I guess I will chime in as a contrarian voice in this comment section. I was diagnosed with autism a few months before my 50th birthday and it clarified so much for me -- it was like I was finally handed a map that accurately depicted the terrain of my life. Rather than feeling pathologized by my diagnosis, I felt (and feel) liberated.
Dr. Taylor is right that the world frames single-minded focus, strong opinions, blunt communication, low tolerance for social niceties, and sensitive radar for injustice in women as something to be controlled, suppressed, or reframed as problematic. But that is precisely why my diagnosis mattered. It explained why I had spent 48 years running myself into the ground trying to camouflage these traits -- not because I was broken, but because I was expending enormous neurological resources doing something my nervous system was never built to sustain.
Not knowing I was autistic made me (and my children) vulnerable to exploitation and abuse. I spent nearly 50 years internalizing the belief that I could not trust my own instincts because I was "too sensitive," "too opinionated," or "too difficult." My diagnosis gave me the framework needed to understand that my instincts were sound all along and that the problem was never me. The diagnosis didn't locate the pathology inside me -- it named the mismatch between my neurology and a world that was never designed for it. My diagnosis finally allowed me to begin the process of inhabiting my own neurology without apology or shame. That is not pathologization -- it is clarity.
I am currently in the midst of a legal process to hold one of my abusers accountable. My diagnosis gave me two things I did not have before: First, it gave me retrospective clarity that what happened was not a failure of my character or my judgment -- it was the result of someone recognizing vulnerabilities in me that I could not yet see in myself and exploiting them. Second, it helped me recognize that I had the backbone to fight back. The very traits Dr. Taylor worries are being pathologized -- my single-minded focus, my pattern recognition, my blunt communication, my lack of deference to authority figures, my sensitivity to injustice -- are exactly what I am using to do the hard work of making sure he is held accountable. A diagnosis did not neutralize my resistance -- it funded it.
You are incorrect. Research supports her and I. Brain differences are notable and a neurodevelopmental difference isn't a defect. Not sure what your agenda is but I don't care, either. GenX women are used to being dismissed. We don't give a fuck.
I think this is really important. I fell down this rabbit hole too and genuinely questioned myself for a year or 2. I took some autism screening tests which suggested I would be diagnosed with Level 1 Austism (aka aspergers) if I were to pursue it. But, the main issue I had about it was that all the things I liked about myself, all the traits I considered to be by best traits, were the ones that would get me the diagnosis. That made me stop and think what would be the benefit of having my best traits labelled as a disorder, would I want those treated? At that point I decided not to pursue it any further. Of course this is only my experience.
In the UK they refer to it as Autism Spectrum Conditions. I know Steve Silberman’s book is very long, but it also illustrates the difference between how a for-profit capitalist healthcare system describes something and how a well-run socialized medicine system that focuses on support works.
Really thought provoking read. I was funnelled into a diagnosis in perimenopause (when my tolerance for “BS and shenanigans” was at an all time low) by occupational health on the basis of not standing for nonsense in my job and whistleblowing on poor practice leading to me being ostracised by my fellow managers - who were quoted in my grievance outcome as confirming they deliberately excluded me because they observed “neurodiverse” behaviours (unquantified) and didn’t want me being “transparent” with my team on some issues they had kept hidden and knowing I operate in a transparent manner.
To this day, I still believe the ‘neurodiverse’ behaviours they made reference to were simply me being boundaried, refusing to engage in office politics and nonsense and their inability to take “no” and “I won’t engage with that” as an appropriate response to poor behaviour and actions.
All the traits I like about myself - strong ethical stance, direct communication minus ‘fluff’, challenging and questioning issues rather than just accepting them, being a transparent practitioner, a preference for deep communication etc was all pathologised and I was treated as though I was abnormal.
And I accepted it. Until literally the point I got a diagnostic label and thought ‘now what’ - this doesn’t change me, my thoughts, feelings or preferences and they aren’t wrong or abnormal. I started to really question the parameters I was operating under and the dynamics and institution I was working in and came to the conclusion I was in a role and institution that did not suit me or my skills and was surrounded by people who felt pressured to conform in a way I don’t.
I’m still thinking this through - it’s a work in progress. But your article couldn’t have come at a more timely moment and has put voice to many of the conclusions I have been coming to.
I share a similar experience with the whistleblowing and what was to come after that. I was left traumatised for several years by that one work experience.
It didn’t reach the point of using neurodivergent behaviour against me - not in that language. But interesting to see how we’ve set ourselves up for that. The traits I share with you are very much the same.
Fellow whistleblower (NHS UK) here. No phoney psychiatric neurospicy 'diagnosis', although I did suffer horribly with depressive symptoms when I realised that I coudn't directly improve the hospital where I worked. The NHS Trust was put in special measures and it helps to think I contributed to that,
I agree with part of the concern, there is a long history of women’s behaviour being pathologised, and social media has definitely blurred the line between awareness and over-identification. I also agree there’s a real risk of stripping women’s behaviour of context and calling it “symptoms.”
But I think this perspective risks flattening complexity in the opposite direction.
ADHD and autism aren’t defined by a lack of intelligence, creativity, or autonomy. Many of the traits described here intensity, deep focus, justice sensitivity, divergent thinking can absolutely coexist with neurodevelopmental differences. The key question often isn’t whether someone is “capable” or “strong,” but whether there’s a consistent pattern of difficulty, effort, or meaningful cost behind the scenes.
I say this as a woman who was diagnosed with ADHD in my fifties: the relief wasn’t about being told something was “wrong” with me it was about finally having language for the internal load (masking, burnout, emotional regulation demands) that wasn’t visible from the outside.
At the same time, I do think it’s important to question how quickly normal variation gets reframed through a diagnostic lens online. Not every difference needs a label, and context social, cultural, relational matters.
So for me, this isn’t an either/or: some people are being over-pathologised; others are finally being accurately understood. The challenge is holding both realities without dismissing either.
I agree that the term "masking" was absolutely liberating for me. It may have been that I was "masking" my intelligence, anger, etc. rather than "masking" ASD. But it was a very useful concept.
Hallelujah! It drives me mad when I see someone post their latest diagnosis of the tisms. There’s absolutely nothing wrong with having a million ideas, multiple projects, day dreaming, being sensitive to the world, picking up on stuff other people miss, seeing through the bollocks etc. thank you for writing this important piece. I think it applies to boys, girls and men too, but I do see more adult women falling into this trap.
This is so important. Especially when you consider that one of the most enduring legacies of abuse is looking at yourself through a lense of "there's something wrong with me". I believe that women who have been abused are probably more likely to feel validated by a diagnosis (or self diagnosis), its like, "Oh, that's what's wrong with me!" instead of, "There's nothing wrong with me and there never was!"
For some, having been labeled "disordered" can help with acceptance of self. The pressure to fit in can lift. For others, it can easily be felt like a diagnosis on its own. Main symptom: Self stigma.
I really appreciate this article. As a mental health professional, I am dismayed by the number of women, young and old, who come to me with their own self-diagnosis of ADHD or Autism. And, as Jess reports, the more we dig into their assumptions, the more it becomes clear they are simply dynamic women who are desperately trying to fit into narrowly-defined traits of "normal". Can we please stop medicalizing being human? We never would have survived as a species if it weren't for our variable differences.
I hope you’re also referring these patients to qualified assessors? Ones who are keeping current with diagnostic criteria and diagnostic biases?
They deserve definitive information that validates or refutes their self-identification. Or they will keep seeing themselves reflected in the world, take your word for it, and continue to feel lost.
That only has bad outcomes so do them a solid as their trusted care provider and encourage a full, rigorous assessment if it’s accessible for them. There’s nothing wrong with honoring their curiosity and admitting you don’t know for sure.
Know that it’s uncommon for those who self-identify as neurodivergent to be incorrect. Adult-identified autistic and AuDHD people will be bottom-up thinkers who very likely research the hell out of things before seeking input.
Here’s a panel of experts confirming the low rates of “guessing wrong”:
I like to think it goes without saying that any mental health professional worth their ethical salt will always act in the best interest of their client so, yes, I encourage them to get a professional diagnosis if they think it will help. I don't appreciate the finger wagging tone of your post.
It's unfortunately more common than not for adults to be told by their care providers that they are not autistic or ADHD or both, sometimes many times over before finally finding confirmation. It can take years, all the while you're second-guessing yourself, doubting yourself, pushing yourself too hard, etc. That harmful time can be made much shorter with a little support, particularly from someone they trust and respect.
You're saying your patients have asked for your input on why they haven't been able to understand why their lives have unfolded as they have. That's a huge opportunity to help.
That's it. Zero hidden meaning. Zero shame. Zero finger-wagging, although that does make a humourous image. That autistic communication is presumed to be rude or confrontational is one of the great reliefs of learning you've been autistic this whole time. I hope you're open to opening that door for people who ask.
“Although that does make a humourous image. That autistic communication is presumed to be rude or confrontational is one of the great reliefs of learning you've been autistic this whole time.”
You’re one of us — this was funny to me except I know there are people who may just find it rude 😔
I’m out here trying to make things better for us, painful tho it continues to be because of reactions like this one. As we are abundantly aware, defensiveness is par for the course when info is taken as attack. Sometimes tho, every joyous now and again, someone hears what is being said and actually understands they can help for no money or real effort—the only cost is understanding and a willingness to open one’s view beyond what they currently know. But for most, that’s too much so they fight and continue to do harm. Let’s hope this is not one of those times.
Agreed. I am also dismayed by the amount of women self identifying. And was likewise disappointed by the finger wagging in another comment. The diagnostic criteria presently allow for up to 300 different symptom profiles to meet criteria for 'autism', and one can shop around for a clinician to validate what one has come to believe about themselves. The ideology around this is a bit cult-like.
Every day, infants are being screened for hip dysplasia as well as 30-50 rare genetic, congenital and metabolic disorders. Children are screened for correct eyesight and hearing. Adults are screened for hypertension and diabetes.
Why? Because they are all being mindlessly, needlessly pushed into diagnosis?
No! Because leaving these conditions undetected and untreated would set individuals up for enormous suffering and risk, potentially fatal, throughout their lives.
How are autism, ADHD and any other form of neurodivergence different?
Before arguing against diagnosis, please get your facts straight. Check the DSM for the diagnostic criteria - getting a valid diagnosis for any of these disorders and disabilities ALWAYS necessitates that the individual has been struggling for a significant length of time in key areas of their life.
An ASD, AD(H)D or other diagnosis of neurodivergent conditions are not scouting badges of honor, dished out to whoever tries hard enough. Nor is there anyone pushing people towards getting diagnosed - on the contrary, waiting lists are long, diagnosis are time-consuming and nerve-wrecking, complex and costly.
Diagnoses of neurodivergence are simply and plainly necessary. They follow the same logic as other health screenings: Leaving a neurodivergent condition undetected, unexplained and untreated means setting up that individual for suffering and health risks.
Study after study shows: Neurodivergent women are vastly under-, not over-diagnosed. They are also frequently misdiagnosed with conditions that are at best co-morbidities and at worst outright misleading like depression and borderline personality disorder. Even worse, they are medicated for these, often with disastrous side effects!
Not every neurodivergent woman is struggling. But those of us who are struggling clearly deserve access to a gender-adapted, state of the art diagnostic screening by experienced healthcare professionals.
Because we need the understanding, the language, the accommodations and support for our disorders and disabilities.
If we do not have these, that’s when we start doubting ourselves. We call ourselves crazy, lazy, bad or unworthy BEFORE having a valid diagnosis.
We heap enormous amounts of shame and blame, exhausting attempts at masking and overcompensating, and a soul-crushing void of disorientation and misinterpretation on top of our existing struggles PRIOR to being diagnosed.
We start self-medicating, self-harming, falling sick, burning out, collapsing when we do NOT get accurate information about what exactly it is that keeps making us fail and fall ill. Many of us attempt to put an end to a life filled with confusion and pain; some succeed.
How is that humane or helpful for anyone? And why is it that people have a right and the necessary access to getting all sorts of other diagnoses - but we neurodivergent women are being denied knowing who we are, how we function, where we need help and how we can build a life worth living?!
What would happen if, instead of being left to struggle all our lives and later diagnosed and medicated, we were instead supported and had our needs met from the off?
When I reference support, I mean emotionally and spiritually, as well as physical, mentally and financially.
I speak from personal experience and a decade of research and trauma healing therapy, there would have been no mental breakdowns, living in burn out or disability by chronic illness to speak of. All of it stems back to this. Whether my lifetime or generational one’s past.
This is area we can begin to learn and understand then change. But first there has to be an interest.
Same here; I don’t know how often I have been told that I am „too direct“. I think there is nothing wrong with stating our case clearly - but the societal expectations still tell us women otherwise. It used to make me doubt myself - now in or beyond menopause I have ran out of fucks to give … So please don’t ever worry!
If anything, we need more people to be direct with us. It helps us understand where we’re at - as opposed to saying it behind people’s backs and complaining. Which, like you say, re the societal expectations is where we’re at, and what is comfortably accepted….encouraged even.
Same re the doubt! I’ve done a shit ton of self doubt work over the years and there’s way less now.
Lately, I’m venturing out in spaces like this to become more visible as I publish my book which includes a lot on the aforementioned topic of supporting all pillars of our health.
So the worry and the self doubt, it has space to creep back in. - all as I grow and take up more space.
Neurodivergence, as presented in this article, in my opinion mostly means not having internalized all the cultural bullshit and as such having retained a soul and critical thinking faculties. The bandwidth of what is considered normal in Western psychiatry is increasingly narrowing and mostly judged by functioning, which is an external demand from a system geared to use us. It's in no way related to wellbeing or becoming a full fledged human. Especially when it comes to women.
Mental health professionals would do well to examine the history of our profession and the possibilities for oppression therein. If we don't, we become enforcers of the system instead of questioning it.
There is a distinction between the word neurodivergent and neurodiverse. As Sonny Jane Wise says, we are all neurodiverse (what you have suggested) but we are not all neurodivergent.
Probably that, at least for now, the bar separating so-called neurodivergence from so-called neurotypicality is thin, contextual, highly subjective and arbitrary? Not that people labeled as ASC/ADHC can't struggle more than other people (I used to consider an assessment and I can testify these traits can be very disabling and frustrating at times), but is divergence actually so abnormal for us to have to make a clear cut between divergence and normality? Also, if autism is a spectrum with so many different subtrait gradients, isn't it contradictory to trace the allistic/autistic line, especially since two people diagnosed with ASC can have a totally different, non-overlapping "symptom" profile? Is the line so necessary to provide support and accommodations? And what about this, as of now scientifically unclear and debated, "neuro" part, based on unreliable brain scan results?
I agree and love how you’ve dropped the D. I do think there is a difference between neurodivergent and neuronormative (as opposed to typical). There are many ways a neuro divergent person’s mind conceptualises and operates that does differ significantly to the normative or typical standards. The other factor to consider is health impact. Research has confirmed that ADHC (following your lead) is a whole body experience not just the brain. So the chronic health impacts show that the divergence from the norm impacts neurodivergent people on a significant level. As you point out there is variance across a spectrum and the term neurodiversity includes a vast number of “diagnoses”. Ultimately, what is important is recognising that distress or co-occurring issues like anxiety and depression are human responses to adverse life events. Indeed, most, if not all, DSM diagnoses are, we’ve just lost sight of that.
Isn’t neurodivergence just a different neurotype? Regardless of what it is labeled, it’s ok to acknowledge a person operates differently than our current norm.
You saw the media, identified with it then had a bad reaction which resulted in you writing this. Unpack your ableism and figure out a different way to help women stop doubting themselves in the face of facism instead of shoving autistic & neurodivergent women into the dirt in the name of whatever belief you think you’re upholding.
I love this — it’s such an important message. People forget that more women are diagnosed with Borderline Personality Disorder / Emotionally Unstable Personality Disorder (!!!) — I was. But it’s another way of pathologising women’s emotions and reactions to outside injustices. I’m sick of this influx of pathologising normal human emotions and traits. PTSD is another big one. Trauma. Narcissism. And on and on. I wrote in my memoir about just this — and that we need to look through a feminist linguistics lens at the reasons behind this. Yet, here we are, further steeped in language and diagnoses built to “other” us.
I was chatting on another thing and I mentioned that narcissism, manipulation and coercive control appears to have been 'normalised' via the mechanism that is social media. I have no data just decades worth of observations from a woman that didn't grow up with social media and found it very weird as a HE lecturer when it first appeared as a thing. I was surprised when a few people agreed.
They are parts of the whole, but my inkling is there's more to it than that. Survival of the fittest (Darwinism in social media and predator form) didn't make sense to me fully at school in the 70s, nor throughout my education. As the famous quote says 'Artists are dangerous as they mix with all kinds of people' This one did/does, so I educated myself - the first step was understanding and accepting critical analysis means you have to engage with stuff that my whole body rebels against. It was finding Lynn Margulis that helped me comprehend co-operation is our natural state. Even Richard Dawkins, arch Darwinian, admired Margulis. He called it 'one of the greatest achievements of 20th century evolutionary biology'
All very well and good, apart from women with undiagnosed and unmedicated ADHD can develop functional neurological disabilities due to the excessive strain on their nervous system from decades of masking. The cumulitive toll of shining brightly leads to enormous physiological crashes during menopause changes that can trigger immune system disorders, and neurological dysfunction. ADHD hypermobility affects the gut, bladder, bowels, cognition, energy, muscles, hearing, vision and balance. Knowing how to avoid pushing yourself too far is the difference between finishing your PhD and being too unwell to read research papers or get out of bed.
Evolutionary genetics has demonstrated that we've always had neurodiverse people in populations. The positives neurodiverse brains bring to humanity are necessary for survival. We've always needed people who can push the boundaries, innovate, be fearless, expend vast amounts of energy to create things, try the berries, run over that mountain, design an irrigation system, map the stars. . . We didn't always live in a world where we called that disordered.
Hopefully the women choosing to be diagnosed now will be the ones raising awareness of the positives of neurodiversity, and not just the negatives. The more the merrier for that fight.
Both can exist at the same time—medical misogyny AND under-diagnosis.
Ableism shapes our world. Ask why it seems preferable not to name a condition, why there’s benefit to avoiding a label. Lives are being saved with the spread of information and self-knowledge.
Is word-of-mouth a flawless way to see ourselves for the first time? No but it beats what? Medical misogyny, that’s what.
As I say to every questioning member who comes in Autastic’s doors, if your life gets better, wgaf what the label is. Living a good life is the goal. And for many of us, learning we are neurodivergent has been the key unlocking the door to living at all.
I would actually say that the medical misogyny has caused this delayed amount of diagnoses in women. Simply because for a very very long time ASC was thought of as a ‘male brain’ and women and girls were believed not to ever have ASC or Adhd and that they couldn't coexist.
This has led to women not being treated correctly (these conditions can affect how individuals react to medications for example). Not to mention the boatload of psychiatric medications women have been put on for want of a proper diagnosis. To me the article is the wrong way round.
I guess I will chime in as a contrarian voice in this comment section. I was diagnosed with autism a few months before my 50th birthday and it clarified so much for me -- it was like I was finally handed a map that accurately depicted the terrain of my life. Rather than feeling pathologized by my diagnosis, I felt (and feel) liberated.
Dr. Taylor is right that the world frames single-minded focus, strong opinions, blunt communication, low tolerance for social niceties, and sensitive radar for injustice in women as something to be controlled, suppressed, or reframed as problematic. But that is precisely why my diagnosis mattered. It explained why I had spent 48 years running myself into the ground trying to camouflage these traits -- not because I was broken, but because I was expending enormous neurological resources doing something my nervous system was never built to sustain.
Not knowing I was autistic made me (and my children) vulnerable to exploitation and abuse. I spent nearly 50 years internalizing the belief that I could not trust my own instincts because I was "too sensitive," "too opinionated," or "too difficult." My diagnosis gave me the framework needed to understand that my instincts were sound all along and that the problem was never me. The diagnosis didn't locate the pathology inside me -- it named the mismatch between my neurology and a world that was never designed for it. My diagnosis finally allowed me to begin the process of inhabiting my own neurology without apology or shame. That is not pathologization -- it is clarity.
I am currently in the midst of a legal process to hold one of my abusers accountable. My diagnosis gave me two things I did not have before: First, it gave me retrospective clarity that what happened was not a failure of my character or my judgment -- it was the result of someone recognizing vulnerabilities in me that I could not yet see in myself and exploiting them. Second, it helped me recognize that I had the backbone to fight back. The very traits Dr. Taylor worries are being pathologized -- my single-minded focus, my pattern recognition, my blunt communication, my lack of deference to authority figures, my sensitivity to injustice -- are exactly what I am using to do the hard work of making sure he is held accountable. A diagnosis did not neutralize my resistance -- it funded it.
Best of luck!
You are talking about vulnerabilities. Have you read what Taylor has to say about looking for "vulnerabilities" in abuse victims (https://substack.com/@whatwouldjesssay/note/p-197190580?r=88lnlh)? What do you think about that?
You are incorrect. Research supports her and I. Brain differences are notable and a neurodevelopmental difference isn't a defect. Not sure what your agenda is but I don't care, either. GenX women are used to being dismissed. We don't give a fuck.
👏 👏
Please learn neuroscience. In fact, check out Eliezer Sternberg’s Neurologic.
I think this is really important. I fell down this rabbit hole too and genuinely questioned myself for a year or 2. I took some autism screening tests which suggested I would be diagnosed with Level 1 Austism (aka aspergers) if I were to pursue it. But, the main issue I had about it was that all the things I liked about myself, all the traits I considered to be by best traits, were the ones that would get me the diagnosis. That made me stop and think what would be the benefit of having my best traits labelled as a disorder, would I want those treated? At that point I decided not to pursue it any further. Of course this is only my experience.
The medical industry is untrustworthy. You did not fall for it.
In the UK they refer to it as Autism Spectrum Conditions. I know Steve Silberman’s book is very long, but it also illustrates the difference between how a for-profit capitalist healthcare system describes something and how a well-run socialized medicine system that focuses on support works.
Conditions is much better than disorders… to insist on sanity in an insane world…
Really thought provoking read. I was funnelled into a diagnosis in perimenopause (when my tolerance for “BS and shenanigans” was at an all time low) by occupational health on the basis of not standing for nonsense in my job and whistleblowing on poor practice leading to me being ostracised by my fellow managers - who were quoted in my grievance outcome as confirming they deliberately excluded me because they observed “neurodiverse” behaviours (unquantified) and didn’t want me being “transparent” with my team on some issues they had kept hidden and knowing I operate in a transparent manner.
To this day, I still believe the ‘neurodiverse’ behaviours they made reference to were simply me being boundaried, refusing to engage in office politics and nonsense and their inability to take “no” and “I won’t engage with that” as an appropriate response to poor behaviour and actions.
All the traits I like about myself - strong ethical stance, direct communication minus ‘fluff’, challenging and questioning issues rather than just accepting them, being a transparent practitioner, a preference for deep communication etc was all pathologised and I was treated as though I was abnormal.
And I accepted it. Until literally the point I got a diagnostic label and thought ‘now what’ - this doesn’t change me, my thoughts, feelings or preferences and they aren’t wrong or abnormal. I started to really question the parameters I was operating under and the dynamics and institution I was working in and came to the conclusion I was in a role and institution that did not suit me or my skills and was surrounded by people who felt pressured to conform in a way I don’t.
I’m still thinking this through - it’s a work in progress. But your article couldn’t have come at a more timely moment and has put voice to many of the conclusions I have been coming to.
I share a similar experience with the whistleblowing and what was to come after that. I was left traumatised for several years by that one work experience.
It didn’t reach the point of using neurodivergent behaviour against me - not in that language. But interesting to see how we’ve set ourselves up for that. The traits I share with you are very much the same.
Fellow whistleblower (NHS UK) here. No phoney psychiatric neurospicy 'diagnosis', although I did suffer horribly with depressive symptoms when I realised that I coudn't directly improve the hospital where I worked. The NHS Trust was put in special measures and it helps to think I contributed to that,
I agree with part of the concern, there is a long history of women’s behaviour being pathologised, and social media has definitely blurred the line between awareness and over-identification. I also agree there’s a real risk of stripping women’s behaviour of context and calling it “symptoms.”
But I think this perspective risks flattening complexity in the opposite direction.
ADHD and autism aren’t defined by a lack of intelligence, creativity, or autonomy. Many of the traits described here intensity, deep focus, justice sensitivity, divergent thinking can absolutely coexist with neurodevelopmental differences. The key question often isn’t whether someone is “capable” or “strong,” but whether there’s a consistent pattern of difficulty, effort, or meaningful cost behind the scenes.
I say this as a woman who was diagnosed with ADHD in my fifties: the relief wasn’t about being told something was “wrong” with me it was about finally having language for the internal load (masking, burnout, emotional regulation demands) that wasn’t visible from the outside.
At the same time, I do think it’s important to question how quickly normal variation gets reframed through a diagnostic lens online. Not every difference needs a label, and context social, cultural, relational matters.
So for me, this isn’t an either/or: some people are being over-pathologised; others are finally being accurately understood. The challenge is holding both realities without dismissing either.
I agree that the term "masking" was absolutely liberating for me. It may have been that I was "masking" my intelligence, anger, etc. rather than "masking" ASD. But it was a very useful concept.
Hallelujah! It drives me mad when I see someone post their latest diagnosis of the tisms. There’s absolutely nothing wrong with having a million ideas, multiple projects, day dreaming, being sensitive to the world, picking up on stuff other people miss, seeing through the bollocks etc. thank you for writing this important piece. I think it applies to boys, girls and men too, but I do see more adult women falling into this trap.
This is so important. Especially when you consider that one of the most enduring legacies of abuse is looking at yourself through a lense of "there's something wrong with me". I believe that women who have been abused are probably more likely to feel validated by a diagnosis (or self diagnosis), its like, "Oh, that's what's wrong with me!" instead of, "There's nothing wrong with me and there never was!"
For some, having been labeled "disordered" can help with acceptance of self. The pressure to fit in can lift. For others, it can easily be felt like a diagnosis on its own. Main symptom: Self stigma.
I really appreciate this article. As a mental health professional, I am dismayed by the number of women, young and old, who come to me with their own self-diagnosis of ADHD or Autism. And, as Jess reports, the more we dig into their assumptions, the more it becomes clear they are simply dynamic women who are desperately trying to fit into narrowly-defined traits of "normal". Can we please stop medicalizing being human? We never would have survived as a species if it weren't for our variable differences.
I hope you’re also referring these patients to qualified assessors? Ones who are keeping current with diagnostic criteria and diagnostic biases?
They deserve definitive information that validates or refutes their self-identification. Or they will keep seeing themselves reflected in the world, take your word for it, and continue to feel lost.
That only has bad outcomes so do them a solid as their trusted care provider and encourage a full, rigorous assessment if it’s accessible for them. There’s nothing wrong with honoring their curiosity and admitting you don’t know for sure.
Know that it’s uncommon for those who self-identify as neurodivergent to be incorrect. Adult-identified autistic and AuDHD people will be bottom-up thinkers who very likely research the hell out of things before seeking input.
Here’s a panel of experts confirming the low rates of “guessing wrong”:
https://community.autastic.com/plans/1901130?bundle_token=42686ffb0fc6598393b0903e7a8c345b&utm_source=manual
I like to think it goes without saying that any mental health professional worth their ethical salt will always act in the best interest of their client so, yes, I encourage them to get a professional diagnosis if they think it will help. I don't appreciate the finger wagging tone of your post.
It's unfortunately more common than not for adults to be told by their care providers that they are not autistic or ADHD or both, sometimes many times over before finally finding confirmation. It can take years, all the while you're second-guessing yourself, doubting yourself, pushing yourself too hard, etc. That harmful time can be made much shorter with a little support, particularly from someone they trust and respect.
You're saying your patients have asked for your input on why they haven't been able to understand why their lives have unfolded as they have. That's a huge opportunity to help.
That's it. Zero hidden meaning. Zero shame. Zero finger-wagging, although that does make a humourous image. That autistic communication is presumed to be rude or confrontational is one of the great reliefs of learning you've been autistic this whole time. I hope you're open to opening that door for people who ask.
“Although that does make a humourous image. That autistic communication is presumed to be rude or confrontational is one of the great reliefs of learning you've been autistic this whole time.”
You’re one of us — this was funny to me except I know there are people who may just find it rude 😔
Fascinating. Thanks for your meaningful engagement in this conversation.
I’m out here trying to make things better for us, painful tho it continues to be because of reactions like this one. As we are abundantly aware, defensiveness is par for the course when info is taken as attack. Sometimes tho, every joyous now and again, someone hears what is being said and actually understands they can help for no money or real effort—the only cost is understanding and a willingness to open one’s view beyond what they currently know. But for most, that’s too much so they fight and continue to do harm. Let’s hope this is not one of those times.
Agreed. I am also dismayed by the amount of women self identifying. And was likewise disappointed by the finger wagging in another comment. The diagnostic criteria presently allow for up to 300 different symptom profiles to meet criteria for 'autism', and one can shop around for a clinician to validate what one has come to believe about themselves. The ideology around this is a bit cult-like.
Every day, infants are being screened for hip dysplasia as well as 30-50 rare genetic, congenital and metabolic disorders. Children are screened for correct eyesight and hearing. Adults are screened for hypertension and diabetes.
Why? Because they are all being mindlessly, needlessly pushed into diagnosis?
No! Because leaving these conditions undetected and untreated would set individuals up for enormous suffering and risk, potentially fatal, throughout their lives.
How are autism, ADHD and any other form of neurodivergence different?
Before arguing against diagnosis, please get your facts straight. Check the DSM for the diagnostic criteria - getting a valid diagnosis for any of these disorders and disabilities ALWAYS necessitates that the individual has been struggling for a significant length of time in key areas of their life.
An ASD, AD(H)D or other diagnosis of neurodivergent conditions are not scouting badges of honor, dished out to whoever tries hard enough. Nor is there anyone pushing people towards getting diagnosed - on the contrary, waiting lists are long, diagnosis are time-consuming and nerve-wrecking, complex and costly.
Diagnoses of neurodivergence are simply and plainly necessary. They follow the same logic as other health screenings: Leaving a neurodivergent condition undetected, unexplained and untreated means setting up that individual for suffering and health risks.
Study after study shows: Neurodivergent women are vastly under-, not over-diagnosed. They are also frequently misdiagnosed with conditions that are at best co-morbidities and at worst outright misleading like depression and borderline personality disorder. Even worse, they are medicated for these, often with disastrous side effects!
Not every neurodivergent woman is struggling. But those of us who are struggling clearly deserve access to a gender-adapted, state of the art diagnostic screening by experienced healthcare professionals.
Because we need the understanding, the language, the accommodations and support for our disorders and disabilities.
If we do not have these, that’s when we start doubting ourselves. We call ourselves crazy, lazy, bad or unworthy BEFORE having a valid diagnosis.
We heap enormous amounts of shame and blame, exhausting attempts at masking and overcompensating, and a soul-crushing void of disorientation and misinterpretation on top of our existing struggles PRIOR to being diagnosed.
We start self-medicating, self-harming, falling sick, burning out, collapsing when we do NOT get accurate information about what exactly it is that keeps making us fail and fall ill. Many of us attempt to put an end to a life filled with confusion and pain; some succeed.
How is that humane or helpful for anyone? And why is it that people have a right and the necessary access to getting all sorts of other diagnoses - but we neurodivergent women are being denied knowing who we are, how we function, where we need help and how we can build a life worth living?!
What would happen if, instead of being left to struggle all our lives and later diagnosed and medicated, we were instead supported and had our needs met from the off?
When I reference support, I mean emotionally and spiritually, as well as physical, mentally and financially.
I speak from personal experience and a decade of research and trauma healing therapy, there would have been no mental breakdowns, living in burn out or disability by chronic illness to speak of. All of it stems back to this. Whether my lifetime or generational one’s past.
This is area we can begin to learn and understand then change. But first there has to be an interest.
That is such an important point @Amber! Yes. 💯 % yes, that would be the ideal.
Oh I’m so glad this has been received in this way. I sometimes worry I’m “too direct”.
Oh, wait, as a woman in business who wanted no nonsense and misunderstanding, clear leadership and direction, I was told that by my male peers!
Thank you for hearing me🙏✨
Same here; I don’t know how often I have been told that I am „too direct“. I think there is nothing wrong with stating our case clearly - but the societal expectations still tell us women otherwise. It used to make me doubt myself - now in or beyond menopause I have ran out of fucks to give … So please don’t ever worry!
If anything, we need more people to be direct with us. It helps us understand where we’re at - as opposed to saying it behind people’s backs and complaining. Which, like you say, re the societal expectations is where we’re at, and what is comfortably accepted….encouraged even.
Same re the doubt! I’ve done a shit ton of self doubt work over the years and there’s way less now.
Lately, I’m venturing out in spaces like this to become more visible as I publish my book which includes a lot on the aforementioned topic of supporting all pillars of our health.
So the worry and the self doubt, it has space to creep back in. - all as I grow and take up more space.
Fascinating stuff!
Yes! Couldn’t agree more. Please let me know when and where your book gets published; will definitely read it!
So many women are not neurodivergent, we’re just awesome.
Let’s normalize claiming our awesomeness!
Neurodivergence, as presented in this article, in my opinion mostly means not having internalized all the cultural bullshit and as such having retained a soul and critical thinking faculties. The bandwidth of what is considered normal in Western psychiatry is increasingly narrowing and mostly judged by functioning, which is an external demand from a system geared to use us. It's in no way related to wellbeing or becoming a full fledged human. Especially when it comes to women.
Mental health professionals would do well to examine the history of our profession and the possibilities for oppression therein. If we don't, we become enforcers of the system instead of questioning it.
Everyone is neurodivergent because our brains are uniquely wired by our experiences!
There is a distinction between the word neurodivergent and neurodiverse. As Sonny Jane Wise says, we are all neurodiverse (what you have suggested) but we are not all neurodivergent.
I used to think that too.
What changed?
Probably that, at least for now, the bar separating so-called neurodivergence from so-called neurotypicality is thin, contextual, highly subjective and arbitrary? Not that people labeled as ASC/ADHC can't struggle more than other people (I used to consider an assessment and I can testify these traits can be very disabling and frustrating at times), but is divergence actually so abnormal for us to have to make a clear cut between divergence and normality? Also, if autism is a spectrum with so many different subtrait gradients, isn't it contradictory to trace the allistic/autistic line, especially since two people diagnosed with ASC can have a totally different, non-overlapping "symptom" profile? Is the line so necessary to provide support and accommodations? And what about this, as of now scientifically unclear and debated, "neuro" part, based on unreliable brain scan results?
I agree and love how you’ve dropped the D. I do think there is a difference between neurodivergent and neuronormative (as opposed to typical). There are many ways a neuro divergent person’s mind conceptualises and operates that does differ significantly to the normative or typical standards. The other factor to consider is health impact. Research has confirmed that ADHC (following your lead) is a whole body experience not just the brain. So the chronic health impacts show that the divergence from the norm impacts neurodivergent people on a significant level. As you point out there is variance across a spectrum and the term neurodiversity includes a vast number of “diagnoses”. Ultimately, what is important is recognising that distress or co-occurring issues like anxiety and depression are human responses to adverse life events. Indeed, most, if not all, DSM diagnoses are, we’ve just lost sight of that.
Dr Jessica Eccles PhD. Her latest findings shed light on the intricate links between neurodivergence, inflammation, hypermobility, and Long COVID
"It is no measure of health to be well-adjusted to a profoundly sick society."
Jiddu Krishnamurti
THIS! Yes, THIS!
Isn’t neurodivergence just a different neurotype? Regardless of what it is labeled, it’s ok to acknowledge a person operates differently than our current norm.
The norm is a myth.
Really good!
You saw the media, identified with it then had a bad reaction which resulted in you writing this. Unpack your ableism and figure out a different way to help women stop doubting themselves in the face of facism instead of shoving autistic & neurodivergent women into the dirt in the name of whatever belief you think you’re upholding.
I had a similar reaction to reading it.
I love this — it’s such an important message. People forget that more women are diagnosed with Borderline Personality Disorder / Emotionally Unstable Personality Disorder (!!!) — I was. But it’s another way of pathologising women’s emotions and reactions to outside injustices. I’m sick of this influx of pathologising normal human emotions and traits. PTSD is another big one. Trauma. Narcissism. And on and on. I wrote in my memoir about just this — and that we need to look through a feminist linguistics lens at the reasons behind this. Yet, here we are, further steeped in language and diagnoses built to “other” us.
Narcissism is an epidemic.
I was chatting on another thing and I mentioned that narcissism, manipulation and coercive control appears to have been 'normalised' via the mechanism that is social media. I have no data just decades worth of observations from a woman that didn't grow up with social media and found it very weird as a HE lecturer when it first appeared as a thing. I was surprised when a few people agreed.
My theory is it’s social media and Epstein. The predation is top to bottom.
They are parts of the whole, but my inkling is there's more to it than that. Survival of the fittest (Darwinism in social media and predator form) didn't make sense to me fully at school in the 70s, nor throughout my education. As the famous quote says 'Artists are dangerous as they mix with all kinds of people' This one did/does, so I educated myself - the first step was understanding and accepting critical analysis means you have to engage with stuff that my whole body rebels against. It was finding Lynn Margulis that helped me comprehend co-operation is our natural state. Even Richard Dawkins, arch Darwinian, admired Margulis. He called it 'one of the greatest achievements of 20th century evolutionary biology'
Bruce Lipton has a new book coming out called Beyond Darwin. Cannot wait to read.
All very well and good, apart from women with undiagnosed and unmedicated ADHD can develop functional neurological disabilities due to the excessive strain on their nervous system from decades of masking. The cumulitive toll of shining brightly leads to enormous physiological crashes during menopause changes that can trigger immune system disorders, and neurological dysfunction. ADHD hypermobility affects the gut, bladder, bowels, cognition, energy, muscles, hearing, vision and balance. Knowing how to avoid pushing yourself too far is the difference between finishing your PhD and being too unwell to read research papers or get out of bed.
Evolutionary genetics has demonstrated that we've always had neurodiverse people in populations. The positives neurodiverse brains bring to humanity are necessary for survival. We've always needed people who can push the boundaries, innovate, be fearless, expend vast amounts of energy to create things, try the berries, run over that mountain, design an irrigation system, map the stars. . . We didn't always live in a world where we called that disordered.
Hopefully the women choosing to be diagnosed now will be the ones raising awareness of the positives of neurodiversity, and not just the negatives. The more the merrier for that fight.
100% agree with this.
Both can exist at the same time—medical misogyny AND under-diagnosis.
Ableism shapes our world. Ask why it seems preferable not to name a condition, why there’s benefit to avoiding a label. Lives are being saved with the spread of information and self-knowledge.
Is word-of-mouth a flawless way to see ourselves for the first time? No but it beats what? Medical misogyny, that’s what.
As I say to every questioning member who comes in Autastic’s doors, if your life gets better, wgaf what the label is. Living a good life is the goal. And for many of us, learning we are neurodivergent has been the key unlocking the door to living at all.
I would actually say that the medical misogyny has caused this delayed amount of diagnoses in women. Simply because for a very very long time ASC was thought of as a ‘male brain’ and women and girls were believed not to ever have ASC or Adhd and that they couldn't coexist.
This has led to women not being treated correctly (these conditions can affect how individuals react to medications for example). Not to mention the boatload of psychiatric medications women have been put on for want of a proper diagnosis. To me the article is the wrong way round.