Working together towards a Learning Disabilities, Autism and Neurodivergence Bill: partial equality impact assessment

Findings

Age

Evidence suggests that neurodivergent people of all ages and those with learning disabilities often experience fragmented support from public services, limited access to independent advocacy, and poorly coordinated transitions.

The Bill proposals could help improve this through a statutory national strategy, local delivery plans and guidance, mandatory training, improved data, and advocacy that extends across all life stages. These measures aim to ensure that neurodivergent people do not lose support as they move between services and through life.

For older adults, the Bill’s age-inclusive approach is intended to recognise those diagnosed under historic terminology, such as Asperger’s Syndrome, and seeks to promote awareness of age-specific needs and continuity of support.

Stakeholders, including Alzheimer Scotland, noted that older people with learning disabilities may experience distinct challenges such as higher risks of early-onset dementia and complex care needs. They emphasised the importance of ensuring that health and social care systems are responsive to these needs and that guidance under the proposed Bill takes account of ageing and long-term conditions.

Mandatory training could provide an opportunity to promote understanding of age-related factors (including the intersection between learning disability, neurodivergence, and conditions such as dementia) ensuring that older adults receive consistent and dignified support across settings.

Disability

Evidence gathered through consultation supports that the potential LDAN Bill is intended to promote equality for disabled people by improving awareness, communication, advocacy, and workforce understanding across public services of neurodivergent people and people with learning disabilities, many of whom are likely to meet the definition of disability under the Equality Act 2010.

For people who are considered to fall within the proposed Bill’s umbrella term “neurodivergence”, these measures are expected to bring significant benefits. Stakeholders highlighted that clear statutory duties, consistent terminology, and mandatory training could help reduce stigma, improve access to tailored support, and ensure that neurodivergent people and those with learning disabilities are better understood when accessing a range of public services.

While the Bill’s consultation was positively received overall, some stakeholders noted that future implementation should continue to reflect the diversity of lived experience within the disability community. While the Bill focuses on a specific group of disabled people this approach reflects some indications of particular barriers that are experienced differently by different disabled groups. The measures proposed are intended to address those particular challenges to ensure equitable access and outcomes for this group.

Furthermore, many organisations who represent a specific type of neurodivergence or learning disability, including Down’s Syndrome, Fetal Alcohol Syndrome Disorder (FASD) and dyslexia emphasised the importance of clarity about terminology and who the Bill was intended to apply to.

Future work on a potential LDAN Bill should continue to engage with underrepresented groups, alongside alignment with existing equality duties, to ensure that, as far as possible, benefits of the LDAN Bill are also felt by the wider disabled population.

Race

Evidence indicates that neurodivergent people and people with learning disabilities from minority ethnic backgrounds face significant barriers in accessing services, including assessment and diagnosis; accessing support; and communication. Consultation responses highlighted that cultural assumptions and limited interpreter availability can delay conditions and support needs being recognised and can exacerbate stigma.

Third sector organisations such as Scottish Ethnic Minority Autistics (SEMA) and Boots and Beards Carers Group described deep-rooted barriers to receiving appropriate support when accessing services, including when accessing assessment, diagnosis and support. Consultation findings suggest that white-centric diagnostic frameworks, cultural assumptions, and a lack of interpreter provision often lead to dismissal or misinterpretation of autistic and other neurodivergent traits. Families also expressed concern that support services do not always reflect their cultural values and faith needs, leaving them excluded from decision-making.

A member of Scottish Ethnic Minority Autistics (SEMA) said: “Being in spaces where I recognise myself/my nephew is powerful. He is a human being in his own.”

These experiences highlight the importance of culturally competent training, diverse representation within services, and inclusive data collection. The Bill’s proposed mandatory training could help embed anti-racist and culturally responsive practice, ensuring that neurodivergent people and people with learning disabilities from minority ethnic backgrounds and their families are recognised, respected, and supported.

Furthermore, advocacy provision that is reflective of diverse backgrounds could also help reduce these inequalities. Improvements to data proposed by the Bill could support better equality monitoring and disaggregation by ethnicity, enabling public bodies to identify and address disparities. The Scottish Government could continue to work with ethnic minority organisations to improve representation in co-production and ensure that strategies and local delivery plans reflect cultural and linguistic diversity.

Sex

Evidence indicates that neurodivergent women and girls and those with learning disabilities are at heightened risk of gender-based violence and exploitation. Studies show that women with learning disabilities experience disproportionately high rates of domestic and sexual violence and may face barriers to disclosure, recognition, and protection. These risks can be further compounded for women from minority ethnic backgrounds due to cultural stigma, language barriers, and limited access to trusted support.

The proposed Bill could help address these inequalities through mandatory training that embeds awareness of gender-based violence, inclusive communication, and trauma-informed practice across public services. The advocacy and data proposals have the potential to strengthen safeguarding by improving early identification of risk and ensuring that responses are sensitive to gender and cultural context.

People First (Scotland) members described significant barriers to relationships, safety, and equal treatment. Many women with learning disabilities reported not being viewed as adults capable of forming relationships or making their own decisions about sex, marriage etc. The lack of accessible information on relationships and sexual health, combined with limited professional understanding, leaves women at increased risk of coercion and abuse.

Members described fear of losing control over their lives if they disclose risk, due to past experiences with adult protection and guardianship processes. They called for support that builds confidence and autonomy, rather than removing choice.

People First explain in their consultation response: “Some of us worry that if we speak up things may blow out of proportion and the situation may go outwith our control. This is because many of us have had bad experiences with Adult Support and Protection and Guardianship.”

These insights underline the importance of gender-sensitive training and accessible information for neurodivergent women and women with learning disabilities. The Bill’s mandatory training and advocacy proposals could help address these inequalities by embedding trauma-informed, rights-based, and inclusive practice across services, ensuring women with learning disabilities are recognised as equal adults entitled to safety, choice, and support.

Gender reassignment

Evidence indicates that trans and non-binary neurodivergent people experience intersecting forms of stigma, exclusion, and poor mental health outcomes. Stakeholders reported that fear of prejudice can deter people from seeking diagnosis or support, particularly within healthcare settings. There is little evidence relating to trans and non-binary people with learning disabilities.

Additional evidence from the Scottish Trans Alliance highlights that neurodivergent trans and non-binary people face barriers both in accessing healthcare and in being recognised as capable decision-makers. It is highlighted that practitioners may wrongly assume that neurodivergent people “do not understand gender”, which may lead to gatekeeping and delay access to gender-affirming care. This misunderstanding re-enforces patterns of distrust and service avoidance.

The Clare Project’s Trans and Non-Binary Autistics Mental Health Study (2023) found that nearly half of participants were severely depressed, two-thirds were severely anxious, and over half met criteria for post-traumatic stress disorder. The study found a strong correlation between poor mental health and experiences of anti-autistic and transphobic discrimination, underscoring the importance of intersectional, person-centred support.

One member of the Scottish Trans Alliance explained: “They rely on phone reviews, which as an autistic individual I can’t deal with… They won’t do anything by text or email, and I can’t cope with face-to-face. They’re utterly inflexible and understand nothing about autism.”

This testimony illustrates how rigid systems can unintentionally exclude neurodivergent trans and non-binary people from essential healthcare.

Stakeholders also emphasised the need for online engagement, and consistent bias training to ensure equitable access to health and advocacy services.

These insights reinforce the need for intersectional training, flexible communication, and inclusive design across all public services. The Bill’s proposed mandatory training and advocacy provisions could promote respectful, affirming, and trauma-informed practice. We will continue to consider how we can seek to better understand the perspectives of transgender and non-binary people with learning disabilities and ensure that their needs are reflected in any future developments for the proposals for the LDAN Bill.

Sexual orientation

Evidence indicates that LGBTQ+ people frequently encounter barriers in public services and higher rates of poor mental health. Consultation evidence from both the Scottish Trans Alliance and LGBT Health and Wellbeing shows that neurodivergent LGBTQ+ people experience multiple layers of discrimination and exclusion, often rooted in assumptions about identity and capacity.

Stakeholders highlighted that these barriers are particularly acute in healthcare, social care, and justice settings. Neurodivergent LGBTQ+ people reported being misunderstood or infantilised when seeking support, and some described being told not to disclose their neurodivergence when pursuing gender-affirming care. Such experiences contribute to mistrust, delayed diagnosis, and avoidance of essential services.

The community also described challenges when engaging with public services such as job centres, mental health services, and the police. Respondents described encounters where their neurodivergence and LGBTQ+ identity were not recognised or were misinterpreted, leading to distress and exclusion.

A member of LGBT Health and Wellbeing's LGBT+ Autism community group relayed: “I think it's easier for police to pick on gays and neurodivergent people. There's also a historic traumatic relationship there.”

Despite these views and experiences, there was strong support among LGBTQ+ neurodivergent communities for the Bill’s proposed training, data, and advocacy proposals. Participants emphasised that mandatory training should be intersectional and co-produced with lived experience groups, and that inclusive data collection will help identify disparities across services.

These insights highlight the importance of ensuring that mandatory training includes awareness of diverse sexual orientations and gender identities, and that strategies developed under the Bill could promote equal access to advocacy, safety, and mental health support. We will continue to consider how we can work with LGBTQ+ organisations to ensure that implementation of the Bill reflects the diversity of neurodivergent experiences and builds trust with communities historically excluded from public services.

Religion or belief

Evidence gathered through consultation did not identify specific impacts related to religion or belief, although some respondents highlighted the importance of culturally sensitive approaches in service design. Faith sensitivity and cultural understanding could therefore be built into workforce training and advocacy models, helping to reduce stigma and ensure that services respect diverse religious and cultural contexts.

Marriage and civil partnership

Evidence from carers and Disabled People’s Organisations emphasised the central role that spouses and civil partners play in sustaining daily support, advocacy, and stability for neurodivergent people and people with learning disabilities. Implementation of the Bill proposals could recognise these relationships as a key part of inclusive practice, ensuring that spouses and civil partners who are also carers and supporters are involved in planning and decision-making, have access to clear information, and are supported through advocacy and communication pathways.

Pregnancy and maternity

Evidence on the experiences of neurodivergent people and people with learning disabilities during pregnancy and maternity remains limited. In their response to the consultation, People First highlighted that people with learning disabilities should have better access to services including sexual health and relationships and parenting support.

Stakeholders also highlighted the need for clear communication, informed choice, and accessible maternity care. Inclusive training for maternity staff and collaboration with public bodies could help ensure that neurodivergent people and people with learning disabilities receive equitable access to information and support regarding pregnancy and maternity and that future research strengthens the evidence base in this area.

Relatedly, research suggests that a high proportion of people with learning disabilities have their children removed from their care. Many people with learning disabilities can feel that their perceived parenting mistakes attract additional or disproportionate scrutiny and serious consequences. The Bill’s mandatory training and advocacy proposals could help to change societal attitudes towards parents with learning disabilities.

Intersectionality and human rights

Evidence from consultation and stakeholder engagement highlighted that discrimination often compounds across characteristics. For example, autistic women from minority ethnic backgrounds described delayed or missed diagnosis due to both gendered and cultural assumptions.

Evidence also showed the interaction between socio-economic deprivation and equality outcomes. People living in areas of higher deprivation are more likely to experience barriers in accessing health care, including for diagnosis, and access to support including advocacy, and these challenges are often compounded by protected characteristics such as disability, race, and gender. The LDAN Bill has an opportunity to align with the Public Sector Equality Duty and the Fairer Scotland Duty by recognising deprivation as a key driver of inequality and ensuring provisions reach those most affected by multiple disadvantage.

Taken together, this evidence demonstrates the need for an explicitly intersectional approach to implementation. The Bill proposals as outlined could deliver this through the cross-cutting proposals which would require equalities-focused implementation to ensure that, for example, mandatory training is reflective of intersectionality and any consultation with neurodivergent people and people with learning disabilities on a statutory strategy includes those who experience multiple forms of disadvantage.