The Pathologisation of Smart Women
Dr Jess discusses the way smart, capable, ambitious, non-compliant, justice-seeking women are being pushed into Autism and ADHD diagnoses.
I am becoming increasingly concerned about something, and I am going to have to write about it here. I am seeing over and over again in my work, in my inboxes, in my professional and personal mentoring sessions, and across all of my social media. It is not subtle anymore. Subtleties are gone. It is not rare. It is not isolated. It is a blaring pattern - shoved right in our faces.
The Pathologisation of Smart Women.
Intelligent, capable, justice-driven women are being steadily nudged, guided, and in some cases outright funnelled towards Autism and ADHD labels. And what bothers me most is that many of the women themselves, believe this is progress. They believe they have finally ‘figured themselves out’. They feel relief. Validation. Explanation.
But when I sit with them, when I actually listen to what they are describing about themselves, I am not hearing any disorder. I am not hearing any deficit. I am not hearing any form of dysfunction.
I am hearing their intelligence and autonomy. Ideas. Justice. Insight. Boundaries. Creativity. Refusal. Resistance. Depth. Focus. Ambitions. Non-conformity in every possible way it manifests.
In other words, I am hearing women who do not fit neatly into what society expects them to be. And that is precisely the point. We are watching the reframing of women’s strengths, resistance, ideas, intelligence, intuition, and divergence from social norms as evidence of neurodevelopmental disorder. ‘Neurodivergence’.
Women who start multiple projects, generate ideas rapidly, and build businesses are being told they have ADHD. They tell me that their doctor or their online diagnosis told them that the real reason they manage multiple projects at once or have loads of business ideas is actually because they ‘have ADHD’!
Women who prefer solitude, depth, or meaningful connection over superficial socialising are being told they are autistic. Appalling.
Women who cut off abusive families, question authority, demand justice, make institutional complaints, or refuse to comply with harmful systems are being told they have ‘rigidity’, ‘black-and-white thinking’, or ‘social deficits’. They are being told they have sensitivity to justice because they must be Autistic.
Even women who pursue PhDs, create new frameworks, challenge dominant paradigms, and become intensely focused on their work are being told they have ‘special interests’.
At what point do we stop and ask what we are actually doing here? Because from where I am standing, this does not look like any form of progression or liberation. It looks like rebranding of pathologisation.
For decades, women like this were called difficult, cold, obsessive, hysterical, aggressive, too much, too intense, too independent.
Now they are being called autistic or ADHD. The language has changed. The mechanism has not. But this time, they’ve convinced women that these labels are good for them. The core message remains the same: there is something about you that is different, and that difference needs to be explained, categorised, diagnosed, medicated, and ultimately located within you as an individual trait or condition.
Not within the society that marginalises you. Not within the systems that punish your non-compliance. Not within the cultures that demand you be smaller, quieter, softer, more agreeable. Not within the expectations that you have no ideas, no intelligence, no ambitions, no desires for a better world.
Within you.
This is what pathologisation does so effectively. It takes traits, behaviours, and responses that make sense in context, and it strips them of that context. It then reinterprets them through a clinical lens, until they become symptoms. And once they are symptoms, they can be named as disorders. Once they are named as disorders, they can be diagnosed. Once they are diagnosed, they can be managed. Usually with medications.
And crucially, once they are managed, they are no longer political. They are no longer about power, oppression, abuse, gendered expectations, or social control. They are about your brain.
I am seeing women come to me and genuinely believe that their drive, their ideas, their refusal to tolerate abuse, and their desire to build something meaningful must be explained by autism or ADHD. They are now questioning their own personalities. They are doubting their own instincts. They are reinterpreting their entire life histories through a diagnostic lens.
And I understand why. Because the messaging is relentless. Scroll for five minutes on any social media platform and you will see it.
‘Signs you are an undiagnosed autistic woman.’
‘Why high-achieving women are actually ADHD.’
‘If you’ve always felt different, this explains everything.’
And now, even more explicitly:
‘Most high IQ women don’t realise they are actually autistic.’
Just check out this example, that popped up on my FYP last night:
This is relentless marketing. And women need to be asking why this is happening to them. It is not because these companies and systems want to ‘help’ us or ‘validate’ us, that’s for sure!
It is the expansion of diagnostic frameworks into wider and wider areas of normal human variation, until increasingly large groups of people can see themselves reflected in them. And women are particularly vulnerable to this expansion, because women’s behaviour has always been more tightly policed, more heavily scrutinised, and more frequently medicalised. They know that women are more likely to self-identify, self-diagnose - or even go to a doctor.
What concerns me is not that some women find these labels helpful. What concerns me is the scale, the direction, and the lack of critical engagement with what is happening. We are not just talking about individual women making personal sense of their lives. We are talking about a cultural shift in which deviation from narrow norms of femininity is being systematically reinterpreted as neurodevelopmental disorder.
We are talking about a generation of women being taught to locate their difference inside their brains, rather than in the world around them. And once that happens, something very important is lost. Because if your refusal to tolerate abuse is a symptom, it does not need to be understood as a rational response to harm. If your intensity and focus are symptoms, they do not need to be recognised as strengths. If your discomfort with shallow social norms is a symptom, it does not need to be interrogated as a critique of those norms.
Everything is pulled back into the individual. Everything becomes internal. Everything becomes treatable, manageable, diagnosable, explainable. And in that process, women’s resistance and power in the world is medically neutralised. That’s how I see this.
I am not saying that no one finds meaning or community in these frameworks - they do. What I am saying is that we need to be far more critical of why these diagnoses are expanding so rapidly in adult women, and what exactly is being captured under these labels.
Because from what I am seeing, it is all of women’s strengths and talents. It is our divergence from gender norms. It is our non-compliance. It is our intelligence. It is our creativity. It is our search for justice and our demands for better.
And historically, those are precisely the traits in women that have always been most at risk of being controlled, suppressed, or reframed as problematic. So I want to ask a different question.
What if these women are not ‘wired differently’ in a disordered sense?
What if they are responding exactly as we would expect intelligent, perceptive, justice-oriented human beings to respond in a world that is often unjust, superficial, and restrictive? What if the issue is not their brains, but the environments they are navigating?
What if, instead of teaching women to reinterpret themselves through diagnostic labels, we supported them to trust their instincts, understand their experiences in context, and recognise their strengths without needing to medicalise them?
Because I am watching too many brilliant women begin to doubt themselves. Too many women start to believe that the very things that make them capable, thoughtful, and powerful are actually signs that something is ‘wrong’ - and they are beginning every meeting or sentence with, ‘sorry, it’s my autism/ADHD that makes me like this!’
And I do not believe that is progress. I think it is the same old story. Just with new language.
You can learn more about my work at www.DrJessicaTaylor.com
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.
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.