Am I autistic enough?
If you think you're autistic but a professional said you're not, this is for you
What happens when you believe you’re autistic—but a professional says you’re not? This essay explores the fallout of diagnostic denial, the slippery criteria for adult autism diagnosis, and the emotional toll of feeling like you don’t fit in… again.
Read on…
Diagnosis changed my life because it changed how I see myself.
Formerly, I saw myself as a broken human. Now, I see myself as a different human—a critical distinction.
I have unusual social instincts and needs and reactions, and now I can trace them to specific autistic traits.
Autism doesn’t relate to everything about me, but it relates to a lot. Diagnosis helped me realize my deck is stacked a certain way. I don’t need to beat myself up over it. It’s just the way I am.
But it was only through diagnosis that I came to this self-acceptance. I didn’t earn it through a meditative journey or deep journaling; it didn’t come from the five years of therapy I did in my early thirties. It was the flip of a switch, a post-intermission Act 3, a reopening after change in ownership.
This makes my shift to self-acceptance seem binary: no, and then yes. It’s not quite that simple, but it’s close. About as close to simple as the messy headspace of self-regard can get.
If diagnosis allowed me to accept myself, what would denial of diagnosis have done? I fear it would have deepened my feeling of defectiveness. That I couldn’t even fit with the misfits.
That’s the problem when self-acceptance rests on an external trigger. The person with the authority to diagnose holds a lot of power.
Within the autism community, there’s significant backlash to the idea that “everyone is a little autistic.”
But I believed a version of that statement long before I seriously considered I might be (fully) autistic. I used those exact words, “a little autistic,” in self-deprecating jokes to my husband as I groaned over social obligation and became insensibly annoyed over minor transgressions by colleagues or neighbors.
It was only when I better understood what autism really is that I saw how much it fit me.
By the time I booked my assessment, I was convinced. In my case, the idea that you can be a “little autistic” was a stepping stone to self-realization.
As it happened, my psychologist agreed with me. But it could have gone differently.
Because in the end, the question of diagnosis is an examination of how autistic you are. Are you a little, or are you a lot? Only if you cross an impossibly slippery line—a line calibrated differently depending on the psychologist—will you receive a diagnosis.
Some people sail over that line. Others may tip just over it, or fall a hair short. The diagnostic assessment is a binary: yes, or no. Either you are or you aren’t.
Mine came back yes, and where exactly I landed on the other side of that line should be irrelevant. But I do wonder.
Now that I’m a regular on the autism forums, I see adults, often women, post about being denied a diagnosis. A handful of examples:
“I’m crushed. The psych told me she can’t offer me a diagnosis because I am able to maintain relationships despite fulfilling literally every other requirement for a diagnosis. I told her throughout […] that maintaining relationships and making friends is and always has been difficult for me, but I’ve learned the steps and I know that relationships are important. I force myself to maintain relationships, it doesn’t come naturally. I’m just so frustrated.” (link)
And:
“No autism because I have friends? The lady [...] said she wouldn’t assume I have autism because I have friends and can feel empathy for my sister. [...] She also said that it doesn't really make sense to diagnose people ‘like me’ anyway, because it wouldn’t change anything for me. [...] I keep finding more symptoms in my research and I have scores in the clinical range on each of the tests that is available. [...] I don't think they are even open to other forms of autism other than the ‘classic’ picture or don’t have the capacity to diagnose everyone of their clients properly. I am so frustrated because I waited so long and then I didn’t feel I was being taken seriously.” (link)
And:
“It basically took me two years to find a psychiatrist whos even willing to write a referral to an ASD clinic and then another year on the waiting list and waiting for the results. This wednesday I finally got my results […] and they basically diagnosed me with everything under the sun except for autism. I knew this could happen so I was prepared to challenge them instantly on all the criterion/symptoms that can only be fully (and best) explained by an ASD diagnosis and they literally shrugged and said I was a highly sensitive person LOL. I am still processing since I cannot believe the ignorance and lack of information (and interest) in how autism presents in AFAB people. They even told me I cant be autistic because I can make eye contact. Are you clowns or doctors lol what is happening?” (link)
The reasons for denial concentrate around themes: you can’t be autistic if you have friends or a romantic relationship, if you graduated college, if you’re a teacher or nurse or other professional, if you’re smart. If you have empathy.
The official term for that is bullshit.
Although it’s true that self-diagnosis is accepted within the autistic community (as part of a general “no gatekeeping” principle, one of many reasons I have immense pride in and respect for this community), self-diagnosis and diagnosis are different things.
Autistic people generally have a low threshold for uncertainty. Gray areas and ambiguities are not just regrettable, they can cause distress. We’re also uncomfortable with things that feel like deception. We strive, compulsively, for truth.
So when I see responses to the forum posts above saying: just self-diagnose, that’s perfectly valid, I agree in theory, but I also see it as an imperfect solution.
Because even if people accept your self-diagnosis, you still remember the denial. And that creates a disconnect, an internal tension, that can grate at you and fester over time.
Perhaps, given that a professional denied you a diagnosis, calling yourself autistic makes you feel like a fraud. Like you’re pretending, or you don’t belong. Maybe not completely, but a little bit. Which is enough to reprise the lifelong cycle of self-rejection you’re trying to break free from.
Sometimes, the forum posters who were denied diagnosis are asked why they’re seeking a diagnosis in the first place, as if that sorts it out.
That question always confuses me. It’s my nature to want to know as much as possible, especially about myself. To resolve uncertainty. So why wouldn’t I seek a diagnosis from a professional if I thought I was autistic? Not all autistic people feel this way. But many of us do.
To top it off, a vocal Autism Purity Army has emerged to complain that people like me are misdiagnosed. Their vitriol especially targets women who think they’re autistic but are not deemed to meet diagnostic criteria.
There’s one really offensive person calling herself the “Antifeminist Psychiatrist” (she’s apparently licensed!) who argues that adults seeking diagnosis are just narcissists who want to bypass accountability for their offensive behavior—and, horror of horrors—to celebrate their “quirks.”
I try not to give her airtime, but Substack keeps feeding me her “antifeminist,” pseudoscientific garbage. And rather than mute her, I’m magnetically pulled to the comments, where I correct misinformation as calmly as I can (calmly, so as not to fuel this narcissism fever dream).
I also comment for the women who wrote those forum posts, and the ones who could have. The ones who recognize their struggles as autistic but are denied the label, with the implicit message that no, you’re just bad at this.
If they see her post and the derisive comments piling on, I want them to also see my pushback.
I want to tell them: I see you. I know you’re struggling. You’re not broken.
You are the only expert on what it is to be you.
And you deserve the same permission and acceptance that diagnosis has given me. I hope more than anything that you find it.
If you have a diagnosis journey you’d like to share, or a question about diagnosis, please drop a comment or send me a DM. You’re very welcome here.
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Looking for more to read? Check out these past posts:
When you see yourself in your child—and start worrying for two
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Stay curious,
Laura
1) you wrote this for me! I am one of those people! I like to think there's a reason I haven't really talked much about this here. I'm afraid y'all will find out and I'm a massive fraud. (for me, it was not "moving in a way they'd expect for an autistic person". I call bullshit on that, too.)
2) The official term for that is bullshit. - that line made me laugh. Thank you.
3) I saw you in her comments and I appreciate you engaging. I left, feeling angry and annoyed and afraid by having clicked on it, more of her garbage would show up in my feed.
4) I love your feistiness (??) / honesty/ directness etc. in calling things bullshit and garbage while also having a nuanced conversation.
5) Not everyone can bring in "I'm a little autistic" in a way that doesn't immediately cause a debate / pushback / withdrawal / eye roll. I love how you bring in nuance in such a real and light but also serious way.
Great article! It’s so strange to read the idea that someone “can’t be autistic” if they have friends or a romantic relationship. I have both, and I was recently diagnosed with ASD. If nothing else, that suggests the criteria aren’t being applied consistently across providers.
But more importantly, I think the whole framework used to define autism as a disorder of “deficits in social communication” and “restricted, repetitive behaviors” is sort of comically inaccurate. It’s like describing the shadow of something and thinking you’re describing the thing. It reduces autism to the traits that can be observed from the outside, while completely ignoring the internal experience of being autistic.
It’s kind of like saying “blood is a red liquid.” That’s what it looks like to the naked eye, but it’s not what blood is. Blood is a suspension of cells in plasma, with complex properties you’d never know just by glancing at a drop. There’s no red liquid in it, it’s a clear/amber liquid with red blood cells suspended in it. That’s what the diagnostic model of autism feels like to me. It describes what’s visible to others with the most cursory observation, but it betrays a fundamental misunderstanding of what’s really going on beneath the surface.
Autism isn’t just about what other people see in us. It’s about how we experience the world. We process information, regulate input, relate to our own thoughts and environment, in ways that are fundamentally different from the non-autistic experience. Defining autism only by how atypical we appear to others flattens it into a list of deficits, instead of recognizing it as a fundamentally different way of existing.
It’s like if you saw someone walking with a limp, and instead of listening when they told you they’re doing this because their foot hurts, you thought they just had never learned to walk properly, or that they were walking that way on purpose just to annoy everyone. So instead of helping them find ways to avoid making the pain worse, you decided to teach them that their movements are wrong, and show them the correct way, so they can look how everyone else looks when they walk.
I really hope the professionals learn to do better with autism.