* [CHAPTER 1](#chapter-1)

* [What Is Autism, Really?](#what-is-autism-really)

* [Defining Autism](#defining-autism)

* [“Typical” Autism](#typical-autism)

* [Why Is Autism Synonymous with White Boys Who Love Trains?](#why-is-autism-synonymous-with-white-boys-who-love-trains)

* [Suspect You’re Autistic?](#suspect-youre-autistic)

* [A Few Notes on Terminology](#a-few-notes-on-terminology)

* [Autism Terminology: Common Dos and Don’ts](#autism-terminology-common-dos-and-donts)

---

When Crystal was young, she exhibited many behaviors psychologists today would recognize as traditionally Autistic: she lined up toys in rows instead of playing pretend with them, chewed on her blanket while staring at the wall, and had trouble understanding in-jokes and teasing. But she didn’t “look Autistic enough” to get easily diagnosed in the 1990s, when she was growing up.

“My mom actually thought I should get assessed,” she says. “But my grandpa shut it down. He was all, no, no way, Crystal’s such a good girl! There’s nothing wrong with her. Don’t even think about stuff like that.”

Crystal’s grandfather probably figured he was protecting her from getting stuck with a label that would bring a lifetime of abuse. He certainly isn’t alone in that. Label avoidance (taking steps to evade diagnosis) is a very common consequence of disability and mental health stigma.[^1.1] Publicly identifying as disabled does mean being viewed as less competent—and less human—by many people. As damaging and self-defeating as it can be to camouflage one’s disability status, it is by no means a paranoid act. It’s a rational reflection of the prejudices disabled people face. It’s not unique to Autism, either; many people with mental illnesses[^1.2] and hidden physical disabilities[^1.3] elect to avoid the mark of shame a diagnosis might bring.

My dad hid his cerebral palsy and seizure disorder for his entire life. No one knew about his condition other than my grandmother, my mom, and eventually me. He never went to college because he would have needed to reveal his access needs to campus disability services. He only ever applied to jobs that didn’t require him to write or type, lest his poor fine motor control be revealed. As a child, I typed up the flyers for his lawn mowing business, because he couldn’t work the computer himself. I only found out about his condition as a teenager; he sobbingly confessed it to me, as if it were a terrible secret, after his marriage to my mother had already fallen apart. He told me that his mother had made him hide his condition because it wouldn’t have been acceptable to be openly disabled in the tiny Appalachian town where he grew up. Shame and self-loathing followed him until the day that he died of diabetes (a condition he developed as an adult and also refused to treat).

I didn’t find out I was Autistic until many years after his death, but he was the first person who demonstrated to me just how painful and self-destructive hiding your disability can be. He had erected an entire life around hiding who he was, and his defensive mechanisms had slowly killed him.

Label avoidance was common among the parents of potentially Autistic children during the 1990s, because the condition was so poorly understood and demonized.[^1.4] Autistic people were assumed to be intellectually disabled, and intellectually disabled people were not valued or respected, so many families did their damnedest to keep the label off their kids’ backs. Though Crystal’s grandfather intended to protect her from bigotry, and from being infantilized, he also denied her important self-knowledge, educational resources, and a place in the Autistic community. Without consulting Crystal, her family determined it would be better for her to suffer and hide her neurodiversity than to have a name for her marginalized position in the world. The weight of this decision is one Crystal continues to deal with now, as an adult who was diagnosed in her late twenties.

“Now I know I’m Autistic, but I kinda found out about it too late,” she says. “If I tell people, they don’t want to believe me. I have my life together too much for them to realize how hard it all is. Nobody wants to hear now about how hard it’s always been, always still is, frankly.”

At this point, I have heard hundreds of Autistic people tell versions of Crystal’s story. Some of the details change, but the narrative arc is always the same: A child exhibits early signs of difficulty, but their families and teachers balk when disability is raised. Parents or grandparents who themselves have Autism spectrum traits dismiss the child’s complaints, claiming that everybody suffers from the social stress, sensory sensitivities, stomach issues, or cognitive fuzziness they themselves experience. Everyone in the child’s life views disability not as an explanation of how a person functions (and what help they need in order to function), but a sign of damage. So they push the label away, and tell their child to stop making such a fuss. Believing they are helping their child “rise above” a limitation and be tough, they encourage the child not to be visibly odd, or to ever ask for assistance.

Though a masked Autistic child has no way of explaining why they find life so difficult, they suffer all the same. Peers detect there’s something unnameably “off” about them, and exclude them despite their best attempts at friendliness. When the child makes themselves small and inobtrusive, they’re granted some of the affection they desperately crave and never get enough of. So they do it more and more, quieting the voice inside themselves that says how they’re being treated isn’t fair. They work hard, demand little, and play by society’s rules as closely as possible. They grow into an adult who is even more self-effacing, and even less capable of voicing how they feel. Then, after decades of forcing themselves into a restrictive neurotypical box, they have some kind of breakdown that finally makes all the turmoil bubbling beneath the surface impossible to ignore. It’s only then that they discover they’re Autistic.

In Crystal’s case, the breaking point took the form of a months-long case of Autistic burnout. Autistic burnout is a state of chronic exhaustion where an Autistic person’s skills begin to degrade, and their tolerance to stress is greatly reduced.[^1.5] It hit Crystal like a Mack truck after she completed her senior thesis in college. College had taken her a few years longer than the rest of her friends, though she couldn’t explain exactly why. She was always having to drop classes in order to hold her life together. A full course load just wasn’t possible. When people asked about it, she lied and said she also worked a full-time job.

In her final year of college, Crystal was required to oversee set design for the theater department’s biggest show of the year. Designing dozens of props, sourcing their materials, managing the building of them, and then keeping track of all the items in a big Google spreadsheet was simply too stressful for her to manage, especially while taking her final remaining classes. She pushed through, losing hair and losing weight, but once the project was completed, she collapsed.

“After I graduated, I was in bed at my mom’s house for three months,” she says. “Didn’t apply to jobs. I barely showered, had all these McDonald’s wrappers on the floor of my bedroom, and my family still insisted I was just being lazy.”

Eventually, Crystal became so lethargic that she no longer wanted to watch TV or play with the family dog. That was concerning enough for her mother to suggest she go see a therapist. An Autism assessment came shortly thereafter.

“At first I couldn’t believe it,” Crystal says. “My family still doesn’t believe it. They had every indication, my whole life, but they don’t want to see it.”

At last, Crystal had an explanation for why she couldn’t get as much done as other people, and why basic-seeming tasks like running to the bank or sitting through a two-hour lecture left her too tired to think or speak. Regular life actually did require more willpower out of her; Autistic people frequently experience inertia in starting a task,[^1.6] and challenges in breaking complex activities down into small steps that follow a logical sequence.[^1.7] This can make everything from basic household chores to applying to jobs and filing taxes incredibly challenging, or even impossible without help.

In addition to all the baseline cognitive and sensory challenges that came with Autism for Crystal, she was also having to put a lot of energy into always seeming “normal.” She constantly fought the urge to suck on her fingers, and when people spoke to her, she had to forcibly point her attention at their words and face. Reading a book took her twice as long as the average person. All she had the energy to do at the end of the day was sit in bed and eat french fries. Crystal’s mother and grandfather were unsatisfied by this newfound explanation, though. They said that if she had really been hurting that bad all her life, they would have realized it.

“I wish I could make them understand,” she says, “Autism isn’t what you think.”

One of the reasons Autism often gets overlooked in women like Crystal is a fundamental misunderstanding that professionals and the public have about what Autism even is. Until fairly recently, most people believed Autism was rare, that only young boys had it, and that it was always easy to see. Think of Dustin Hoffman’s portrayal in the film Rain Man: he’s institutionalized as a child because he’s profoundly disabled and too “difficult” to have at home, he never gives eye contact, wanders off dangerously when not closely watched, and has a preternatural talent for math that his nondisabled brother exploits for personal gain. This is how all of us were trained to view the disability: a horrible condition that renders you freakish and helpless, your life only as valuable as your savant-like skills are to other people.

By the mid-1990s, when Crystal was a kid, some people also had a vague awareness of what was then called Asperger’s Disorder. Asperger’s was stereotyped as a “higher functioning” flavor of Autism found in really smart, nerdy, usually rude men who worked in fields like tech. In both forms, Autism was associated with being awkward and uncaring (and male) with a penchant for numbers. People had little to no understanding of Autism’s causes, what it felt like to be an Autistic person, or that the disability shares features with other disorders like epilepsy, Social Anxiety Disorder, Attention-Deficit Hyperactive Disorder (ADHD), or Post-Traumatic Stress Disorder (PTSD).

Despite what people believe, Autism is not defined by rudeness, masculinity, or having any kind of mathematical skill. In the scientific literature, it’s arguable whether the disability should even be defined by the presence of clear behavioral signs, such as trouble reading social cues or hesitating to initiate contact with other people.[^1.8] Instead of looking to the external signals of Autism that others might pick up on, it’s important that we instead focus on the neurobiological markers of the neurotype, and the internal experiences and challenges that Autistic people themselves report.

Autism is neurological. Autism is a developmental disability that runs in families[^1.9] and appears to be largely genetically heritable.[^1.10] However, it is also multiply determined, meaning it has no single cause: a whole host of different genes appear to be associated with Autism,[^1.11] and every Autistic person’s brain is unique and exhibits its own distinct patterns of connectivity.[^1.12] Autism is a developmental disability because compared to neurotypical milestones, it comes with delays: many Autistic people continue to grow in their social and emotional skills for much later in life than allistics tend to.[^1.13] (However, this may be due to the fact that Autistic people are forced to develop our own social and emotional coping skills from scratch, because the neurotypical methods taught to us don’t suit how we process information—more on this later.) Autism is associated with specific and pervasive differences in the brain, which result in us diverging from neurotypical standards, in terms of how our brains filter and make sense of information.

Autistic people have differences in the development of their anterior cingulate cortex,[^1.14] a part of the brain that helps regulate attention, decision making, impulse control, and emotional processing. Throughout our brains, Autistic people have delayed and reduced development of Von Economo neurons (or VENs), brain cells that help with rapid, intuitive processing of complex situations.[^1.15] Similarly, Autistic brains differ from allistic brains in how excitable our neurons are.[^1.16] To put it in very simple terms, our neurons activate easily, and don’t discriminate as readily between a “nuisance variable” that our brains might wish to ignore (for example, a dripping faucet in another room) and a crucial piece of data that deserves a ton of our attention (for example, a loved one beginning to quietly cry in the other room). This means we can both be easily distracted by a small stimulus and miss a large meaningful one.

Autistic brains have unique connection patterns that deviate from what is normally observed in neurotypical people. When infants are born, their brains are typically hyperconnected; much of human development is a process of slowly pruning unhelpful connections and becoming more efficient at responding to one’s environment, based on life experience and learning. In Autistic brains, however, researchers have found that some regions remain hyperconnected throughout the life span, whereas other regions may be underconnected (relatively speaking). It is difficult to sum up these connectivity patterns because, as neurobiologists at the Weizmann Institute of Science have found, every Autistic brain exhibits a different connectivity pattern. Our brain wiring appears to actually be more diverse than the wiring of neurotypical brains, which researchers believe have a consistent pruning pattern.[^1.17] The researchers at the Weizmann Institute have theorized that this means Autistic brains respond to our environments differently; whereas neurotypical brains are believed to readily adapt to the sensory and social input they receive from the outside world, Autistic brain development and pruning appears to be “disrupted.”[^1.18]

Autistic people also exhibit less of what neuroscientists call global-to-local interference:[^1.19] we are inclined to zero in on small details, even when those details don’t jibe with the overall “big picture” that a non-Autistic person might see. For example, one series of studies found that Autistic people are far better than allistics at copying down a drawing of a distorted 3-D object that couldn’t exist in real life.[^1.20] Allistics got caught off guard by how impossible and illogical the overall image was, whereas Autistics could just focus on the individual lines and shapes that made up the image, and re-create the drawing from the bottom up. This high degree of attention to detail also applies to how we navigate social situations: we focus on the small features of a person’s face rather than taking in their likeness or emotional expression as a whole, for instance.[^1.21] This helps explain why many Autistic people have prosopagnosia (the inability to recognize faces),[^1.22] and experience difficulty reading emotions on neurotypicals’ faces.

Together, all of this means that Autistic people tend to have the following qualities:

* We are hyperreactive to even small stimuli in our environment

* We have trouble distinguishing between information or sensory data that should be ignored versus data that should be carefully considered

* We are highly focused on details rather than “big picture” concepts

* We’re deeply and deliberatively analytical

* Our decision-making process is methodical rather than efficient; we don’t rely on mental shortcuts or “gut feelings”

* Processing a situation takes us more time and energy than it does for a neurotypical person

Now that I’ve explained some of the neurological markers correlated with Autism, I think it’s important to clarify a finer point: the fact that a disability has some biological markers does not mean it is more “real” or legitimate than a disability that you can only observe in a person’s behavior. And Autism is still diagnosed based on behavior and reported challenges the Autistic person is facing, not on a brain scan. The fact that Autism has neurological features doesn’t mean it is a more sympathetic disability than, say, an eating disorder or substance addiction. It also doesn’t mean Autistics are doomed to always function in a particular way, or to always struggle.

While understanding the biology of human difference is helpful in a lot of ways, there are real risks to reducing a disability to its physical “causes.” It can lead people to believe that our biology is our destiny, and that we are lesser to neurotypicals in some unchangeable way. In fact, some research suggests that when people understand disabilities such as depression and ADHD as being purely biological, they actually show more stigma toward people with those conditions, not less.[^1.23] The idea that a disabled group can’t help being the way they are is dehumanizing and restrictive, even though some also find it liberating and validating.

When society first starts flirting with accepting a marginalized group, that acceptance is often wrapped up in a born this way type narrative. For example, in the early 2000s, many straight allies claimed to support gay people because being gay wasn’t a choice, and we couldn’t help being the way that we are. There was a lot of pop science writing at that time exploring the search for the “gay gene,”[^1.24] and suggesting that certain hormone exposures in the womb might predispose a fetus to being gay. Today we don’t have conversations about the biological causes of gayness very much anymore. In the United States at least, being gay has started becoming accepted enough that queer people don’t have to justify our existence by saying we can’t help but be this way. If someone were to choose to be gay, that wouldn’t be a problem, because being gay is good. Similarly, Autistic people deserve acceptance, not because we can’t help but have the brains we have, but because being Autistic is good.

Autism is associated with a deliberative processing style. When making sense of the world, Autistic people usually defer to logic and reason rather than emotion or intuition. We dive deep into all the pros and cons, sometimes excessively so, not knowing where to draw the line between an important variable and an unimportant one. We tend not to get habituated to familiar situations or stimuli as readily as other people, so we often think through a situation as if it’s completely new to us, even if it isn’t.[^1.25] All of this requires a lot of energy, focus, and time, so we get exhausted and overloaded quite easily. However, it also makes us less prone to errors. Experimental research shows that Autistic people are far less susceptible to the biases allistic people commonly fall prey to.[^1.26] For example, consider this relatively simple problem:

In experimental studies, over 80 percent of non-Autistic people get this question wrong. They parse the question quickly, go with their gut, and answer that the ball must cost ten cents.[^1.27] The correct answer is that the ball costs five cents, and the bat costs a dollar more, $1.05, which together adds up to $1.10. It takes an extra moment of careful processing to skip the “obvious” (and wrong) answer and provide the correct one. For most allistic people, the default way of thinking is to go with what’s obvious. But since Autistic people do not process information intuitively, we don’t see “obvious” answers to things, and have to carefully break the question down instead. This results in us being far more likely to get the answer right.

This slow, deliberative style of processing comes with its fair share of downsides. We can’t always pick up on irony or “obvious” implied meanings people haven’t said explicitly. Allistic people often accuse us of overthinking things, or being too slow and hesitant to come up with a response. We also get overwhelmed when presented with mountains of data, which neurotypical people find much easier to just ignore.

Autistic people process the world from the bottom up. If you want to understand Autism as a disability and a source of human difference at a glance, it’s best summed up this way: we process in a careful, systematic, bottom-up way. Allistic folks, in contrast, make sense of the world in a very top-down fashion. They’ll enter a new environment, such as an unfamiliar restaurant, take a quick look around, and jump to reasonable conclusions about how to order, where to sit, what kind of service to expect, and even how loudly they should talk. Their brains will immediately begin to filter through sounds, lights, and other stimuli, and adjust accordingly. They might notice a clanging pinball machine in the corner for a moment, for instance, but soon habituate to it, and become able to ignore it. When the waiter approaches, they probably can chat without much difficulty, even if something unexpected gets said or the item they planned to order is sold out. They don’t rely on memorized conversational scripts, and they don’t have to carefully parse every single piece of data they encounter to make sense of it. They can wing it.

Autistic people, on the flip side, don’t rely on knee-jerk assumptions or quick mental shortcuts to make our decisions. We process each element of our environment separately, and intentionally, taking very little for granted. If we’ve never been in a particular restaurant before, we may be slow to make sense of its layout or figure out how ordering works. We’ll need really clear-cut indications of whether it’s the kind of place where you sit down and get table service, or if you’re supposed to go to a counter to ask for what you like. (Many of us try to camouflage this fact by doing extensive research on a restaurant before setting foot inside.) Every single light, laugh, and smell in the place is taken in individually by our sensory system, rather than blended into a cohesive whole. To cope with unpredictability, we analyze our experiences for patterns, and memorize rule sets: if the waiter says X, I reply with Y. When something unexpected happens, we have to carefully sort out how to respond. Too much change may cause us to become really exhausted, or to freak out.

Autism touches every part of the Autistic person’s life. Of course, many non-Autistic people might resonate with some of the feelings and sensations I just described. There’s a difference between being allistic (which simply means non-Autistic) and being fully neurotypical (which means lacking any mental illness or cognitive disability). An allistic person with a social anxiety disorder may also feel overwhelmed in busy bars and restaurants, just as Autistic people do. Someone with post-traumatic stress disorder may similarly be rattled by a noisy pinball machine. The difference between Autism and these other disorders, however, is that Autism is a cognitive and sensory difference that affects every area of life. You wouldn’t expect a socially anxious person to get overwhelmed by the sound of a clanking radiator when they’re alone at home, for example (unless they’re also Autistic or have a sensory processing disorder).

Because the neural and cognitive features of Autism are so pervasive, it affects almost every aspect of a person’s body and brain. It’s related to coordination and muscle tone, the ability to read emotions on people’s faces, communication skills, reaction time, and even how a person recognizes feelings of pain or hunger.[^1.28] When I look at a person’s face, I don’t simply see “happiness” or “sadness” radiating off them, for example; I see minute changes in their eyes, forehead, mouth, breathing, and posture, which I then have to effortfully piece together to make an informed guess about how they feel. Often, it’s too much discordant data to make sense of. When I don’t have the energy to carefully process others’ emotional expressions, people are inscrutable to me and arouse a lot of anxiety.

Autism can influence how intensely we focus on an activity, and how we perceive textures, tastes, and sounds.[^1.29] Autism can predispose a person to having fanatical interests (often referred to as special interests)[^1.30] and to following rules very rigidly. Many of us have trouble identifying sarcasm or reading nonverbal signals. Disruptions to our routines or expectations can make us panic. Learning new skills may take us far longer than other people.

Autism is behavioral. Autism is associated with repetitive self-stimulatory behavior (“stimming”),[^1.31] which can be something as benign as hand-flapping, or as severe as chewing one’s fingers until they bleed. Stimming is an important means of self-regulation. It helps soothe us when we’re anxious or overloaded with stress, and it helps us express joy and enthusiasm. There are a variety of ways to stim, and stimming can make use of any of the five senses. Some of us stim using echolalia, the repeating of words, sounds, or phrases that feel good vibrating in our throats. Others stim by engaging the body’s proprioceptive system (the neural system that tracks the body’s physical movement) by jumping up and down or swaying in place. Sucking on candy, smelling scented candles, staring at lava lamps, listening to recordings of rain and thunder—all of these activities can be stims. All humans stim to an extent (if they didn’t, fidget spinners wouldn’t have become so popular several years ago), but Autistic people stim more frequently, more repetitively, and more intensely than neurotypicals do.

Repetitiveness is a key feature of Autistic behavior, according to the Diagnostic and Statistical Manual of Mental Disorders (the DSM). And it is true that many of us crave the stability that repetition provides. Because we find the external social world so unpredictable, most of us prefer consistent routines. We often eat the same meals over and over again, or only enjoy a limited range of foods (sometimes called samefoods in the community). We hyperfixate on activities that we enjoy and can get so engrossed in them that we forget to eat or take a break to stretch our legs. We echo phrases from movies and TV because they help us emulate “normal” social behavior, or because we lack our own words for how we are feeling, or simply because the sounds feel pleasant to have vibrating in our vocal cords. Even having special interests can be viewed as a repetitive behavior. Many of us watch the same movies over and over or read and compile facts about our favorite subjects far beyond the point that an allistic person would find entertaining.

For many masked Autistic people, however, repetitive behavior is something that needs to remain hidden. If you chew your fingers a lot or keep humming the same three-note tune to yourself, people will notice and mock you for it. If you come across as too obsessed with a weird subject (say, mortuary science), people will be put off by your enthusiasm and keep their distance. Most of us have to figure out ways to conceal our stimming and special interests. We might maintain a secret blog about our interests, for example, or find socially acceptable ways to get our energy out, such as long-distance running or fidgeting with our phones.

Autistic people are at risk. Timotheus Gordon Jr. is an Autistic researcher, advocate, and the founder of Autistics Against Curing Autism Chicago. He tells me that for him, choosing to stim (or how to stim) is highly dependent on which neighborhood he’s in, and how people are likely to react.

“Walking into certain neighborhoods in Chicago or in the Chicagoland area, I can’t wear my headphones to enjoy music,” he says, “otherwise I’ll get robbed potentially. Or if I walk around and fidget with toys, police or certain people in the neighborhood will think I’m strange or doing something illegal and I might get arrested, killed, or beat up.”

Timotheus says that in some circumstances, he masks his need to stim by choosing a more socially acceptable outlet, such as bouncing a basketball. As a Black Autistic person, he is frequently having to take the temperature of his surroundings, gauging how others will react to his actions, and modulating himself accordingly. The risks of being himself are simply too great to take for granted.

Autistic people are at a high risk of violence, as well as negative mental health outcomes. Since we can’t openly stim or engage in other repetitive behaviors, some masked Autistic people reach for flawed coping strategies to help manage stress. We’re at an elevated risk of eating disorders,[^1.32] alcoholism and drug addiction,[^1.33] and insecure attachments to others.[^1.34] We tend to maintain shallow relationships, out of fear that people would hate getting to know our “real selves.” We may withdraw from other people, leading to negative emotional and psychological outcomes. And the more isolated we are, the less practice we get socializing, leading to a feedback loop of social disempowerment and shame.

Autism is also highly correlated with physical symptoms such as gastrointestinal issues,[^1.35] connective tissue disorders,[^1.36] and seizures[^1.37] largely for genetic reasons. It co-occurs with other disabilities such as Attention Deficit Hyperactive Disorder (ADHD)[^1.38] and dyslexia at a high rate.[^1.39] Many Autistic people have trauma histories and post-traumatic stress symptoms, and as I’ve already mentioned, a lifetime of masking puts us at a high risk of conditions like depression and anxiety.[^1.40] These are some of the most common conditions that co-occur alongside Autism, but later in the book we’ll discuss additional disorders that overlap (or are mistaken for) Autism.

Autism is a neurodivergence. Autism is a type of functioning (or a neurotype) that differs from what psychology defines as normative or neurotypical (NT). Autism is a particularly diverse and varied form of neurodivergence; there are just so many ways in which we are punished for deviating from the norm. Every case of Autism is a bit different, and traits can present in seemingly contradictory ways. Some Autistic people can’t speak; others are incredibly hyperverbal from a young age, with huge vocabularies. Some Autistics can read people’s emotions so easily that it’s overwhelming; others empathize with animals or objects, but not people; some of us have zero emotional empathy.[^1.41] But all of us are full-formed humans with a capacity to care for others and behave ethically. Some Autistic people have no “special interests”; others are fanatical about dozens of subjects. Some of us have skills we are adept at; others need help in every facet of our existence. What unites us, generally speaking, is a bottom-up processing style that impacts every aspect of our lives and how we move through the world, and the myriad practical and social challenges that come with being different.

Since mainstream standards for behavior are so narrow, there are a variety of ways in which a person can diverge—and be punished for diverging. Having frequent panic attacks is a neurodivergence, as is exhibiting signs of an eating disorder. If you struggle in your close relationships because of attachment trauma or an inescapable fear of rejection, you’re neurodivergent too (you might also get stuck with a particularly stigmatizing label, such as Borderline Personality Disorder).

Almost anyone can be viewed as defective or abnormal under our current medicalized model of mental illness—at least during particularly trying periods of their lives when they are depressed or their coping breaks down. In this way, neurotypicality is more of an oppressive cultural standard than it actually is a privileged identity a person has. Essentially no one lives up to neurotypical standards all of the time, and the rigidity of those standards harms everyone.[^1.42] Much as heteronormativity harms straight and queer folks alike, neurotypicality hurts people no matter their mental health status.

Autism is just one source of neurodiversity in our world. The term neurodiverse refers to the wide spectrum of individuals whose thoughts, emotions, or behaviors have been stigmatized as unhealthy, abnormal, or dangerous. The term was coined in 1999 by sociologist Judy Singer. In her honor’s thesis, Singer wrote about the difficulty of making sense of her daughter’s disabilities, which closely resembled traits her own mother exhibited when Singer was growing up. At the point that Singer was writing, Autism was poorly understood, and adults with Autistic traits, such as Singer’s mother (and Singer herself) rarely received diagnoses. Singer’s daughter seemed to inhabit a space somewhere between Autism, ADHD, and a variety of other disabilities. All three women were difficult to neatly categorize, which only obscured just how marginalized and socially adrift they all were. Just because their challenges couldn’t be easily named didn’t mean they didn’t exist.

“My life as a parent was a battleground for various belief systems,” she writes,[^1.43] “all of which had one thing in common: an inability to come to terms with human variability.”

Singer and her family were disabled in a way that no one knew how to name, so she created a name for them: they were neurodiverse, and they suffered because the world demanded they be neurotypical. These terms would be popularized by journalist Harvey Blume and widely adopted by disability advocates a few years later. The label neurodiverse includes everyone from people with ADHD, to Down Syndrome, to Obsessive-Compulsive Disorder, to Borderline Personality Disorder. It also includes people with brain injuries or strokes, people who have been labeled “low intelligence,” and people who lack any formal diagnosis, but have been pathologized as “crazy” or “incompetent” throughout their lives. As Singer rightly observed, neurodiversity isn’t actually about having a specific, catalogued “defect” that the psychiatric establishment has an explanation for. It’s about being different in a way others struggle to understand or refuse to accept.

Autism is diverse. Though the neurological and mental features of Autism cut across a wide swathe of people, the way it presents is always a bit different. In fact, Autistic traits can manifest in downright paradoxical ways. At times, I can be so intensely focused on a task (such as reading or writing) that the rest of the world entirely drops away. When I’m hyperfixating, I fail to notice things like someone speaking to me or smoke filling the room because I forgot to turn the oven off. At other times, I’m an anxious and distractible wreck, unable to make my way through a single sentence of a book because my pet chinchilla is hopping around in his cage and making the bars rattle. These two very disparate responses have the same root cause: the overexcitability of Autistic people’s neurons and the inconsistent way that we filter stimuli (at least compared to allistics). We tend to be both easily disturbed by sound in our environment, and unable to tell when a noise actually merits our attention, at the same time.[^1.44] I often brute-force my way into paying attention to something by shutting the rest of the world out. I think it’s also likely that lifelong masking has rendered me hypervigilant, almost as a trauma response. My sensory system is used to scanning the environment, to determine whether I’m alone and thus “safe” enough to be myself. Trauma survivors often become hypervigilant, which tends to come with intense sensory issues.[^1.45] Some researchers have also theorized that sensory issues in Autistics are, at least in part, caused by the anxiety and hypervigilance we experience from living in a world that doesn’t accommodate us, and often treats us with hostility.[^1.46]

Most people have heard that Autism is a spectrum, and it’s really true: each of us has a unique constellation of traits and features, all at various degrees of intensity. Some people are also subclinically Autistic, meaning they might not qualify for an official diagnosis, in the eyes of psychiatrists, but share enough struggles and experiences with us that they belong in the community. Relatives of diagnosed Autistic people, for example, frequently are found to exhibit subclinical traits.[^1.47] Of course, what’s considered to be “subclinical” is often more a function of a person’s ability to hold down a job and conform to societal rules than it is a reflection of how much they are suffering.

“Everybody is a little bit Autistic,” is a common refrain that masked Autistic people hear when we come out to others. This remark can feel a bit grating to hear, because it feels like our experiences are being downplayed. It’s similar to when bisexual people get told that “everybody is a little bit bi.” When most people make remarks like these, they’re implying that because our difference is so universal, we can’t actually be oppressed for it, and should just shut up about it. However, I do think that when allistic people declare that everyone is a little Autistic, it means they are close to making an important breakthrough about how mental disorders are defined: why do we declare some people broken, and others perfectly normal, when they exhibit the exact same traits? Where do we draw the line, and why do we even bother doing so? If an Autistic person benefits from more flexibility at work, and more social patience, why not extend those same benefits to everybody? Autistic people are a normal part of humanity, and we have qualities that can be observed in any other non-Autistic human. So yes, everyone is a little bit Autistic. That’s all the more reason to broaden our definition of what is deserving of dignity and acceptance.

Autism can appear in any person, regardless of their age, class, gender, race, or other disability status. Despite the incredible diversity of Autism and Autistic people, the average person (and even many mental health professionals) has a singular image of Autism in their minds. You might sometimes hear this called “typically presenting” Autism, though that’s really a misnomer. It’s more like stereotypical Autism.

“Typical” Autism is visible from an early age, and usually results in a diagnosis by the time a child is in early elementary school. Typical Autistics don’t communicate the way neurotypical society wants them to; they might be nonverbal or slow to develop speech, and they avoid gazing at other people or approaching them. They engage in repetitive behaviors that are recognizable: they rock in place, slap themselves in the head, or yell and chirp. Their sensory pain and social overwhelm is near-constant, and they can’t hide how profoundly they’re suffering. Their parents have trouble managing their meltdowns and sensory overloads, seeing these responses as “behavioral issues,” or “noncompliance.” They may complain Autism has “stolen” their once well-behaved baby from them. Typical Autistics are probably boys, and they’re probably white, and they are likely to come from wealthy or upper-middle-class families who can access diagnosis and therapeutic support (and who tend to have pretty restrictive norms of what constitutes “appropriate” public behavior).

In reality, typical Autistics aren’t all that typical. The vast majority of Autistic people who have been diagnosed flout this incredibly rigid set of criteria in one way or another.[^1.48] That’s despite the fact all existing diagnostic tools for Autism were developed with wealthy, white, gender-conforming boys in mind. When we consider the evidence that Autism is underdiagnosed in girls, Black, indigenous, Asian, and Latinx people,[^1.49] and those in poverty,[^1.50] among other groups, we can see that “typical” Autism is probably even less typical than official figures would have us believe.

The line between “typical” Autism and “atypical” Autism is quite permeable, and often has more to do with a person’s position in society than it does the supposed severity of their Autistic traits. Crystal had all the classic indicators of Autism: repetitive play, lack of social engagement, self-stimulatory behavior, difficulty staying on task at school. But because Crystal didn’t look like the “typical” Autistic person, she didn’t register as disabled to most of the world. For all the distress she was in, teachers and school counselors never again raised it as a possibility.

“Report cards called me a joy to have in class, and sensitive,” she says. “Which was a sneaky way of saying they thought I cried too much and got too hurt when kids were mean to me. Spacing out in math class wasn’t like, this alarming sign I was retreating into a shutdown. I was just a daydreamy girl who cried sometimes, which for a lot of my male teachers was probably their feminine ideal, when you think about it.”

An Autistic shutdown happens when an Autistic person gets so overstimulated and stressed, they can no longer process their surroundings.[^1.51] It’s the quieter, more interior counterpart to an Autistic meltdown, which tends to involve more crying, self-harm, or outward aggression. Shutdowns are essentially a way of dissociating from one’s surroundings. It can look like falling asleep very suddenly, becoming unresponsive, or just kind of zoning out (which is how it presented in Crystal’s case). Crystal suspects that had she been an Autistic boy, her shutdowns would have been viewed differently. Boys are supposed to have agency and confidence, and engage actively with the world. Being nonresponsive and depressed might have inspired early intervention, rather than morphing into an unspeakable family secret. Instead, Crystal’s parents told her to stop being “so weird” and to sit up and “look alive.” When confusion and frustration made her want to break down and cry, she was similarly told to tamp those urges down.

“Getting smaller and asking for nothing was how I kept people from calling me too sensitive so often,” she says. “That and assuming that if I was bad at something, it’s because I was never, ever gonna be good at it. Better to not ask.”

Now that she knows she’s Autistic, Crystal is trying to unlearn these deep-seated beliefs about herself. She wants to become someone who doesn’t apologize for crying, and doesn’t always cope with stress by locking herself away from the world. She wants to be able to build a life around the fact that a twenty- or thirty-hour workweek is the most she can manage. And she wants to relearn math with a nonjudgmental tutor, who’ll explain things to her in a direct, patient way, without any implied meanings or latent sexism.

“Can I look back one day and say to myself, all the things I hate about myself are actually my greatest strengths?” She ponders. “I don’t know. Someone should have always been telling me that. But you try to accept what happened. I can’t really yet. I’m too pissed.”

Like many people who have only recently figured out they’re Autistic, Crystal is still reeling about her newfound identity, and can’t seem to stop thinking about how unfairly she was treated in the past. There’s an entire class of Autistic people who are excluded and alienated in these ways, and we’ll get to meet many more of them in the next few chapters. But first, we need to dive into exactly why the image of typical Autism is what it is.

The Autistic people who wind up needing to mask the most are usually those who are undiagnosed due to things like gender, race, or socioeconomic status. These same populations of people also tend to be raised to be more agreeable and pleasant than their white male peers. For example, developmental psychology research has repeatedly noted that even small acts of play-aggression in girls are severely discouraged and punished by their teachers and parents as “inappropriate.” A girl might be admonished for slamming a couple of toys into one another, for example. Meanwhile, most boys are allowed to be rough and sometimes violent in their play.[^1.52] Because girls are held to a much more restrictive social standard than boys are, they learn to hide any troublesome, “violent,” or disruptive Autism features much earlier. Similar dynamics are at play for Autistic people of color and trans Autistic people of a variety of identities, as well as other maskers.[^1.53]

For a long time, Autism researchers believed the condition was truly less severe and less common in people of color and girls. Today, some still truly believe “female Autism” is less severe, though most professionals recognize that members of these marginalized groups are simply not given as much social latitude to be strange or disruptive, and that the same qualities are perceived differently in a boy than in a girl.[^1.54] However, the legacy of erasing Autistic girls, trans and gender-nonconforming Autistics, and other marginalized populations lingers.

The idea that Autism is a “boy’s” disorder goes all the way back to when the condition was first described at the turn of the twentieth century. Hans Asperger and other early Autism researchers did study girls on the spectrum, but generally left them out of their published research reports.[^1.55] Asperger in particular avoided writing about Autistic girls because he wanted to present certain intelligent, “high-functioning” Autistic people as “valuable” to the Nazis who had taken over Austria and were beginning to exterminate disabled people en masse. As Steve Silberman describes in his excellent book NeuroTribes, Hans Asperger wanted to spare the “high functioning” Autistic boys he’d encountered from being sent to Nazi death camps. Silberman described this fact somewhat sympathetically; Asperger was a scientist who had no choice but to collude with the fascist regime and save what few children he could. However, more recently unearthed documents make it clear that Asperger was far more complicit in Nazi exterminations of disabled children than had been previously believed.[^1.56] Though Asperger held intelligent, “little professor” type Autistics close to his heart, he knowingly sent more visibly debilitated Autistics to extermination centers.

Informed by eugenicist ideals that only granted rights to those who were “valuable” to society, Asperger focused on describing Autism as a disorder for intelligent, yet troubled boys, usually ones from wealthy families. Girls with disabilities were seen as more disposable, so they were left out of the conversation.[^1.57] Black and brown Autistics weren’t described at all by Asperger or most of his contemporaries, even those who were doing research in more racially diverse countries such as the United States. The existence of LGBTQ and gender nonconforming Autistics was similarly ignored. In fact, the developer of the first therapeutic “treatment” for Autism, Applied Behavioral Analysis therapy, was Ole Ivar Lovaas, who also invented anti-gay conversion therapy.[^1.58] That legacy still haunts the lives of many LGBTQ Autistics, who often feel out of place both in mainstream queer spaces and in Autism groups.[^1.59]

Since early published research in both English and German only described Autistic boys, some psychiatrists from that era concluded the condition was caused by an “extremely male brain.”[^1.60] Autistic people were supposedly too analytical, too rational, and too individualistic to function in society on their own. This view influenced how all the diagnostic guidelines were written, and created a feedback loop that endured for decades: the Autistics who got diagnosed were primarily wealthy white boys, and those boys continued to set the standard of what Autism was and how it was understood in the studies that followed.[^1.61] The few white girls who were diagnosed had to be very obviously “masculine” in how their Autism presented. Nonwhite Autistics were instead identified as defiant, antisocial, or schizophrenic—all disorders that made it easier to incarcerate them, or forcibly place them in institutions.[^1.62]

A century after these trends first began, massive gender- and race-based disparities in Autism diagnoses still exist. For decades, Autistic boys have outnumbered girls at a ratio of 4 to 1.[^1.63] Girls like Crystal are still routinely passed over and denied assessments, because they are well-behaved and too pleasant to “really” be Autistic. Autistic trans people and people of color are similarly excluded.[^1.64] When any of us do discover our identities and come out, we risk being told we “don’t look Autistic.”

In media, nearly every Autistic character is a white man with a monotone voice, rude demeanor, and a penchant for science. Think of the irascible genius Rick from Rick and Morty,[^1.65] the hypercompetent yet cold Shaun Murphy from ABC’s The Good Doctor, or the nerdy and condescending Sheldon Cooper from The Big Bang Theory. In this cultural landscape, there’s little room for Autistics who are sensitive, emotionally expressive, artistic, or uninterested in academic success. Autism is so broadly associated with assholery that many of us initially hate associating with the term, and try to overcompensate by being excessively easygoing and nonconfrontational. It takes many years of research and meeting real-life counter-examples for most of us to recognize Autism isn’t the cold, robotic condition we’ve been told it is.

Being exposed to these misconceptions and shallow stereotypes can have a profound impact on how Autistic people see ourselves, and which qualities we aim to mask.

In the exercise below, I’d like you to ponder what messages about Autism you might’ve absorbed as a child, and how that may have shaped your self-perceptions and your mask. For reasons we’ll get into more thoroughly in the next few chapters, an Autistic person’s mask tends to be informed by the Autistic qualities they have been trained to hate or fear the most.

**Autism Stereotypes**:

* How Have They Affected You?

* 1. Think of some images of Autism that you saw on TV or in movies. If you can, name a few Autistic characters or figures you saw during this time.

* 2. Pick a few Autistic characters (or characters implied to be Autistic) and describe them in three to five words. For example, I might describe Dustin Hoffman’s Rain Man as distant, a genius savant, and helpless.

* `Character:_____­_____­_____­__` `Traits: _____­_____­_____­_____­___`

* `Character:_____­_____­_____­__` `Traits: _____­_____­_____­_____­___`

* `Character:_____­_____­_____­__` `Traits: _____­_____­_____­_____­___`

* 3. Complete the sentence:

* 4. In what ways are you different from these images of Autism?

* 5. Has anyone ever told you that you “don’t look Autistic” or that you “can’t be Autistic”? What do you think they meant by that? How did hearing that feel?

These days, varied portrayals of Autistic people do exist. Abed Nadir on the sitcom Community is a Palestinian Muslim man with a sharp wit and a penchant for movies, as well as the more clichéd chilly demeanor and difficulty smiling. In the popular multiplayer game Overwatch, Symmetra is a confident Autistic Indian woman who blasts her opponents with turrets she’s invented. Beth Harmon of the Netflix series The Queen’s Gambit is a beautiful, substance-addicted chess player, and is heavily implied to be Autistic. I only started seeing characters like these when I was in my late twenties, after I already knew I was Autistic, had met a variety of Autistic people in real life, and began seeking representation that went beyond the tortured white genius image. Diversifying and deepening my knowledge of what Autism could be was absolutely essential to understanding myself and slowly beginning to build self-love and acceptance. For many of the masked Autistic people I interviewed for this book, meeting a variety of mold-breaking, “atypical” Autistics of many different backgrounds was similarly important.

Masked Autistic people are basically everywhere, though by our very nature we’re socially invisible. You can find us in any number of fields people might not associate with stereotypically Autistic behavior, including sales, the service industry, and the arts. Because so many of us mask through inhibition and withdrawal, we might not stand out as socially awkward, at least not in a way anyone can pinpoint. Though many of us experience sensory issues, anxiety, meltdowns, and debilitating mental health symptoms, we push as much of that misery into the private realm as possible. Our elaborate veils of coping mechanisms and camouflaging can create the illusion we don’t need help. Often this comes at the expense of giving up on the areas of life where we might need assistance. We may eschew relationships, drop out of grueling academic programs, avoid working in fields that require networking and socializing, or completely disengage from activities that involve using our bodies, because we feel so detached and uncoordinated in them. Most of us are haunted by the sense there’s something “wrong” or “missing” in our lives—that we’re sacrificing far more of ourselves than other people in order to get by and receiving far less in return.

Due to the fact that Autism is so severely underdiagnosed, it’s hard to estimate just how prevalent the neurotype really is. We do know that as public awareness of Autism has increased, and as diagnosis procedures have gotten a tiny bit less biased, the diagnosis rate has continually gone up. As of 2020, one in 54 children is diagnosed as Autistic, up from one in 68 just four years ago. In the 1990s only one in every 2,500 children was diagnosed.[^1.66] This upward trend shows no sign of stopping, as all evidence suggests the condition is still profoundly underrecognized in women, trans people, Black and brown people, people in poverty, and those without access to screening and therapy. In the United States, as many as 50 percent of all people who need mental health support lack access to it,[^1.67] so we are talking about a truly massive underdiagnosis rate.


From all this data, we can assume that at least half of all Autistic people in the United States currently fail to get diagnosed. That’s a conservative estimate, based on the assumption that every Autistic person with access to therapy gets an accurate diagnosis, a fact we know not to be true. It’s also worth bearing in mind that Autism runs in families, and that for every diagnosed Autistic child reflected in that chart, there’s probably several other relatives who exhibited Autism spectrum traits. In my own family, almost everyone has some Autistic traits and can be considered a part of the Autism community, even if some might not qualify based on an official assessment or might not be interested in identifying as disabled.[^1.68]

If you’re reading this book, you probably suspect that you or someone you know is a masked Autistic, or otherwise neurodiverse. I have been writing about my own journey of Autistic self-discovery for many years now, and every single time I post online about it, I’m inundated with messages from people who are questioning whether they’re on the spectrum, and want my advice on how to find out. Usually, their first question is how to get tested for Autism Spectrum Disorder. My initial response to that is to present them with three questions:

* Do you have health insurance that covers Autism assessments?

* Can you find an Autism assessment specialist in your area who has a proven track record of working successfully with Autistic adults?

* What do you hope to get out of a formal diagnosis?

The first and second questions can prove quite dispiriting to answer. In the United States, many health insurance plans do not cover Autism assessment in adults.[^1.69] A limited number of specialists are qualified to assess and diagnose Autism (your average psychologist can’t do it), and the diagnostic process typically involves multiple tests, screening surveys, and even interviews with the Autistic person’s family and friends. Without insurance coverage, this process can cost anywhere from $1,200[^1.70] to $5,000.[^1.71]

Even when a person can afford to be assessed, identifying a specialist who knows how to diagnose Autistic adults can be prohibitively difficult. My friend Seb (who’s in their mid-twenties) sought out an assessment in the UK and was subjected to tests clearly designed for small kids. A therapist asked Seb to arrange various toys on a table and make up stories about them (this is part of a common diagnostic tool called the Autism Diagnostic Observation Schedule, or the ADOS, and it was developed for use in children).[^1.72] A questionnaire was given to Seb’s mother to fill out, and Seb wasn’t permitted to look at what she’d said. They were completely disempowered by the whole process. Some people whom I interviewed for this book reported being turned away by multiple assessors, for things as simple as being a woman, dressing well, or having voices that weren’t completely monotonous. Sometimes assessors decide to give adults labels they view as less stigmatizing, such as nonverbal learning disorder, rather than identifying them as Autistic explicitly.

“I had to see two specialists,” Crystal tells me. “The first one said basically the same thing my grandpa used to say: girls usually aren’t Autistic. You’re doing fine in life. Don’t worry about it.”

To this day, a majority of Autism assessment tools are based on the decades-old ones developed for white male children from wealthy and middle-class families.[^1.73] With years of clinical experience, some experts learn to recognize Autism in those who mask. They may know, for example, that masked Autistics can make eye contact, though many of us stare too strongly by neurotypical standards, or for too long. They might understand that Autistic women and people of color have to appear friendly as a means of survival, so their tone of voice might not be totally flat. Perhaps they’re even aware of Autism’s link with substance addictions and eating disorders, particularly among people who have to fake neurotypicality all day long at their jobs. However, these facts are not a core part of how assessors are trained, and many spend their entire careers reinforcing old sexist, white supremacist notions of how the disability looks.

This brings me to my third question: what do you hope to get out of being formally diagnosed? It can come with serious social and legal benefits under the Americans with Disabilities Act (and laws in other countries like it), and other antidiscrimination statutes worldwide. You might hope that people will take your problems more seriously when a psychiatrist has validated them. A formal diagnosis means you can receive disability accommodations at school or work, and you can pursue a legal case if an employer or landlord shows documentable signs of bias against you. In some places a diagnosis can qualify you for a medical marijuana card, or a therapy animal. Family members who have told you that you’re whiny and lazy may finally get off your case when they realize you have a developmental disorder. A therapist or medical care provider may tailor their treatment of you to your neurotype. These are the kinds of outcomes many neurodivergent people hope for when they pursue formal recognition.

Unfortunately, a diagnosis is not a guarantee you will receive any of these benefits. Proving in a court of law that you’ve been discriminated against as an Autistic person requires extensive documentation[^1.74] and is prohibitively expensive to pursue for most disabled people. Even though a diagnosed disability entitles you to accommodations on paper, many employers and educators refuse to provide them, or mistreat the employees and students who request them (for more on the limitations of the ADA and its inconsistent enforcement, see Chapter 8). And as much as I’d like to promise that being recognized formally as an Autistic will get judgmental friends and family off your back, I’ve heard too many counter-examples to claim that’s really the case. Your family members may find your disability even more threatening once it’s validated by a doctor, or they might use your diagnosis to undermine your judgment or infantilize you. This isn’t intended to dissuade you from seeking a diagnosis; I just don’t want anyone to have the impression that a piece of paper signed by a psychiatrist magically unlocks a suite of resources and social respect.

Additionally, an Autism diagnosis does not grant you access to any particular therapy or medication, because there are no evidence-based treatments for Autism in adults. Most therapists are not trained to work with Autistic adults, and many of them harbor very shallow, outdated understandings of what the neurotype is. Even those who do specialize in Autism are usually trained primarily in working with Autistic kids, “helping” them to behave in a more agreeable, passive fashion. Here in Chicago, I’m aware of just one therapist who is competent in treating Autistic adults who mask, and the only reason I know they’re competent is that other Autistic people have vouched for them to me. I do know several mental health providers in other cities who have confessed to me privately that they are Autistic, and love working with fellow Autistic patients. However, each of them has told me they cannot openly identify as Autistic professionally. There’s too great a risk that their colleagues would view them as incompetent or unprofessional if they were open about their neurodivergence.

Of course, even the idea of pursuing a treatment “for” Autism is predicated on the idea we are broken or sick. This is an idea the neurodiversity movement completely rejects. There is no medication for Autism, no cure for it, and no way of changing one’s neurotype. As a community, most Autistics oppose attempts to “fix” us. There are some modifications that can be made to existing therapeutic methods, to make them a better fit for Autistic adults, but unless a provider takes the time to self-educate, they may be unaware such modified treatments exist. For the most part, learning you’re Autistic is a journey of self-acceptance, community building, and growing self-advocacy, and you might not need or want a diagnosis to go down that path.

For all the reasons outlined above, I firmly support Autistic self-determination. I prefer the terms self-determination or self-realization to self-diagnosis, because I believe it’s more sensible to view Autistic identity through a social lens than a strictly medical one.[^1.75] Diagnosis is a gatekeeping process, and it slams its heavy bars in the face of anyone who is too poor, too busy, too Black, too feminine, too queer, and too gender nonconforming, among others. The Autistics who lack access to fair diagnoses need solidarity and justice the most desperately out of all of us, and we can’t just shut them out.

Though people like Crystal often regret having not been assessed for Autism at a young age, Autistic children who are diagnosed when they are young experience both greater access to resources, and more intense, institutionalized stigma. Being identified formally as disabled is very much a double-edged sword; a diagnosis can even be used against you in divorce proceedings or child custody cases, or to force a legal adult under a financial conservatorship. This doesn’t mean I would recommend against pursuing diagnosis in all cases. I know masked Autistic parents who are very glad their Autistic children got assessed and diagnosed when they were young. For many Autistic parents, it’s the diagnosis of their children that kicks off their own exploration of an Autistic identity. Having a recognized diagnosis of Autism in the family can also ensure that professionals take your suspicion you’re Autistic more seriously (that certainly has been true in my case).

The parents I know who have had a positive experience with assessment entered the diagnostic process recognizing they would need to fight many battles to have their child’s agency and humanity respected. This is true of the adults who have successfully pursued formal diagnosis for themselves as well. Unfortunately, Autistic people are frequently put in the position of having to educate our own health care providers. Autistic children in particular need strong advocates in their corner, fighting to make sure their boundaries are respected and that any treatment they are given is actually in their best interest. If you wish to get diagnosed, or wish for your child to be, you should go into the process with accurate expectations, armed with as much information as possible, and ready to fight or switch providers multiple times if needed.

If you don’t wish to brave the long, arduous, and often expensive process of being assessed, you do not have to. Medical documentation does not make your experience any more real. Self-realized Autistics are not lesser members of the community. In most Autistic self-advocacy spaces I frequent, I have no idea who is diagnosed and who is not, because it truly does not matter.

I believe that Autistic people have the right to define who we are, and that self-definition is a means of reclaiming our power from the medical establishment that has long sought to corral and control us. Our deviance from the norm doesn’t have to be the core part of how we understand ourselves. We can push for social norms to be widened, until we reach the point that Autism is viewed as a neutral fact about a person’s being, on par with needing glasses or having freckles. As we make major gains in public awareness and advocacy, we will begin to occupy a less disabled position in society. But we’ll still all be Autistic. Accordingly, we shouldn’t let the view of Autism as an impediment shape how we see ourselves or determine who belongs among us.

Throughout this book, I capitalize “Autistic” for the same reason members of the Deaf community capitalize “Deaf”—to indicate it is a part of my identity I am proud of, and to signal Autistics have our own culture, history, and community. Since Eugen Bleuler first coined the word in the early 1900s, Autism has largely been used in negative and dehumanizing ways, and to this day many parents and educators are still deeply frightened by it. By capitalizing Autism, I signal that it’s actually an important, meaningful aspect of who we are, one we don’t need to shy away from.

Throughout, I will also refer to Autism as a disability. Disability is not a bad word, because being disabled is not a shameful thing. We are not “differently abled”—we are disabled, robbed of empowerment and agency in a world that is not built for us. “Differently abled,” “handi-capable,” and similar euphemisms were created in the 1980s by the abled parents of disabled children, who wished to minimize their children’s marginalized status. These terms were popularized further by politicians[^1.76] who similarly felt uncomfortable acknowledging disabled people’s actual experiences of oppression.[^1.77] These words obscure reality and reflect a discomfort many people have with disabled bodies and brains. A person who is completely blind is not “differently sighted”—they lack an ability that other people have, in a world that was designed by and for people who can see. The world actively dis-ables people by failing to provide accommodations they need. Naming the reality of disability shows respect for disabled people and awareness of how we are oppressed. “Differently abled” attempts to erase that behind a cutesy euphemism, and many of us find the term offensive.

In a similar vein, I almost always will use “Autistic” and not “person with Autism.” Many non-disabled parents of Autistic kids prefer what’s called “person first” language rather than “disability first” or “identity first” language.[^1.78] Disability service organizations that are not run by disabled people tend to advocate for person first language as well. I also know many clinicians and social workers who tell me that when they were in school, they were taught to always separate a person’s disability from their identity in this way.

When people use person-first language, they often say it’s because they don’t want disabled people to be defined by their disability. However, phrases like “person with Autism” distance a person’s disabled status from their humanity in a way that can be quite harmful. Autism is not a thing that is added on to a person—it’s integral to their life and cannot be removed from who they are. We don’t call Asian people “people with Asianness” and we don’t call gay folks “people with homosexuality” because we recognize it is respectful to view these identities as parts of their personhood. Language such as “identifies as Autistic” can also come across as dubious. If I really respect a trans woman’s gender, for example, I wouldn’t say “this person identifies as a woman.” I’d simply say, “she’s a woman” and leave it at that.

The vast majority of Autism self-advocates prefer identity-first language and dislike euphemisms like “special” and “differently abled,” for all the reasons I’ve outlined here. They also discourage describing a person as “high” or “low” functioning, preferring instead things like “high support needs.” Here’s a table summarizing some of the most common terminology preferences expressed by the community:

| Use This | Avoid This |

| --------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------- |

| Autistic person <br> Autist <br> Autistic <br> On the Autism spectrum | Person with Autism |

| Is Autistic | Identifies as having autism |

| Is disabled <br> Has a disability | “Special needs” <br> “Differently abled” <br> “Handi-capable” |

| Neurotypical (NT) <br> Allistic <br> Non-Autistic | Normal |

| Has high support needs <br> Has low support needs | Low functioning <br> High functioning |

| Masked Autism | Female Autism <br> Asperger’s <br> High-functioning Autism |

| Nonverbal <br> Loses speech | Mute <br> Dumb |

| Intellectually disabled <br> Developmentally disabled | Retarded <br> Stupid <br> Special |

| Direct language about what a person can or can’t do, and what kind of support they need | Euphemisms, language that minimizes challenges, language that belittles or condescends |

Autistics are a diverse group, though, and we don’t all have to agree on which terms we like and dislike having used for ourselves. If you are Autistic, you get to decide what language works best for you. Some people prefer to say they are “on the spectrum,” for example, rather than strictly Autistic. Others identify as having Asperger’s, though that disorder label no longer exists, and was rooted in Hans Asperger’s eugenicist research.[^1.79] I recognize that people who had that term forced on them in the past may feel an attachment to it, or a desire to reclaim it. The word bisexual was once a mental illness label,[^1.80] but we don’t tell bisexual people they can’t use it because of its offensive history. When someone like folklorist Anand Prahlad writes a book like The Secret Life of a Black Aspie, it’s clear his use of the term “Aspergers” is not intended to reinforce old, white supremacist notions of what the disability is. I find it’s far more important to question the belief that supposedly “higher functioning” Autistic lives matter more than others than it is to scrub all people’s language of outdated or problematic terms. Additionally, it is vital that the disability self-advocacy community remain accessible to all people of all ability levels. That requires we extend grace and understanding to people who don’t communicate exactly the way we might like them to.

Though most of the community discourages the use of such terms, some Autistic people do identify as “low functioning” or “severely Autistic.” Functioning labels oversimplify the Autistic experience, and they do serve to imply that we should be defined by how productive and independent we are. That’s a big problem. At the same time, function labels can occasionally be used to highlight the fact that those of us who can talk, dress ourselves, or hide our meltdowns have social privileges other Autistic people do not have. I don’t function “highly” in every single realm of my life, but I am able to get by more easily than many other Autistics. My acceptance in society is conditional on my behaving respectably and being productive. That’s really a deeply ableist reality, but I shouldn’t pretend it isn’t true. Though having to mask as a desirable, respectable person can be very soul-crushing, it does protect me from physical violence, institutionalization, poverty, and loneliness. I can understand why my friend Angel believes it’s worth pointing out that his life as a nonspeaking person with intellectual disabilities is really different from mine. Angel says he is low functioning, and says that he has severe Autism; though some in our community find that offensive, I stand by his right to name his own experience.

I love that every Autistic person has their own unique relationship to these labels, and their own thoughts. Our disagreements show that the Autistic community is diverse, filled with people who form their own opinions and speak their minds. We’re not a monolithic group, and our individual journeys shape how we express our identities to the world. I’ve done my best in this book to honor the terminology each individual Autistic person uses for themselves. This means that sometimes I’ll call someone a “person with Autism” or a “low-functioning” person, even though self-advocacy groups have good reasons to discourage allistics from using such words thoughtlessly. If someone self-identifies as an Aspie or as having Asperger’s, I’ll accurately reflect that as well. I hope that even if you have specific stances on which terms you like and dislike, you can respect my interview subjects’ agency to name themselves, as I have strived to do.

[^1.1]: Corrigan P. W. (2016). Lessons learned from unintended consequences about erasing the stigma of mental illness. World Psychiatry, 15(1), 67–73. https://doi.org/​10.1002/​wps.20295.

[^1.2]: Ben-Zeev, D., Young, M. A., & Corrigan, P. W. (2010). DSM-V and the stigma of mental illness. Journal of Mental Health, 19(4), 318–327.

[^1.3]: Ysasi, N., Becton, A., & Chen, R. (2018). Stigmatizing effects of visible versus invisible disabilities. Journal of Disability Studies, 4(1), 22–29.

[^1.4]: Mazumder, R., & Thompson-Hodgetts, S. (2019). Stigmatization of Children and Adolescents with Autism Spectrum Disorders and their Families: A Scoping Study. Review of Journal of Autism and Developmental Disorders 6, 96–107. https://doi.org/​10.1007/​s40489-018-00156-5.

[^1.5]: Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A.,…& Nicolaidis, C. (2020). “Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining Autistic Burnout. Autism in Adulthood, 2(2), 132–143.

[^1.6]: Buckle, K. L., Leadbitter, K., Poliakoff, E., & Gowen, E. (2020). “No way out except from external intervention”: First-hand accounts of autistic inertia.

[^1.7]: Demetriou, E. A., Lampit, A., Quintana, D. S., Naismith, S. L., Song, Y. J. C., Pye, J. E.,…& Guastella, A. J. (2018). Autism spectrum disorders: meta-analysis of executive function. Molecular Psychiatry, 23(5), 1198–1204.

[^1.8]: Some people who otherwise exhibit Autism spectrum traits and report Autistic cognitive challenges do not exhibit social or behavioral signs, due to camoflauging of symptoms: L. A. Livingston, B. Carr, & P. Shah. (2019). Recent advances and new directions in measuring theory of mind in autistic adults. Journal of Autism and Developmental Disorders, 49, 1738–1744.

[^1.9]: Thapar, A., & Rutter, M. (2020). Genetic advances in autism. Journal of Autism and Developmental Disorders, 1–12.

[^1.10]: Gernsbacher, M. A., Dawson, M., & Mottron, L. (2006). Autism: Common, heritable, but not harmful. Behavioral and Brain Sciences, 29(4), 413.

[^1.11]: Rylaarsdam, L., & Guemez-Gamboa, A. (2019). Genetic causes and modifiers of autism spectrum disorder. Frontiers in Cellular Neuroscience, 13, 385.

[^1.12]: Hahamy, A., Behrmann, M. & Malach, R. (2015). The idiosyncratic brain: Distortion of spontaneous connectivity patterns in autism spectrum disorder. Nature Neuroscience 18, 302–309. https://doi.org/​10.1038/​nn.3919.

[^1.13]: Autistic people of all genders continue to develop in their social skills and communication abilities throughout the life span. See: Rynkiewicz, A., Schuller, B., Marchi, E. et al., (2016). An investigation of the “female camouflage effect” in autism using a computerized ADOS-2 and a test of sex/gender differences. Molecular Autism 7, 10. https://doi.org/​10.1186/​s13229-016-0073-0.

[^1.14]: Zhou, Y., Shi, L., Cui, X., Wang, S., & Luo, X. (2016). Functional Connectivity of the Caudal Anterior Cingulate Cortex Is Decreased in Autism. PloS One, 11(3), e0151879. https://doi.org/​10.1371/​journal.pone.0151879.

[^1.15]: Allman, J. M., Watson, K. K., Tetreault, N. A., & Hakeem, A. Y. (2005). Intuition and autism: A possible role for Von Economo neurons. Trends in Cognitive Sciences, 9(8), 367–373.

[^1.16]: Rosenberg, A., Patterson, J. S., & Angelaki, D. E. (2015). A computational perspective on autism. Proceedings of the National Academy of Sciences, 112(30), 9158–9165.

[^1.17]: Hahamy, A., Behrmann, M., & Malach, R. (2015). The idiosyncratic brain: Distortion of spontaneous connectivity patterns in autism spectrum disorder. Nature Neuroscience 18, 302–309. https://doi.org/​10.1038/​nn.3919; Dinstein, I I., Heeger, D. J., & Behrmann, M. (2015). Neural variability: Friend or foe? Trends in Cognitive Sciences, 19(6), 322–328.

[^1.18]: See this press release from the Weizmann Institute: https://www.eurekalert.org/​pub_releases/​2015-01/​wios-abg-012115.php.

[^1.19]: Koldewyn, K., Jiang, Y. V., Weigelt, S., & Kanwisher, N. (2013). Global/local processing in autism: Not a disability, but a disinclination. Journal of Autism and Developmental Disorders, 43(10), 2329–2340. https://doi.org/​10.10007/​s10803-013-1777-z.

[^1.20]: L. Mottron, S. Belleville, E. Ménard. (1999). Local bias in autistic subjects as evidenced by graphic tasks: Perceptual hierarchization or working memory deficit? Journal of Child Psychology and Psychiatry, 40, 743–755.

[^1.21]: D. Hubl, S. Bolte, S. Feineis-Matthews, H. Lanfermann, A. Federspiel, W. Strik, et al. (2003). Functional imbalance of visual pathways indicates alternative face processing strategies in autism. Neurology, 61, 1232–1237.

[^1.22]: Minio-Paluello, I., Porciello, G., Pascual-Leone, A., & Baron-Cohen, S. (2020). Face individual identity recognition: A potential endophenotype in autism. Molecular Autism, 11(1), 1–16.

[^1.23]: Longdon, E., & Read, J. (2017). ‘People with Problems, Not Patients with Illnesses’: Using psychosocial frameworks to reduce the stigma of psychosis. Israel Journal of Psychiatry and Related Sciences, 54(1), 24–30.

[^1.24]: https://www.wired.com/​story/​how-earnest-research-into-gay-genetics-went-wrong/.

[^1.25]: Guiraud, J. A.; Kushnerenko, E.; Tomalski, P.; Davies, K.; Ribeiro, H.; & Johnson, M. H. (2011). Differential habituation to repeated sounds in infants at high risk for autism. Neuroreport, 22, 845–849.

[^1.26]: Brosnan, M., Lewton, M., & Ashwin, C. (2016). Reasoning on the autism spectrum: A dual process theory account. Journal of Autism and Developmental Disorders, 46(6), 2115–2125.

[^1.27]: Brosnan, M., Ashwin, C., & Lewton, M. (2017). Brief report: Intuitive and reflective reasoning in autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(8), 2595–2601.

[^1.28]: Seltzer, M. M., Krauss, M. W., Shattuck, P. T., Orsmond, G., Swe, A., & Lord, C. (2003). The symptoms of autism spectrum disorders in adolescence and adulthood. Journal of Autism and Developmental Disorders, 33(6), 565–581.

[^1.29]: Hazen, E. P., Stornelli, J. L., O’Rourke, J. A., Koesterer, K., & McDougle, C. J. (2014). Sensory symptoms in autism spectrum disorders. Harvard Review of Psychiatry, 22(2), 112–124.

[^1.30]: Jordan, C. J., & Caldwell-Harris, C. L. (2012). Understanding differences in neurotypical and autism spectrum special interests through internet forums. Intellectual and Developmental Disabilities, 50(5), 391–402.

[^1.31]: Kapp, S. K., Steward, R., Crane, L., Elliott, D., Elphick, C., Pellicano, E., & Russell, G. (2019). ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming. Autism, 23(7), 1782–1792.

[^1.32]: Tchanturia, K., Smith, K., Glennon, D., & Burhouse, A. (2020). Towards an improved understanding of the Anorexia Nervosa and Autism spectrum comorbidity: PEACE pathway implementation. Frontiers in Psychiatry, 11, 640.

[^1.33]: Wijngaarden-Cremers, P. J. M., Brink, W. V., & Gaag, R. J. (2014). Addiction and autism: A remarkable comorbidity. Journal of Alcoholism and Drug Dependence, 2(4), 170.

[^1.34]: McKenzie, R., & Dallos, R. (2017). Autism and attachment difficulties: Overlap of symptoms, implications and innovative solutions. Clinical Child Psychology and Psychiatry, 22(4), 632–648.

[^1.35]: McElhanon, B. O., McCracken, C., Karpen, S., & Sharp, W. G. (2014). Gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. Pediatrics, 133(5), 872–883.

[^1.36]: Baeza-Velasco, C., Cohen, D., Hamonet, C., Vlamynck, E., Diaz, L., Cravero, C.,…& Guinchat, V. (2018). Autism, joint hypermobility–related disorders and pain. Frontiers in Psychiatry, 9, 656.

[^1.37]: Bolton, P. F., Carcani-Rathwell, I., Hutton, J., Goode, S., Howlin, P., & Rutter, M. (2011). Epilepsy in autism: Features and correlates. British Journal of Psychiatry, 198(4), 289–294.

[^1.38]: Antshel, K. M., Zhang-James, Y., & Faraone, S. V. (2013). The comorbidity of ADHD and autism spectrum disorder. Expert Review of Neurotherapeutics, 13(10), 1117–1128.

[^1.39]: Russell, G., & Pavelka, Z. (2013). Co-occurrence of developmental disorders: Children who share symptoms of autism, dyslexia and attention deficit hyperactivity disorder (pp. 361–386). InTech.

[^1.40]: Hull, L., Levy, L., Lai, M. C., Petrides, K. V., Baron-Cohen, S., Allison, C.,…& Mandy, W. (2021). Is social camouflaging associated with anxiety and depression in autistic adults? Molecular Autism, 12(1), 1–13.

[^1.41]: https://leader.pubs.asha.org/​doi/​10.1044/​leader.FTR2.25042020.58.

[^1.42]: This essay by Damian Milton sums it up well: “…there is no neuro-typical to deviate from other than an idealised fantastical construction of Galtonian inspired psychological measurement.” (Francis Galton is the inventor of eugenics. Thanks to Jesse Meadows for sharing this piece with me.) http://www.larry-arnold.net/​Autonomy/​index.php/​autonomy/​article/​view/​AR10/​html.

[^1.43]: Singer, Judy. (1999). “Why can’t you be normal for once in your life?” From a “problem with no name” to the emergence of a new category of difference. In Corker, Mairian, & French, Sally (eds.). Disability Discourse. McGraw-Hill Education (UK). p. 61.

[^1.44]: Takarae, Y., & Sweeney, J. (2017). Neural hyperexcitability in autism spectrum disorders. Brain Sciences, 7(10), 129.

[^1.45]: Stewart, L. P., & White, P. M. (2008). Sensory filtering phenomenology in PTSD. Depression and Anxiety, 25(1), 38–45.

[^1.46]: Though of course sensory overwhelm can also contribute to anxiety. It’s likely a bidirectional relationship; see: Green, S. A., & Ben-Sasson, A. (2010). Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders: Is there a causal relationship? Journal of Autism and Developmental Disorders, 40(12), 1495–1504.

[^1.47]: Bora, E., Aydın, A., Saraç, T., Kadak, M. T., & Köse, S. (2017). Heterogeneity of subclinical autistic traits among parents of children with autism spectrum disorder: Identifying the broader autism phenotype with a data-driven method. Autism Research, 10(2), 321–326.

[^1.48]: https://www.cdc.gov/​mmwr/​volumes/​67/​ss/​pdfs/​ss6706a1-H.pdf.

[^1.49]: Mandell, D. S., et al. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99(3), 493–498. https://doi.org/​10.2105/​AJPH.2007.131243.

[^1.50]: https://www.cdc.gov/​ncbddd/​autism/​addm-community-report/​differences-in-children.html.

[^1.51]: Stevens, K. (2019). Lived Experience of Shutdowns in Adults with Autism Spectrum Disorder.

[^1.52]: Endendijk, J. J., Groeneveld, M. G., van der Pol, L. D., van Berkel, S. R., Hallers-Haalboom, E. T., Bakermans-Kranenburg, M. J., & Mesman, J. (2017). Gender differences in child aggression: Relations with gender-differentiated parenting and parents’ gender-role stereotypes. Child Development, 88(1), 299–316.

[^1.53]: Cage, E., & Troxell-Whitman, Z. (2019). Understanding the Reasons, Contexts and Costs of Camouflaging for Autistic Adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/​10.1007/​s10803-018-038 878-x.

[^1.54]: Andersson, G. W., Gillberg, C., & Miniscalco, C. (2013). Pre-school children with suspected autism spectrum disorders: Do girls and boys have the same profiles? Research in Developmental Disabilities, 34(1), 413–422.

[^1.55]: Silberman, S. (2015). NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. New York: Penguin. Chapter 5: “Fascinating Peculiarities.”

[^1.56]: https://www.nature.com/​articles/​d41586-018-05112-1.

[^1.57]: Burch, S., & Patterson, L. (2013). Not Just Any Body: Disability, Gender, and History. Journal of Women’s History, 25(4), 122–137.

[^1.58]: https://nsadvocate.org/​2018/​07/​11/​treating-autism-as-a-problem-the-connection-between-gay-conversion-therapy-and-aba/.

[^1.59]: Hillier, A., Gallop, N., Mendes, E., Tellez, D., Buckingham, A., Nizami, A., & OToole, D. (2019). LGBTQ + and autism spectrum disorder: Experiences and challenges. International Journal of Transgender Health, 21(1), 98–110. https://doi.org/​10.1080/​15532739.2019.1594484.

[^1.60]: https://www.spectrumnews.org/​news/​extreme-male-brain-explained/.

[^1.61]: Evans, S. C., Boan, A. D., Bradley, C., & Carpenter, L. A. (2019). Sex/gender differences in screening for autism spectrum disorder: Implications for evidence-based assessment. Journal of Clinical Child & Adolescent Psychology, 48(6), 840–854.

[^1.62]: Metzl, J. M. (2010). The Protest Psychosis: How Schizophrenia Became a Black Disease. Boston: Beacon Press.

[^1.63]: Halladay, A. K., Bishop, S., Constantino, J. N., Daniels, A. M., Koenig, K., Palmer, K., Messinger, D., Pelphrey, K., Sanders, S. J., Singer, A. T., Taylor, J. L., & Szatmari, P. (2015). Sex and gender differences in autism spectrum disorder: Summarizing evidence gaps and identifying emerging areas of priority. Molecular Autism, 6, 36. https://doi.org/​10.1186/​s13229-015-0019-y.

[^1.64]: Becerra, T. A., von Ehrenstein, O. S., Heck, J. E., Olsen, J., Arah, O. A., Jeste, S. S.,…& Ritz, B. (2014). Autism spectrum disorders and race, ethnicity, and nativity: A population-based study. Pediatrics, 134(1), e63–e71.

[^1.65]: Though fans have long suspected that Rick was Autistic (much like his creator Dan Harmon), this wasn’t officially confirmed until the finale of season three, “The Rickchurian Mortydate,” where during a brief exchange, Rick acknowledges this fact to Morty.

[^1.66]: https://autismsciencefoundation.org/​what-is-autism/​how-common-is-autism/​#:~:text=In%20the%201980s%20autism%20prevalence,and%20later%201%20in%201000.

[^1.67]: https://www.nami.org/​Support-Education/​Publications-Reports/​Public-Policy-Reports/​The-Doctor-is-Out#:~:text=800%2D950%2DNAMI&text=Each%20year%20millions%20of%20Americans,States%20go%20without%20any%20treatment.

[^1.68]: Bora, E., Aydin, A., Saraç, T., Kadak, M. T., & Köse, S. (2017). Heterogeneity of subclinical autistic traits among parents of children with autism spectrum disorder: Identifying the broader autism phenotype with a data-driven method. Autism Research, 10(2), 321–326.

[^1.69]: For a state-by-state breakdown of what is covered, see here: https://www.ncsl.org/​research/​health/​autism-and-insurance-coverage-state-laws.aspx.

[^1.70]: https://www.clarifiasd.com/​autism-diagnostic-testing/​#:~:text=There%20is%20a%20cost%20associated,more%20than%20doubles%20the%20cost.

[^1.71]: https://www.quora.com/​How-much-does-it-typically-cost-to-get-a-formal-diagnosis-of-an-autism-spectrum-disorder.

[^1.72]: https://www.wpspublish.com/​ados-2-autism-diagnostic-observation-schedule-second-edition.

[^1.73]: https://devonprice.medium.com/​from-self-diagnosis-to-self-realization-852e3a069451.

[^1.74]: https://www.bgsu.edu/​content/​dam/​BGSU/​equity-diversity/​documents/​university-policies/​evidence-prove-discrimination.pdf.

[^1.75]: For a good primer on the social and medical models of disability, and their interplay, see Goering S. (2015). Rethinking disability: The social model of disability and chronic disease. Current Reviews in Musculoskeletal Medicine, 8(2), 134–138. https://doi.org/​10.1007/​s12178-015-9273-z.

[^1.76]: https://www.phrases.org.uk/​meanings/​differently-abled.html.

[^1.77]: Longmore, P. K. (1985). A Note on Language and the Social Identity of Disabled People. American Behavioral Scientist, 28(3), 419–423. https://doi.org/​10.1177/​000276485028003009.

[^1.78]: https://journals.sagepub.com/​doi/​abs/​10.1177/​000276485028003009?journalCode=absb.

[^1.79]: https://www.nature.com/​articles/​d41586-018-05112-1.

[^1.80]: Significant Gay Events Timeline (PDF). Gay Police Association Scotland. Archived from the original (PDF) on March 15, 2014. Retrieved March 15, 2014.