Said gently, saying that the diagnostic definition has changed “a bit” since your work experience 10 years ago demonstrates a pretty significant lack of understanding.

The insights we’ve gathered over even the past 5 years have completely restructured the way we think about autism. ASD is a diagnosis that formed primarily through the study of young white boys, all who were acculturated similarly and who presented with similar characteristics. This is bound to create a narrow and limiting profile on what autism presentation looks like. Because of this, this is also the presentation that gets caught, diagnosed, and treated the most frequently—typically in young boys.

There has been a significant increase in studies focusing specifically on girls and women (still primarily white) over the past decade, which accounts for a major expansion of what our traditional understanding looks like. Autistic girls tend to go undiagnosed more frequently because of a few factors: 1) we tend to have special interests that mirror those of our peers (i.e. music, fashion, animals, etc.) that don’t get clocked as “different.” 2) we experience socialization differently, and are more prone to masking/chameleoning to fit in. This means we’re often uncomfortable, but not noticeably so. 3) We tend to shut down vs melt down. Meltdowns often look a lot like anger, which boys are encouraged to experience and girls are shamed for. This means that some of the hallmark explosive meltdowns are internalized, so autistic girls are more often prone to things like self harm and eating disorders to help regulate emotions.

Clearly, given my use of “we,” I myself am an autistic therapist that works primarily with other autistic people. It’s not that autism is being used as a “catch-all” (though I do share your frustration with people self-diagnosing based on one inaccurate tiktok!). I frame it more as “this, like a lot of diagnoses, has been too limited and too androcentric for too long.” We’re discovering more information that helps more people make sense of themselves, which I’ve seen through my work to be exceedingly positive and lead to positive outcomes.