Rewriting Autism Narratives: From Diagnosis to Liberation
Challenging the Medical Model, Embracing Neurodivergence, and Confronting Systemic Barriers to Inclusion
The Toledo Blade’s recent article, Autism in Adults: Often Diagnosed in Childhood, the Disorder Can Also Become Evident Decades Later, highlights the growing recognition of adult autism diagnoses and the systemic barriers autistic individuals face in accessing services. Whilst the article provides valuable insight into the challenges of late diagnosis and the unique struggles of masking, it primarily follows a medical model framework—focusing on autism as a set of deficits requiring diagnosis and intervention. This approach, though common in mainstream discussions, fails to address the broader systemic and societal factors that shape autistic experiences.
By centring the medical model, the article overlooks critical questions: Why are autistic adults forced to mask in the first place? Why are support systems designed around conformity rather than inclusion? And how do power dynamics and societal structures perpetuate these inequities? These omissions highlight the need to reframe the conversation from an autistic lens—one that prioritises lived experience, challenges societal barriers, and embraces neurodivergence as a valid and valuable way of being.
This re-framing requires moving beyond deficit-based narratives to adopt the Power Threat Meaning Framework (PTMF) and a critical theory perspective. Such an approach would shift the focus from “fixing” autistic people to addressing the ableist structures that exclude them. In today’s article, I’ll reimagine the article’s core themes—diagnosis, masking, services, and identity—to centre the voices and perspectives of autistic adults, calling for a systemic reckoning rather than piecemeal solutions.
Autism in Adults: Reclaiming Identity in a Neurotypical World
Understanding the barriers to recognition and support for autistic adults through a systemic lens.
For many autistic adults, the process of recognising their neurodivergence is as much about reclaiming identity as it is about understanding their differences. Yet, society remains unprepared to meet their needs, prioritising a deficit-based approach over systemic change.
“Autistic ways of being are lifelong,” said Douglas Felt, who has worked with neurodivergent individuals for decades. “But the challenges autistic people face often stem from how our environments and social systems are structured to exclude difference.”
Power and Diagnosis: Who Decides, and Why Does It Matter?
In a world where the norms of the neuro-majority dominate, the gatekeeping of autism diagnoses reflects underlying power dynamics. Adults who seek a diagnosis often face barriers, from limited availability of professionals to systemic biases that exclude marginalised groups.
Autistic women, for example, are frequently misdiagnosed with anxiety or personality disorders. This reflects a broader societal expectation for women to “perform” social norms, leading many to mask their differences at great personal cost. The emotional labour of camouflaging can be profound, yet it is rarely acknowledged within systems focused on fixing the individual rather than addressing the pressures that demand masking.
Threats and Social Context: The Role of Systemic Exclusion
Many of the so-called “symptoms” of autism, such as sensory sensitivities or difficulty interpreting the often ambiguous social cues of the neuro-majority, can be understood as adaptive responses to environments that are not designed for diversity. For instance, overwhelming sensory input is not an inherent problem but becomes disabling when public spaces fail to accommodate sensory needs.
During the COVID-19 pandemic, many adults began to recognise these patterns within themselves. Time spent away from high-pressure social environments revealed how much energy went into masking and “passing” as a member of the neuro-majority. This realisation has led to a surge in adults, particularly women, seeking recognition and support.
The Meaning of Identity: Finding Power in Community
A diagnosis can offer autistic adults a framework for understanding their experiences, but it should not be the end of the conversation. Diagnosis alone cannot dismantle the societal structures that exclude neurodivergent individuals from full participation.
“Instead of asking how we can change autistic people to fit into spaces designed by and for the neuro-majority, we need to ask how we can change those spaces to include everyone,” said Molly Mallory, an advocate for neurodivergent inclusion. For many, the real transformation comes from finding community and embracing neurodivergence as a valid and valuable way of being.
Expanding Services or Expanding Justice?
The Blade article’s original focus on service shortages highlights an important issue but misses a critical question: why do services remain so scarce? Critical theory reminds us that systemic inequities, shaped by capitalism and ableism, prioritise “productivity” over well-being. Services are often framed as ways to help autistic individuals conform to neurotypical expectations, rather than as tools for empowering self-determination.
For example, the reliance on applied behaviour analysis (ABA) reflects a troubling history of compliance-based interventions. Many autistic advocates, myself included, have criticised ABA for prioritising behavioural conformity over authentic self-expression. Instead, services should focus on supporting autistic individuals in navigating and reshaping the environments that marginalise them.
Reimagining the Future: From Services to Solidarity
Data showing rising autism prevalence and significant gaps in adult support should not lead to panic but to a call for systemic change. This means moving beyond the narrow confines of diagnosis and intervention to embrace a broader vision of justice and inclusion.
Rather than framing autism as a growing “problem” to be solved, society must confront the structures that create barriers for neurodivergent individuals. This includes rethinking education, workplace accommodations, and public policies to prioritise accessibility, autonomy, and equity.
As more adults recognise themselves as autistic, the opportunity grows to reshape societal narratives around neurodivergence. “The goal isn’t to make autistic people fit into society,” Mallory said. “It’s to make society fit for everyone.”
Final thoughts …
The need to reframe conversations around autism using the PTMF and critical theory extends beyond this discussion—it taps into a broader societal resistance to examining systemic inequities. Critical theory encourages us to question who holds power, who benefits from the status quo, and how existing systems perpetuate oppression. In doing so, it offers tools for imagining a more equitable society. However, this capacity to challenge entrenched power dynamics is precisely why critical theory has come under fire in solid red states like Florida and Oklahoma.
Recent legislation in these states has banned the teaching of critical race theory and prohibited educators from critiquing capitalism or industries like oil and coal. These measures are not about protecting students from controversial ideas but about safeguarding the interests of the powerful. By silencing critical perspectives, lawmakers aim to prevent challenges to the systems that prioritise profit over people and perpetuate inequality.
Florida’s hostility to critical theory mirrors the same resistance we see in mainstream autism discourse. The medical model dominates because it frames autism as an individual issue—a “problem” to be treated or fixed—rather than a systemic issue requiring societal change. This framing conveniently absolves institutions and governments of responsibility for creating inclusive environments, just as silencing critical theory absolves power structures of accountability for systemic oppression.
In Oklahoma, bans on discussing Marxism or criticising capitalism reflect a similar fear of empowerment. These laws aim to stifle the very conversations that might inspire students—or society at large—to question the inequities baked into our economic and political systems. Teachers are forbidden from discussing how extractive industries harm the environment and communities, much as autistic advocates are often excluded from policy conversations about services and support.
By banning critical theory, these states seek to reinforce a narrative that upholds existing hierarchies of power. Autistic people, like many marginalised groups, often find themselves at the mercy of these structures—forced to mask, to conform, to seek approval in systems that were never designed for them.
The move to silence critique is a warning sign for all of us. It is a deliberate effort to stifle progress and prevent marginalised communities from finding their voice. But the voices of autistic people, and the principles of critical theory, remain powerful tools for envisioning a more just society. We must continue to amplify them, pushing back against attempts to erase the tools we need to build a better world.