Student girl finding it difficult at study and comprehend scool tasks

Over the past few years, media outlets have issued dire warnings from psychiatrists about waves of people self-diagnosing mental health conditions. They say that memes on Twitter and videos on TikTok cause people to believe they have imaginary disorders, that self-diagnosis causes people to avoid getting real help, and that people sometimes even fake their conditions for attention.

While it’s true these platforms can contain misleading information, self-diagnosis isn’t the problem—it’s the deeply pathologizing and insulting way society and the medical community discuss these issues. The signs typically used to diagnose mental health conditions focus on what neurodivergence looks like to outside observers. These descriptions may be unrecognizable to someone struggling to understand why they feel “different,” and may not resonate with those who know them. That, in turn, leads to these issues being massively underdiagnosed.

I speak from personal experience: I wasn’t formally diagnosed with autism and ADHD until age 34. I asked for help for decades, only to be told that I wasn’t trying hard enough. If a social interaction didn’t make sense, I needed to pay closer attention. If I had trouble focusing on a task, I wasn’t applying myself. If I struggled to prioritize, I was making excuses.The list of unspoken rules around social interaction seemed endless, and no one would tell me what they were.

This mismatch in communication style and abilities is what disability rights advocates call “neurodivergence”—a term used to acknowledge the different ways that human brains can function without pathologizing them. The term encompasses a variety of developmental disorders and learning disabilities and is sometimes used to refer to mental illness. People who do not have these traits and behave and process information in ways that reflect what’s considered the cultural norm are called “neurotypical.” Because a person’s neurotype isn’t changeable—it’s a matter of how their brain is wired—it’s important to help them find ways to work with their condition to live a happy and successful life.

For that to happen, however, neurodivergent people must be empowered with knowledge of their conditions. I had to learn that I wasn’t alone in my experiences as an adult through social media. And I felt I couldn’t share that with my doctor when I approached her asking for a psychiatric referral if I wanted to be taken seriously.

Neurodivergence is dramatically underdiagnosed in marginalized populations

Research demonstrates many people fall through the cracks like I did. People assigned female at birth (AFAB) are far less likely to be identified with either ADHD or autism because both neurotypes tend to present differently in children assumed to be girls, due in part to pressures put on AFAB people in a misogynistic society.

From a young age, AFAB people are expected to respond to other people’s emotions and tend to be more adept at mirroring the behaviors of others to fit in. When it comes to ADHD, AFAB people often present with inattentive symptoms rather than hyperactivity, which is more common in children assigned male at birth (AMAB). Well-behaved, inattentive children are less likely to receive screening.

Because of this, AMAB children are four-to-five times more likely to be identified as autistic and three times more likely to be diagnosed with ADHD. These cultural biases are even more complicated when addressing queer and trans youth, who are more likely to be autistic than the general population. The conversations around ADHD and autism are steeped in narrow assumptions about gendered behavior that exclude the realities of gender-diverse people.

Racial bias also plays into diagnosis. Autism and ADHD are both still considered by many to be conditions that primarily affect white boys. Black and Latinx children are more likely to have their struggles in school written off as a behavior disorder or receive punishment, rather than having their needs identified and supported. 

While any child who doesn’t fit the “typical” image of autism or ADHD faces an uphill struggle being identified, obtaining a diagnosis as an adult is even harder. By the time an adult enters a doctor or therapist’s office with questions, they’ve likely learned a host of coping mechanisms (not all of them positive or helpful) and may be able to “mask” how ADHD or autism can shape their lives.

This masking, however, comes with a heavy psychological toll: it’s not easy to live life when you’re spending all your emotional and mental energy trying to act “normal.” Depression, anxiety, and even severe burnout can result from the constant pressure to “fit in.” Providing neurodivergent people with answers about their needs and resources to understand why they’ve been struggling is the only real solution.

The diagnostic criteria themselves are flawed

The bias toward cisgender white boys is not, however, the fundamental problem. The way these conditions are described in medical literature focuses primarily on how ADHD and autism are perceived to inconvenience other people, not on how the people experiencing those conditions may see themselves.

For example, many people—including clinicians—still believe that a defining characteristic of autism is a lack of empathy, rather than understanding empathy as a personality trait that varies between people of all neurotypes. Research has shown that this is not the case. One 2018 study showed that autistic people often have trouble recognizing neurotypical people’s emotional states, but when they are told what someone is feeling, they can be very responsive to others’ emotions and needs. When interacting with other autistic people, they demonstrate a higher rapport than displayed when interacting with non-autistic people. Yet people seeking an autism diagnosis who have deep, lasting friendships or otherwise demonstrate empathy may be turned away by mental health professionals.

This attitude is also reflected in the DSM-5 diagnostic criteria. It describes a litany of “deficits” and “failures” to respond to social interactions based on non-autistic expectations and paints autistic people’s tendency to focus deeply on specific areas of interest as “abnormal” instead of a source of knowledge and skill. Sensory issues that may cause someone to eschew certain foods, fabrics, or environments are painted as problems to overcome rather than legitimate preferences. The desire to adhere to a stable routine is painted as “inflexibility” rather than a positive trait like reliability. 

The same is true of ADHD. I’ll never forget when a clinician was screening me, and asked, “Do you talk excessively?” I wasn’t given an explanation of what “excessive” might look like—the clinician simply assumed I understood what a neurotypical person might find frustrating. Despite being completely subjective, this is part of the official diagnostic criteria listed in the DSM-5.

Some of the other criteria aren’t much better: “Does not follow through on instructions, and fails to finish schoolwork, chores, or duties in the workplace;” “avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time;” “fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.”

No one with ADHD intentionally shirks their responsibilities, avoids challenges, or overlooks details. These traits are all framed in negative and unflattering terms based on how they affect other people. But for the person struggling to complete tasks because of ADHD, daily life is overwhelming. None of this is intentional or done to hurt other people. Often, the person with ADHD is angrier and more frustrated with themselves than anyone else could be.

Social media shows an accessible world is possible

Over the years, I had toyed with the idea that I might be neurodivergent. But when I looked for answers, all I found were clinical articles painting all my greatest strengths as character flaws and all my weaknesses as deliberate slights against the people around me. Of course, I didn’t identify with the checklists used by medical providers. It was impossible to see myself in them.

I had no words for who I was until I stumbled onto neurodiverse Twitter and found others sharing experiences that sounded like mine and answering each others’ questions in a way that didn’t shame or blame people for their struggles.

In my daily life, I was used to my “quirks” being met with blank stares. Online, I learned I wasn’t the only person who couldn’t absorb verbal information and sit still at the same time. That other people also wrote up lengthy to-do lists and then promptly lost them. That needing to rehearse what I was going to say before a phone call wasn’t as unusual as I thought. While many of these posts were framed as jokes, they were deeply comforting. My struggles were normal, mundane—at least within the neurodiverse community.

What’s more, I was able to find resources written by people who shared my experiences, giving me helpful insights on how to manage my life in a way that worked with my brain rather than against it. For example, advice like “use a planner” was useless because I had no intuitive sense of how to prioritize—until I discovered journaling strategies created by people with ADHD.

I’d spent my life trying to follow advice from people who didn’t understand or share my mental health needs, hoping to appear “normal.” Now I was learning from authors who emphasized that no amount of hard work would fundamentally alter my neurology. These efforts to fit in were making me less functional and productive. It was never that I wasn’t trying hard enough—I’d been trying the wrong things.

The reality is, many people—especially those from marginalized populations—only hear the negative stereotypes about these conditions. Many of us are denied opportunities to learn about ourselves due to sloppy, inaccurate diagnostic practices and a lack of cross-cultural awareness. Often, those factors continue to impact our lives after diagnosis. Gender-diverse people can have autism diagnoses weaponized against us and used to deny gender-affirming care. While a diagnosis can enable us to ask for accomodations at work and school, disclosing a disability can also result in retaliation. This knowledge has real-world consequences living within a social and political system that’s hostile to our needs. But speaking to others who share our struggles can empower us to meet those challenges head-on.

Social media is not making autism and ADHD “trendy.” Instead, it’s telling us that there are aspects of our experience that should be celebrated, that the difficulties are manageable, and that we are part of a supportive worldwide community. While I am much happier navigating the world with access to resources and medication, people with different neurotypes aren’t inherently less capable of success and happiness. 

The social model of disability posits that physical and mental conditions become disabling because the world we live in is not made accessible to anyone outside of a narrowly defined “norm.” If classrooms and offices had been structured to support people who learn and think the way I do from the outset, I would never have struggled so much earlier in life. 

Much as it’s important to recognize and celebrate differences in culture, race, gender, sexual orientation, and physical ability, the concept of “neurodiversity” recognizes that people with different ways of thinking and seeing the world are an important part of society who should be provided with the support they need to succeed. Ultimately, the neurodiversity movement is pushing back on stigmatizing medical understandings of many psychiatric conditions. We are finding ways to function better without trying to fundamentally change who we are and reasons to embrace—or at least accept—those traits that define us.

Some may see this approach as dangerous, as if we are glorifying ADHD and autism and discouraging people from pursuing a formal diagnosis. I don’t think that’s true. I think there are a lot of confused people out there, struggling to make sense of their lives, who have been denied accommodations, treatment, and sympathy due to structural barriers and medical misunderstandings. With the rise of the internet and social media, we’re finally feeling heard.

Orion Rodriguez (he/they) is a nonbinary writer, artist, and activist. His writing has been published in Salon, Lightspeed Magazine, Inhabitat, and elsewhere. He is currently working on "The Life and Times...