By Lydia MacBride
Shrouded in stigma and stereotype, autistic adults face extreme difficulty under the capitalist system, all whilst being left out of many discussions regarding oppression. Frequently written off as a childrens’ condition, many autistic adults are left in limbo, with a constant feeling that our voices are unheard. But in spite of this, growing awareness of neurodiversity is leading to more and more adults realising they are autistic and seeking diagnosis. However, our underfunded welfare and medical systems are ill equipped to support them, and our capitalist social norms and regressive stereotypes continue to alienate and harm autistic folk.
Autism is a condition that primarily affects sensory processing, socialisation and patterns of thought. This includes sensory issues that lead to being ‘overstimulated’ by various sensory inputs, such as sound (known as hyperacusis), difficulty communicating via certain means, such as body language or verbalisation, and thought patterns that land anywhere between hyper-fixations, compulsions and the questioning of authority and social norms. On top of this, autistic people are generally prone to increased levels of anxiety and depression. What autism isn’t – is a monolithic condition; every autistic person’s symptoms and experiences differ greatly.
Discussion around autism has been so heavily permeated by capitalist ideals of ‘productivity’ and ‘success’. You have probably heard the phrases ‘high-functioning autistic’ and ‘low-functioning autistic’ as some qualities inherent to autism, but it’s little more than capitalist drivel. Society and pop culture fetishise the fictionalised idea of the Rainman type autistic person, while shaming us for any of our behaviour that’s considered “too weird”. The label ‘high-functioning’ is used to deny autistic people care, whereas those labelled ‘low-functioning’ are denied agency. There’s no compassion for the complex individual needs of an autistic person, and we are instead reduced to “functioning” labels based solely on whether or not we are considered employable and in line with conservative social norms.
This leads to the all-too-common phenomena that we call ‘masking’, that is hiding and suppressing the socially frowned upon aspects of our autism. This includes forcing ourselves to adhere to social norms, such as small talk and eye-contact, dressing in uncomfortable clothing and refraining from stimming in public (a set of repeated movements autistic people do either to calm themselves or to express joy). Masking, to put it simply, is really, really, really exhausting. Having to mask everywhere out of fear of social ostracisation is soul destroying and leads to the unfortunately near-ubiquitous experience of autistic burnout. On top of this, given the correlation between autism and being trans, it’s easy to see how for many, masking intersects heavily with gender repression.
A stew not a spectrum
More progressive types might reframe this dichotomy as a spectrum instead – with even the current official diagnoses being “Autism Spectrum Disorder” (ASD). But this is just a new framing of being ‘more’ or ‘less autistic framed through the same conservative, capitalistic social norms; never-mind the declaration of autism as a “disorder”, when the suffering we face is – in its largest part – systemic. Every autistic person is as autistic as the next, our autism just manifests differently on an individual basis. None of these labels have ever been coined by us, it’s always outsiders declaring what we are and are not with little to no consultation with autistic people. Instead of the spectrum as a method of description I think a pot of stew is a more apt analogy, it’s a set of common symptoms in the pot, but everyone has a different scoop of them, with the various ingredients in different quantities.
Furthermore, this approach of viewing autism as a stew can be extended to neurodiversity more broadly. The distinction between autism, ADHD, OCD, etc. are lines drawn in the sand nearly arbitrarily by the flawed psych community. There is an extreme degree of overlap between various neurodivergencies. The phrase: “where there’s smoke, there’s fire” is incredibly relevant to many disabled people, as in my experience it seems rarer to find someone with just one condition than it is to find someone with multiple. It’s easy to imagine that in a slightly different timeline, the general experience of all neurodivergent people could have been drawn into a different set of near-arbitrary diagnoses.
The capitalist, chauvinist ideals in the psych community extends further into the under-diagnosis of minority members. Women are historically under-diagnosed as autistic, with their issues chalked up to typical misogynistic ideals of being “overly emotional”, often times as part of a misdiagnosis for conditions like bipolar. Also under-represented in autism diagnosis are people of colour, worsened by the overall mistreatment that people of colour face at the hands of the medical system. Both of these demographics are further hurt by the social perception of autism as either a “little boy’s” condition, or something that only affects nerdy white men. It’s also vital to note that ableist policy and healthcare disproportionately affect autistic people from compounding minority backgrounds. For example, one in four autistic women are institutionalised by the age of 25 and black people are four times more likely to be detained under the Mental Health Act in the UK.1 Consequently, the majority of existing ‘supports’ for autistic adults are solely focused on ‘fitting in’ and employability. Very few focus on helping autistic people be self-fulfilled and happy. It’s more about trimming our rough edges to fit us into capitalist views of ‘normal’.
Compounded by class
One of the symbols used by Autism Speaks, a eugenicist organisation frequently misattributed as one that advocates for autistic rights, is a jigsaw piece. They care nothing more than filing off our rough edges, oftentimes with violent force through practices like Applied Behavioural Analysis – a polite euphemism for a practice developed by gay and trans conversion therapy’s creator Ole Ivar Løvaas.2 As sparse as the supports are for autistic children, the situation for autistic adults is even more dire. There is no public route to obtaining an autism (or ADHD) diagnosis as an adult in this country, and at the time of my diagnosis, it cost me €800. Nowadays the diagnosis costs around €1,000. This creates an obvious class divide regarding diagnosis and care, especially when so many autistic people are stuck in the loop of needing a diagnosis to get disability allowance, but being unable to afford a diagnosis because they are limited in employment and can’t get disability allowance without it.
As mentioned previously, the view of autism as a children’s condition means that many, including the healthcare and welfare systems, hold the false idea that you ‘grow out’ of being autistic once you turn 18. The process for applying for disability allowance is drawn-out, bureaucratised and humiliating. Cases are accepted, rejected and appealed on what feels like an almost arbitrary basis with minimal feedback to the applicant. The rates are too low – €928 a month to cover the cost of living in this country, not even taking into consideration the generally higher cost of living disabled people face. Being on disability allowance also comes with a feeling of insecurity – with the Government’s big ideas of reforms like the Green Paper posing the very real threat that what little stability disability allowance provides, could all be swept away in an instant. With only 29% of autistic adults in the UK being employed,3 and similar figures internationally, there are crystal clear signs of discrimination in the workplace.
It isn’t that autistic people cannot work, we’re often incredibly eager to and very capable of applying ourselves, but workplaces refusing to provide accommodations, and active discrimination during hiring processes – such as using eye-contact and body language during the interview process – leave us in the dirt. Long hours and socially-enforced masking amplify the aforementioned risk of autistic burnout, providing a major barrier to long-term, stable employment. But because we can work, even just temporarily, we face people refusing to believe that we are disabled, further complicating the already tedious process of applying for accommodations or disability allowance. It’s also vital to note that of the 29% of employed autistic adults, cisgender white men with no other conditions are overrepresented. For autistic people of other minority backgrounds, stable employment is often little more than a pipe dream.
No confidence in establishment ‘promises’
The discrimination autistic people face for failing to meet ableist social norms extends beyond employment. Similarly to how missing ‘normal’ social cues can get an autistic person dismissed during a job interview, missing these cues can have potentially fatal consequences when dealing with law enforcement and the justice system. There is a shocking number of cases – disproportionately affecting people of colour – where parts of someone’s autism has been misconstrued by cops as acting suspicious, stimming in a moment of stress as reaching for a weapon or getting physically aggressive. To quote Jodie Hare’s Autism is not a Disease: “In the United States, reports have found that half of all people killed by police officers are disabled, and that by the age of twenty-eight more than half of disabled African-Americans have been arrested – double the number reported for white disabled Americans.”
Commonly comorbid conditions, like Ehler-Danlos Syndrome (EDS), are nearly never diagnosed in this country (as far as I can tell, there are no EDS specialists in Ireland). EDS is a broad condition: most commonly affecting connective tissue and skin causing joint hypermobility, but can also come with auto-immune issues, respiratory problems and cardiac problems, amongst countless other symptoms. There is a statistical correlation between EDS and autism, and in many cases EDS being a degenerative condition requiring medical support and intervention, patients are forced to travel abroad for expensive treatment. Recently it was announced that the Government is planning new supports for autistic people in order to “improve understanding and accommodation of autism within society and across the public system.”4 However, there are minimal details on what this programme actually entails or how far-reaching it will be. I’m personally not hopeful, as I feel that Taoiseach Simon Harris, who is advocating for this scheme, has a track record of doing little more than tokenising his autistic brother, Adam Harris, for credibility in the face of repeated criticism from disability rights activists for his multiple failures as Minister for Health, Higher Education and now Taoiseach.
Additionally, the establishment parties’ bending of the knee towards the far right in recent times further guts any confidence I have in them improving the lives of autistic people. Autistic people are frequently both weaponised and targeted by the far right. We are used as the ‘smoking gun’, proving the supposed evils of vaccination. We are little more than an ideological cudgel in the eyes of the anti-vax movement: the worst possible thing a person could be – that it’s better to be dead than autistic – and how our existence is proof that nobody should be vaccinated. But simultaneously, the far right – particularly the growing manosphere – insists that for autistic adults, it’s all in our heads; something that can be fixed with dieting, exercise, the general self-help book drivel, but with a helping of incel ideologies like ‘nofap’ mixed in.
Backward medical profession
Since the initial origins of the autism diagnosis – originally “childhood psychosis” – the study of autism has been swamped in eugenics. With the likes of Hans Asperger, eponymous with the now defunct diagnosis of Asperger’s Syndrome – a devout catholic with ties to the Hitler Youth and operating a clinic in 1940s Austria – research of autistic people has a grim history. As long as capitalism remains in place this history is bound to continue, with every research project dedicated to finding the “autism gene” or “preventative treatment” for autistic children posing an existential threat to the autistic community. And this is a project that our universities are investing into, with TCD announcing such a project in 2019.5 It’s known that there are reasons to believe that autism is hereditary in some capacity, and under a socialist project I believe further research into the matter would benefit in our understanding of the human experience, but under capitalism this knowledge can and will only be used in a eugenicist manner in the pursuit of a more ‘productive’ society.
This history of eugenics, combined with active discrimination from the medical community, creates an atmosphere of fear for both those diagnosed and those considering getting one. With news stories breaking during the pandemic of UK GPs pressuring autistic patients into signing ‘do not resuscitate’ orders,6 or transgender people nationally being denied access to gender affirming care by the NHS on the basis of being autistic,7 it’s reasonable to be apprehensive of even getting diagnosed. I personally have to pick and choose which medical professionals get to know that I’m autistic as I fear substandard care, and even with doctors that don’t actively discriminate against me, not a single one has ever had a working understanding of what autism actually is beyond superficial stereotypes.
As I am writing this, I am just over a medical scare, during which I had a trip to A&E after a GP ignored my symptoms of asthma, to instead grill me on how it was weird that I was autistic, despite me being able to make eye contact. Medical literature is still framing the most basic understanding of autistic people as ground breaking research. As I was preparing this article, Rutgers University published an article titled ‘Understanding the complex emotions of autistic adults can help shape better therapy strategies for neurodivergent people, says Rutgers researcher’.8 This is the state of autism research, where it’s considered a breakthrough to finally come to the realisation that autistic people feel emotions. It was published on 15 September 2024. That month, a researcher finally stopped to consider that autistic people might not be unthinking, unfeeling robots. This was a surprise to them.
On top of this, companies have cynically noticed a market niche for creating products – of varying usefulness – marketed to disabled people. This extends far and wide, such as the rebranding of plastic tat as ‘sensory toys’, but one of the most disgusting examples of this is the AI industry scapegoating us as a theoretical user base. AI advocates have frequently hid behind the excuse that AI helps neurodivergent and disabled people in their day-to-day lives when faced with the many valid criticisms of AI, from its environmental damage to companies scraping images and artwork off the internet without consent. In the case of generative AI, models like Midjourney and ChatGPT are marketed as ways for disabled people to express their creativity. But this only serves to infantilise disabled people as incapable of making art, whilst undermining the flourishing disabled arts community.
A vital issue for the left
I think the far right’s predatory attachment to the struggle of autistic people, and cynical attempts to commercialise neurodiversity, make it imperative for us to make a dedicated effort to include disability rights as a key issue within the left. Campaigns like those on the school placements scandal are vital to combat opportunistic attempts at co-opting our struggle, as a shortage of school placements could very easily be spun into the typical anti-immigrant bile. For anyone who attended Disability Pride this year, it was impossible to miss just how radicalised and ready to fight the disabled community is. And there’s a lot for us to learn from the disability rights movement, with their unwavering courage in the face of harsh systemic oppression; mobilising when it comes with significantly increased accessibility issues; and the practical community safety focus of the movement through the requirements of simple things like de-stigmatising words like ‘disabled’ and ‘autistic’, or requiring face masks at events.
From my conversations with other disability rights activists, it’s hard to miss their begging and pleading for non-disability-specific activist organisations to be better at wearing face masks. We should ensure that we have our own masks that we take with us to events and wear them on the way, especially if public transport is involved. Wearing a mask is a visible act of solidarity with the disabled community, and I know personally, as someone who was severely negatively impacted by a COVID infection because of my autism, EDS and asthma, I feel grateful whenever I see another person in public that is still masking. The establishment’s response to the COVID-19 pandemic demonstrated just how disposable capitalism views the disabled, and it’s morally imperative that as leftists we don’t replicate their vile apathy.
Being autistic can be a very radicalising experience, and is personally a core part of my radicalisation into socialist politics. As a demographic, autistic adults are a strong group to organise with. One of the diagnostic criteria used in autism diagnosis is “a strong sense of justice”, and it’s easy to see how that commonly overlaps with socialist thinking. Disability rights will always be a core part of any Marxist movement, to the point that it almost feels cliche to say “from each according to their ability, to each according to their needs” when discussing the matter.
Notes
1. Jodie Hare, Autism is not a Disease: The Politics of Neurodiversity, 10 September 2024.
2. Ibid
3. Simon M. Bury et al., “Employment profiles of autistic people: An 8-year longitudinal study”, https://journals.sagepub.com/doi/10.1177/13623613231225798, 19 January 2024.
4. Diarmuid Pepper, “Government to approve new Autism strategy and increase number of college places in therapies”, https://www.thejournal.ie/government-toapprove-new-autism-strategy–6444578-Jul2024/, 24 July 2024.
5. Trinity College Dublin, Autism and Neurodevelopmental Research Group, https://www.tcd.ie/media/tcd/medicine/psychiatry/pdf/autism-tcd-currentresearch-studies-leaflet-october–2019.pdf, October 2019.
6. BBC, ‘Coronavirus: Autistic support group “told it needed DNR orders”’, https://journals.sagepub.com/doi/10.1177/13623613231225798, 9 April 2020.
7. Han Tiernan, “National Gender Service in crisis as Ireland fails to meet WHO obligation”, https://gcn.ie/national-gender-service-crisis-ireland-fails-whoobligation/, 6 January 2022.
8. Greg Bruno, “Understanding the complex emotions of autistic adults can help shape better therapy strategies for neurodivergent people, says Rutgers researcher”, https://www.rutgers.edu/news/getting-autism-right, 15 September 2024.
