In 2021, Caragh McMurtry was selected to race for Great Britain's rowing team at the Tokyo Olympics. Her spot was just reward for a glittering career that produced multiple World Cup and World Championship medals. But behind the scenes, Caragh* struggled with a range of interpersonal issues that caused rifts with teammates and coaching staff. "I'm very honest, blunt and straight to the point," she says. "I think what made it hard for people to understand me was my need to break everything down … to understand 'why'. "I couldn't just take something for granted, and that would rub coaches up the wrong way. They'd think I was undermining them or being facetious". Caragh was bothered by a "lack of transparency" in decision-making. She felt some athletes were treated favourably based on how they were able to "promote" themselves, rather than objective criteria. "I have a massive justice complex," she says. "It wouldn't even necessarily be about me. If I saw something and it wasn't right, I'd get really hung up on it. "That shouldn't be a problem if things are fair … but unfortunately, in elite sport, the system is very hierarchical." There were sensory challenges, too. In the gym — which Caragh calls a "hellscape" — the music would be turned up so loud that the floor shook. Meanwhile, the one place she could take refuge — the cafe, or "crew room" — was overwhelmingly bright and full of strong smells. In retrospect, Caragh recognises these challenges as characteristic of her autism. It's a diagnosis she didn't receive until late in her sporting career, and only after first being misdiagnosed as having bipolar disorder. This led to a severely disruptive five-year period in which Caragh was placed on several medications, including the mood stabiliser lithium, that hampered her performance and wellbeing. She would go winless throughout this time, returning to the podium only after coming off her medication to take silver in the Women's Four at the 2021 Rowing World Cup, before she raced in the Women's Eight at Tokyo, where Great Britain were eliminated in the repechage. Now retired, and as founder of not-for-profit organisation Neurodiverse Sport, 32-year-old Caragh is turning her passion for justice into a mission to make sure other neurodivergent athletes don't just survive their time in elite sport, but "thrive". Autistic traits critical to Caragh McMurtry's success Caragh hasn't always embraced her diagnosis as autistic: "It made sense, but I was like, 'I wonder what people will think of that? It's another thing to set me apart. I've gone from bipolar to autism, wonderful.'" Over time, however, she realised that autism had been "defined by people who are not autistic". "I've grown up with all the messaging and stereotyping that everyone else had about autism," Caragh says. "But when I read about autism from the perspective of people who are autistic, it made me feel a lot better about it." Looking back on her sporting career, Caragh now understands that autism was critical to her success as an elite athlete. Qualities like her "obsessiveness, hyperfocus, attention to detail and pattern recognition" worked in her favour. "To be an elite athlete, you need a spiky profile, you need to be extreme in some way," Caragh says. Erin Hoare, a psychologist and researcher with expertise in neurodiversity, argues that people with ADHD and autism may have an edge in elite sport. "The examples we often talk about are a preference for repetitive routines, the ability to hyperfocus on a goal and rapid reaction to stimuli — for example when there's minimal time allowed for decision-making," Dr Hoare says. "Their strengths could ultimately lead to a competitive advantage." Women and girls are underdiagnosed, adept at 'masking' Dr Hoare says there is some epidemiological evidence to suggest neurodivergent people are over-represented in elite sport, although more research is needed. This is in part because understanding of autism is developing rapidly and it is still under-diagnosed, especially in women and girls. Dr Hoare puts this down to gendered biases in medicine and science more broadly. "Science has focused on a very specific demographic throughout history, and that has generally excluded women, their experiences, insights and contributions," she says. With ADHD and autism specifically, diagnostic criteria have largely been based on the experiences of men. Women, she says, are also adept at "masking" or "camouflaging" their neurodivergence, which means using "compensating behaviours" to meet social expectations. "The societal consequences are also harsher for them not meeting those expectations. That in turn leads to a risk of being undiagnosed or misdiagnosed." With Caragh's initial misdiagnosis of bipolar disorder, she believes what might externally have looked like mood swings was a cycle of burnout and regrouping. Autistic burnout is commonly understood as a state of mental and/or physical exhaustion that results from trying to navigate an environment that is incompatible with someone's needs. "I just carried on because I was, like, [rowing] is my life: this is my obsession, this is everything to me, and I need to find a way to make it work," Caragh says. She also believes gender stereotyping played a role in the way she was judged for her patterns of behaviour: "I don't think my traits would have been a problem [as a man]. "Some of the advice I got was, if you were on the men's team, your honesty and bluntness might come across as passion. But you're on the women's team, so you need to learn to sugar-coat things." Caragh also felt there was less room to lean into her sensory preferences, like wearing noise-cancelling headphones. How to build more inclusive sporting environments Caragh now spends much of her time educating sporting organisations about how to make their environments more inclusive. This starts by explaining that not all neurodivergent people are the same and that relying on diagnoses or labels isn't especially helpful. "Many people are not diagnosed, don't want to be diagnosed, or have co-occurring conditions," she explains. Instead, she directs organisations to a "traits-based" approach to support their athletes. This means recognising that everyone — not just those who are autistic — has different thinking and learning styles, as well as sensory preferences. "You can do so much to help people, it's just about being flexible, innovative and meeting people where they're at. "It's also about challenging your own assumptions and not putting people in boxes." Dr Hoare, who is also a former elite netballer and AFLW footballer, endorses this approach. "The starting point is talking directly to autistic athletes, working in closer partnership and collaboration with them about their experiences and having curiosity about their world view," she says. This "inside knowledge", she says, is critical to "developing an environment where communication and sensory preferences are explored and accommodated". "Neurodivergent people have incredible strengths and differences that are potentially an untapped resource." *Caragh requested that we use her first name, instead of her surname, for this article.