism diagnostic system, leaving them without formal support and even more vulnerable to having their traits misjudged (19, 20). These compounded barriers are not limited to the Black community; neurodivergent individuals from other ethnic minorities also face intense, culturally specific stereotyping. A recent study of ethnic minority professionals across the UK and US found that while neurodiversity intensifies “deficit” stereotypes for Black and Latinx professionals, it paradoxically contradicts the expected “model minority” stereotype for Asian professionals (21). Across these groups, neurodivergent traits are often misjudged simply as cultural mismatches with dominant corporate norms, forcing ethnic minority employees to engage in exhausting identity management strategies to survive and advance in their careers.

When neurodivergence intersects with gender, race, or any protected characteristic, the challenges are exponentially magnified.

Conscious Disclosure

The reality that faces many professionals in the corporate workplace is that disclosing neurodivergence to people leaders carries profound risks. Worryingly, these fears are grounded in statistics. Recent data demonstrates that the stigma surrounding neurodiversity remains a potent barrier to career progression:

  • Data reported by Zurich UK reveals that 63% of neurodivergent adults believe employers view neurodiversity as a “red flag” rather than a strength to be harnessed. Consequently, 51% feel they cannot or should not disclose their neurodiversity out of fear that the associated stigma will prevent them from securing employment (22).
  • This report also noted that 31% of neurodivergent candidates reported their job applications were not progressed after disclosure (22), with another study indicating that autistic candidates report instances of their applications being halted or rejected due to stigma after disclosure (2).
  • Impact of disclosure: A UK-based peer-reviewed study surveying 238 autistic adults found that employees were highly concerned about how colleagues would react, leading many to only disclose selectively or after issues arose. Worryingly, just over a third of participants reported that disclosing to their supervisors and coworkers actually yielded a positive impact (23).

When employees hide who they are to protect their livelihoods, the organisation loses out on authentic insights, and the employee suffers. Given that the risks of disclosure are statistically very real, we cannot place the onus on the most vulnerable employees to ask for help. The burden falls firmly on leadership to proactively create psychological safety within their teams. By anticipating these needs and normalising different ways of working, leaders can build an environment where individuals don’t have to formally ‘out’ themselves just to be set up for success.

When employees hide who they are to protect their livelihoods, the organisation loses out on authentic insights, and the employee suffers.

Reasonable Adjustments

Under the UK Equality Act 2010, employers have a legal responsibility to make reasonable adjustments so that disabled workers, which includes many neurodivergent people, are not substantially disadvantaged (24). But in the context of professional dignity, we need to move beyond standard operational adjustments like specialised software or noise-cancelling headphones.

Systemic adjustments require flexibility in how we measure success and manage people:

  • Re-evaluating performance metrics: Evaluate professionals on the output, accuracy, and quality of their work rather than highly subjective measures like “charisma” or “team fit”.
  • Flexible communication structures: Provide written agendas prior to meetings to allow for processing time. Normalise asynchronous communication and written feedback rather than forcing on-the-spot responses and high-pressure brainstorming sessions.
  • Adjusting social expectations: Remove the unspoken penalty for opting out of non-essential corporate social events or after-hours networking. Social stamina is not a reliable indicator of professional competence.

A Call for Professional Dignity

Neurotypical professionals are rightfully afforded the freedom of expression and the right to their own personalities, and neurodivergent people deserve that exact same right.

True neuro-inclusion requires us to audit our own managerial reflexes, and leaders must honestly evaluate whether they are managing performance or policing personality. We must stop asking our brightest minds to spend their energy pretending to be someone else.

Professional development should be about enhancing skills, expanding knowledge, and achieving scientific excellence, and not about policing personality. By respecting the professional dignity of neurodivergent employees, we not only create a more equitable workplace, but we unleash the full and unbridled potential of the minds working to advance pharmaceutical medicine.

If these are issues that resonate with you, you are not alone. If you would like to find out more about the support that is available, a good place to start for FPM members is FPM Connect, a mentoring platform where you can link with other pharmaceutical professionals.

The UK government also support the Access to Work scheme to help those with mental health conditions get or stay in work, and the Autistic Doctors International organisation offers support, advocacy, and education. In many organisations, you may find access to Employee Resource Groups (ERGs) and Disability Networks that aim to establish formal and informal peer support networks and offer safe and confidential spaces for neurodivergent employees to share experiences, offer mutual support, and advocate for systemic workplace changes.

True neuro-inclusion requires us to audit our own managerial reflexes, and leaders must honestly evaluate whether they are managing performance or policing personality. We must stop asking our brightest minds to spend their energy pretending to be someone else.

References

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