I went through school in the 1970s and 80s with no autism diagnosis as one didn’t really exist at the time. Autism was considered extremely rare. Even when I was diagnosed in 1994 I was told that only 1 in 25,000 women were autistic. My experience of being autistic has been punctuated by changes in how the people I speak to about autism respond. When I was first diagnosed people said ‘What’s that?’ A few years later people would say ‘oh I’ve heard of that…’. This was followed by people saying ‘my [insert distant relative] has that….’ And now people tend to have a much greater understanding of what autism actually is even where they are not autistic or closely connected to an autistic person themselves. It has taken a very long time though and there are still unhelpful attitudes and a lack of understanding. If the person lacking understanding is a health or mental health clinician it can make life very hard for autistic people and – among other things – result in misdiagnosis.
Diagnosis
My journey to a diagnosis – and to accepting that diagnosis – was something of a saga and not very straightforward. I spent my entire childhood and teen years being considered ‘different’ but nobody knew what to call my ‘difference.’ My mum had a colleague with an autistic son who was diagnosed in 1994. They got talking and my mum thought autism described my experience too. At the time I was in prison and quite adept at masking. In fact I was so good at masking that I believed that I actually was the character that I was working so hard to present to the world which at the time was a matter of survival. I was a very convincing actor and believed this myself. At the time I was diagnosed I thought autism was a diagnosis of ‘nerd’ which didn’t describe my version of me at the time!
At the time I received my diagnosis I was 20. I strongly reacted to the autism diagnosis, refusing to accept it, even though doing so would have helped me to navigate the world a lot better than I was at the time. It was – to my mind – my parents finding excuses for my poor behaviour. It was also very raw and personal and forced me to view myself in ways I did not want to. I couldn’t even watch a TV show on autism, and reading about Temple Grandin in ‘An Anthropologist on Mars’ was extremely difficult for me. It took me seven years to accept my autism and even then I thought is was a shameful secret for some time after accepting it. I was happier to tell people I had been in jail than that I was autistic.
Misdiagnosis
Despite already having an autism diagnosis from a competent clinician, I did end up getting misdiagnosed with borderline personality disorder in the mid-1990s. The psychiatrist who misdiagnosed me knew very little about autism and was quite misogynistic. Most of the women in the hospital he managed had a borderline diagnosis. I think he viewed it as histrionic woman syndrome! My parents told him I had two diagnoses – autism and schizophrenia and he ignored them and misdiagnosed me anyway.
The misdiagnosis had immediate and lasting consequences – mostly negative ones. When I was in hospital with the doctor who misdiagnosed me I was quite unwell with psychosis. I was also overloaded, very stressed and having violent meltdowns. However he did not see that and thought my behaviour was the result of me acting out intentionally. This eventually resulted in me returning to prison, going there on and off for a further three years. I became institutionalised.
My misdiagnosis followed me to jail and I suffered a lot. A diagnosis is an indication of what treatments and interventions clinicians can offer to address a health condition. Getting the ‘label’ wrong usually means getting the treatment wrong. This can derail a person’s life.
Overcoming misdiagnosis
I finally accepted my autism diagnosis when I was 27. Sadly the psychiatrist who had misdiagnosed me in 1996 was the chief doctor in the publicly funded mental health clinic I attended at the time! I told my clinical manager I had finally accepted that I was autistic. He promptly took this information to the offending doctor who denied it. I figured I needed to make a decision to support my mental health and ended up seeing a lovely private system psychiatrist who said that if the psychologist who diagnosed me as autistic had diagnosed me then I was 100 peer cent autistic as that psychologist knew what she was talking about!
I think some clinicians have no idea how much power they wield in this space. I remain terrified to go to psychiatric hospital because I – possibly rightfully – worry that my medication or diagnoses may be invalidated and changed to something which harms me. That a 47 year old, highly confident advocate and author, someone who manages their life well and has a large following can be terrified to access services because of mistreatment by a psychiatrist thirty years ago is very telling.
An appropriate diagnosis is a gift and can enable positive change and being able to access supports and interventions that make life better. Conversely a misdiagnosis can damage people and deny them access to supports that they need.
And just a brief point on self-diagnosis of autism… I am of the opinion that many people need to self-diagnose due to the barriers faced by many autistic people in accessing a formal diagnosis. A lot of autistic women and girls for example cannot access a diagnosis due to clinicians’ lack of understanding of the more internalised autism presentation that women and girls – and some others – might have or simply the cost off the assessment putting a formal diagnosis out of someone’s reach. Accessing a diagnosis can be fraught and impacted by social and political issues so in my book (pun intended) self-diagnosed is valid.










