His screen debut happened as an infant in a 1985 instructional film on natural childbirth.
While at Zeno Mountain Farm, a camp for people with and without disabilities, Gottsagen met filmmakers Tyler Nilson and Michael Schwartz. Per Gottsagen's request for Nilson and Schwartz to make a movie with Gottsagen as the star, Nilson and Schwartz wrote and directed The Peanut Butter Falcon. In the movie Gottsagen plays the starring role as an aspiring professional wrestler with Down Syndrome.
In 2020, Gottsagen became the first person with Down Syndrome to be a presenter at the Academy Awards, when he and Shia LaBeouf presented the Academy Award for Best Live Action Short Film at the 92nd Academy Awards. In 2019, he was recognized as a Breakthrough Entertainer by the Associated Press.

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