Modern day autism stigma

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Like I wrote, it’s a hot mess. The main problem is that we don’t know a lot about what Autism is and is not. A lot of experts think what we call Autism is Autisms. Today’s diagnosis is done via a combination of observation and questioners(parents, siblings, or self report). This is highly subjective. As of now there is no blood test, biopsy, or MRI that can objectively prove who is autistic.

Last edited by ASPartOfMe on 01 Jan 2026, 12:56 pm, edited 1 time in total.

Two points here
1. Having a wide range of presentations under one label is not unusual. There are stages of cancer, and many subtypes(throat, lung, and on and on). These have widely varying presentations and treatments. There is no campaign to make them completly separate conditions. Burns, Pain, Flu similar. The Autism community is an outlier with having problems with subtypes.

2. If they thought the Aspergers label was too broad how in hell was putting it in an even broader label supposed to fix the problem?

Presuming a physical test is not coming to me in the DSM 6 there should many more subcategories of Autism based on predominant traits. That would be unwieldy and far from perfect because of the issue I wrote about above, but at least it would be more understandable.

I agree. I am no expert but I feel pretty sure that the experts that think it is Autisms is right. And that leads to the problem that everyone defines Autism from the brand of Autism they have experience of. Add to that, that many intelligent people have a great ability to mask and find strategies to cope. It seems to me that it's often confused by being less autistic.

Autism is not comparable to a physical disorder like cancer or diabetes. Even my previous analogy with Mosaic Down Syndrome is problematic, since that and all other subtypes of DS can be determined simply by looking at a person’s chromosomes. As with most things in mental health, an autism diagnosis isn’t based on a blood test or mammogram or any other concrete assessment, but on observing a cluster of traits that are thought to create challenges for a person’s ability to function in the world. And the history of psychology shows how much of the field has been impacted by evolving social norms, where conditions are defined as disorders based purely on their stigma—one of the prime examples is homosexuality.

Just to be clear, I’m not trying to imply it’s perfectly objective and clear-cut what a physical disorder is, and indeed the physical/mental boundary itself can get blurry. And we all know how common misdiagnoses of physical conditions are. My point is simply that autism falls at the far end of lacking any concrete data on what exactly it is and how it’s to be defined.

Isn't that what people don't like today? Autism having different ''subtypes''? Many people seem to argue that there is only one autism, and that is autism, and that we're all just autistic as each other but only personalities and co-morbids and how we mask separate us.

I still wish they'd just call autism SCSD (Social Communication Sensory Disorder), as it's so much less misleading than a fancy word like ''autism'' or an embarrassing Nazi name like Asperger's. As soon as people hear you have autism, they're all suddenly sympathetic like you've just told them you have cancer or something. I don't seem to get this same ''sympathy'' when I say I have ADHD, but if ADHD was known as something with a fancy name like whatever the Greek term for ''hyperactive'' is (even though not everyone with ADHD is hyperactive, just like not everyone with autism is all about the ''self'') then it would probably sound more serious, like a disease or an embarrassing sort of disability. Abbreviated labels of things seem to sit better with NTs. I don't know why, it just does.

I recently met a man with MDS. I didn't know it at first (you know how you can immediately tell when someone has Down's by their face). But he was in a day program so I asked him what his disability was (hoping he'd say autistic, of course). He said he had MDS. I was quite intrigued because I had once read of a woman with this who didn't know she had it until a doctor gave her a genetic test for DS to find out why she'd had two miscarriages of DS babies and a third one who survived.

Anyways, the man had NO physical features telling of MDS, and he was even 5-10. But your analogy is pretty accurate.

I wish people would stop indiscriminately using the term "learning disability." This refers to a specific type of "difference," of which there's several, including dyslexia. dysgraphia and dyscalculia. I wish the APA would do away with "learning disability" because it's commonly mis-used to describe people who only have autism or only have an intellectual disability. If you want to use the term "learning," then follow it with "difficulty," or "challenge." People with actual learning disabilities (dyslexia, etc.) can have a high IQ. Cher and Olympian Greg Louganis have LD's, but I'd hardly call them low in IQ. Now someone with a LD just also might have a low IQ, but my point is that the LD term needs to be used correctly or, better yet, the specific type of LD can be used, such as, "She has dysgraphia."

Regarding not being able to ID autism by looking at a chromosome like you can DS...maybe one day we WILL. But that doesn't mean until then, autism shouldn't be taken seriously when it's "mild."

As for how can a person with HFA have the same condition as a nonverbal who can't even toilet? Well, here's my brilliant analogy: How can a person who's 50 lbs overweight (clinically has obesity), who can run, climb mountains, race after his kids, ski and play basketball....have the same condition (obesity) as those on "My 600 lb Life" who can barely ambulate from bed to bathroom?

The dude who's "only" 50 lbs overweight functions far closer to a thin person than a 500 pounder, yet this doesn't mean they can't possibly have a real diagnosis of obesity.

It's also been said that the mildness or severeness of autism is that which NTs (and other autistics) observe on the outside, but that mildly-presenting (or high masker) person could be struggling a shit-ton on the inside.

Fascinating!

Where it gets even more confusing is the fact that the meanings of these terms differ by country. In the UK, "learning disability" is commonly used to mean what we Americans would call an intellectual disability (and what used to be called ret*d). More broadly, "general learning disability" means intellectual disability, "specific learning disability" means dyslexia, dysgraphia, etc. But that's pretty arcane to most people.

Agreed. And I want to be clear: the expansion in the diagnostic criteria for autism over the past generation has been a godsend for people like me. Just because something isn't hard science doesn't mean it can't have value. I'm just pointing out that, at the present time, it isn't a hard science. Maybe one day we'll have a complete picture of relationship between autism and what's going on in a person's body and brain, but we're a pretty long way from reaching that point at present.

I'd have to disagree with you on your point about autism being easy to get a diagnosis of. Here in Canada people can and do wait on years long wait lists just to get an assessment for their child. And adults seeking diagnosis have to pay thousands out of their own pocket for an autism assessment.

Also, you have to keep in mind that a child or adult may be rejected for being "too high functioning to be autistic" and will have to go through the whole process again to get a second opinion.

However, I do feel like ADHD is way way overdiagnosed. I mean it's pretty natural for little boys to be hyperactive and unable to pay attention or sit still in class. I mean I'm damn near 30, and I would have difficulty paying attention during a standard day in elementary school.

What you have said above, steve30, reminds me of this old George Carlin bit from the 90's.

If the Asperger's label hadn't existed back in the 90s then I probably wouldn't have got a diagnosis, as I wasn't "serious" enough to be considered to have autism, by 90s standards (back when autism was autism, rather than this infinite spectrum that's sucking every mental health issue and learning difficulty into it). They'd probably have just said I was a highly anxious child. I mean, ADHD was still just the "naughty schoolboy" stereotype back then, so that's why I didn't get assessed for ADHD in childhood, even though my symptoms were blatantly obvious.

Which brings me to this:-

ADHD isn't just about being a "bad schoolboy". There were many boys in my class at school who were hyperactive (to the point where they were annoying), but usually it was down to gender expectations were boys were actually supposed to be obnoxious and active, showing off and messing around together, and angering the teacher by not listening in class.
But all those boys didn't have ADHD. Despite not often listening to the teacher, they still somehow managed to not struggle or get anxious over keeping up with their schoolwork. They still didn't require extra support in the classroom. They weren't habitually daydreaming to escape the boredom and frustration of school life. They weren't rejected by their peers for being too impulsive or "bossy" in the playground. They didn't feel a great deal of anxiety in school mornings because abiding to school rules being such a conscious effort to have to follow not because of rebellion but because of having a different brain wiring that doesn't always suit the standards of rules and causes you to chafe under discipline. They didn't go home and bounce off the walls to release the tension they'd been building up all day, driving their families mad and needing a social worker to sort the family issues out.
ADHD is a disorder, not a phase or personality trait.

LOL. Thanks, I needed a laugh .

My concern is that the criteria are not being consistently applied, not the criteria themselves.

Mind you, we were having a very similar discussion 18-ish years ago

At that time, autism was becoming more visible every year, and diagnoses were skyrocketing. Many people who had always felt different suddenly felt like they understood why.

Of course, there are innumerable reasons, developmental/societal/emotional/psychiatric/etc., why people go through life with this sense of being different. So one concern back then was that the label would replace an earnest process of inquiry. People would hear the label, attach it to their sense of being different, and there would be no skilled exploratory process for them beyond that. Which would be a shame for them and also make it harder for services to find and support the people who most needed it, and harder for those voices to be heard.

I remember sitting in a psychiatrist's waiting room trying not to hear a man on the other side of the wall screaming at the psychiatrist for withholding a diagnosis. He knew he was autistic: everything in his life made sense if he was autistic. When I went in for my own appointment, the psychiatrist told me it was an increasingly common exchange. Autism seemed like a solution, so talk of differential diagnoses, or simply anomalous experience, was being sidelined.

The other side of that concern was that representation and resource allocation would increasingly favour people on the higher-functioning end of the spectrum, as these people tended to have more social or financial capital. I am an old fuddy-duddy but I feel that to some extent this has happened and that it has not been a boon for authentic representation. At times autism feels like a cultural commodity.

I do not think it's our job to represent autism we are all just muddling through. Rigorously formulated criteria consistently applied; thoughtfully critiqued media.

No, there has never been any fairness at all in who has access to psychiatric services. Some regions/demographics are much luckier than others. I think autism is overdiagnosed, but at the same time it clear that many people who should receive a diagnosis have simply no access. It is not a fair process.