Professor Uta Frith’s recent TES interview raises important questions about autism, diagnosis, and scientific rigour. But some of her claims about the spectrum, later diagnosis, and masking risk overlooking current evidence and the lived realities of autistic people. This article offers a critical response, drawing on research as well as personal experience.
Professionals with a prestigious track record or public voice in certain fields can have significant power when it comes to public opinion, and thus people’s lives. In health and social care, education, and other newsworthy fields, individuals can have influence over large groups of professionals, as well as over the media, the public, and policymakers. Especially in an era of divisive politics, ‘culture wars’, and spending cuts, there is a special responsibility to communicate carefully in public interviews and opinion pieces, where claims are tested less by peer review than public interpretation.
In the field of autism research, Professor Uta Frith has had an enormous impact. She was one of the first people in the UK to study Asperger syndrome, and remains Emeritus Professor in Cognitive Development at the Institute of Cognitive Neuroscience at University College London. She has written widely on the neuroscience of autism and dyslexia, won several awards and prizes, been elected Fellow of many prestigious societies. Frith has mentored leading figures in autism research and clinical practice, including Simon Baron-Cohen, Francesca Happé and Tony Attwood. Her foundational work has shaped the field, and her call for rigour in the interview is a continuation of that commitment, but it warrants further discussion in light of recent developments.
Frith was recently interviewed in TES Magazine (formerly known as the Times Educational Supplement; Amass, 2026) in a piece entitled “Uta Frith: why I no longer think autism is a spectrum”. The title itself was bound to raise both eyebrows and alarm, especially in the context of how the spectrum has emerged from empirical research and helped to destigmatise a condition now known to affect far more people than previously believed. Frith argued that “the autism spectrum has widened to the point of collapse”. While she rightly calls for scientific and clinical rigour, some of her positions appear to overlook emerging evidence, disregard the complexities of neurodivergent lived experience, and underestimate how her statements might be interpreted and misused.
I am wary treating any scientist as beyond criticism. Like all of us, researchers bring perspectives and assumptions that can shape how they interpret evidence. Autism is not my field of professional expertise, but as a psychologist with lived and family experience of autism, ADHD, and related conditions, I approached Prof Frith’s interview with mixed feelings. Her research record and impact is undeniable, but I was soon concerned about the potential implications of what I read.
In this response, I’ll structure my analysis around some of her major claims, drawing on research along with personal reflections to hopefully offer a balanced yet critical perspective. I aim not to undermine Frith’s legacy but to explore where her views might diverge from certain strands of emerging evidence, and to reflect on how the claims and language in the interview may inadvertently harm those with autism spectrum disorder (ASD) diagnoses, and those considering assessment.
The Autism Spectrum Concept
“The spectrum has collapsed.” Frith believes that the autism spectrum has expanded to the point of meaninglessness, suggesting it no longer unites those diagnosed under a coherent framework. “We’re all neurodiverse in some way,” she noted, making “a medical diagnosis completely meaningless.” This phrasing, while highlighting her very real concerns, has proven appealing to media outlets and social media commentators seeking provocative angles.
Before we go on, for those unfamiliar with autism, it is important to clarify what ‘the spectrum’ means. Most authors and organisations do not conceive of the spectrum as a simple linear scale from ‘mild’ to ‘severe’ autism, where someone is more or less autistic. Instead, the autistic spectrum is typically seen as a multidimensional concept that recognises variability in how autism affects different areas of life. These areas include social communication, forming relationships, sensory processing, repetitive behaviours, restricted interests, executive functioning (such as planning and flexibility), and more. There is no standardised ‘spectrum’ as such, but the ASD diagnostic criteria are, of course, standardised. Some autistic people have unusual gifts or strengths, perhaps due to focused interests. Some autistic people have intellectual disabilities. There are, however, several meanings of the term ‘spectrum’ in relation to autism (see Lai et al, 2013), which DSM-5 does not define.
Diagnostic frameworks like the DSM-5 include levels of support needed (e.g., Level 1 for requiring “some support”, up to Level 3 for ”very substantial support”), rather than assigning an overall ‘severity label’. This avoids oversimplifying people into problematic categories like ‘high-functioning’ or ‘low-functioning’, which many autistic advocates criticise for ignoring the unique profile of strengths and impairments each person has, and the variability of functioning. For instance, one may be high-functioning in some abilities or aspects of life, but unusually low functioning in others: a so-called spiky profile.
Importantly, ‘high-functioning’ autistic people may function poorly when it comes to mental and physical health, which raises the question of what ‘high-functioning’ really means. It is noteworthy that rates of depression and anxiety (Hollocks, et al 2018), traumatic events and post traumatic stress disorder (Andrzejewski et al, 2024; Quinton, et al, 2024), and suicide (Newell, et al, 2023) are significantly higher among autistic people, especially those without intellectual disability. In an umbrella review, French et al (2026, in press) found, across 134 reviews, a wide range of adverse mental health, physical health, and social and lifestyle outcomes.
The spectrum model emerged from research and from attempts to capture this continuum of experiences, where traits interact dynamically with environments. Dismissing it risks reinforcing outdated binaries, ignoring how the ‘disorder’ part of ASD often arises from person-context mismatches rather than inherent deficits. Evolutionary perspectives suggest that some autistic traits, such as strong attention to detail, intense interests, and sustained focus on patterns or systems, may have had adaptive value in certain ancestral or historical contexts, while modern social and institutional demands can render the same traits disabling, pathologised, or occasionally valorised (Baron-Cohen et al., 2009; Hunt & Procyshyn, 2024).
Going back to Frith’s claim, there are valid questions and concerns about diagnostic boundaries, particularly since the removal of Asperger syndrome from manuals such as DSM-5, which broadened inclusion but risked diluting specificity. (DSM-5 replaced the previous group of four pervasive developmental disorders with a single diagnosis: Autism Spectrum Disorder or ASD.) It seems defensible that over-expansive categories may strain resources, at least for diagnosis (for most who are diagnosed, that is where the resources end), and complicate targeted interventions. However, while her critique raises important questions about boundaries, dismissing the spectrum entirely might overlook its ongoing utility in research and practice.
In response to Frith’s assertion, Baron-Cohen was interviewed on the Radio 4 Today programme five days later, on 9 March 2026. He agreed that “the term ‘autism’ is far too wide”, including not only autism but people with and without intellectual disability, and people who are both verbally fluent and those with minimal or no spoken language. He disagreed with Frith on the term spectrum, invented by Lorna Wing in the 1980s (43m 48s into the programme) (see Gillberg, 2015). The spectrum reminds us, he said, that there are individual differences among those who are autistic.
TES later published a direct counterpoint by Dr Sue Franklin, who argued that progress in recognising autistic girls remains too fragile to risk reversing, and that dismissing masking underestimates the educational and mental-health consequences for girls and women (Franklin, 2026). That follow-up made clear that Frith’s article was not the only credible interpretation presented even within TES itself.
It’s tempting to think that the modern interpretation of autism is a recent development that has diverged sharply from historical accounts. We now know that this is not accurate. In 1925, Russian child psychiatrist and researcher Grunya Efimovna Sukhareva published a paper in which she described the cases of six boys (10-13 years), using what would now be recognised as ASD terminology. Sukhareva described sensory features that only appeared in DSM-5 (2013). The clinical picture was similar to that reported by Hans Asperger in 1944, and later in accounts of ‘high-functioning’ ASD. (The first English-language translation was by Wolff [1996].) Later, in 1927, Sukhareva described five girls (12-14 years), emphasising sex-related differences in autistic features. According to Sukhareva, girls with ASD showed some differences compared with boys, including a weaker and less prominent overall clinical picture, “greater affect dysregulation, less idiosyncratic interests” while the similarities included “autistic disposition, low or absent affective empathy, unimpaired cognitive empathy, systemising thought processes, and motor skill deficits” (Simmonds and Sukhareva, 2020; p. 549).
Frith’s push for precision and validity is warranted. But evidence from diverse studies continues to support the spectrum’s utility in promoting understanding, reducing stigma, and guiding intervention. Balanced, evidence-based refinements, rather than abandonment, could better serve the field and those it serves. Still, Frith connects the spectrum with a rise in diagnosis.
On the Rise in Diagnoses
A second contentious issue in the interview is the “dramatic increase in ASD diagnosis” that we have seen in recent years. Frith attributes the increase to the spectrum’s widening, driven by subjective self-reports and cultural trends, potentially pathologising normal variations. This resonates with concerns about both social media influence and resource strain. Frith argues for the need for more objective criteria (including observation, but potentially including biomarkers), as vague boundaries could be leading to over-identification.
Again, her claim is one opinion among many held by researchers with significant research records. Professor Baron-Cohen argued on BBC Radio 4 (and posted on X) that “we’ve got to be very careful we don’t conclude that there’s over-diagnosis; there’s no evidence for over-diagnosis”. So we have two leading experts making seemingly contrasting statements. In fact, Frith did not specifically state that there is over-diagnosis. The interview author wrote that the issue of rising diagnoses is something that Frith “has so far been ‘hesitant’ to comment on, due to the sensitivity of debates around overdiagnosis and uncertainty about how an already stretched SEND system should best meet growing need” (Amass, 2026). But ‘overdiagnosis’ has been inferred from her statements, perhaps because of her choice of language. Diagnoses after early-childhood, she said, was “increasing at a rate that is just frightening”. She also commented about the folding in of the previous diagnosis of Asperger syndrome into ASD: “the spectrum was stretched over and over into including people who would never have met the criteria of Asperger syndrome.”
It is important to note that the DSM-5 changes were largely empirically driven, and were seen as more valid than DSM-IV. Mandy (2013), citing Frith (2004) herself, concluded that, “On current evidence, there is no convincing argument to be made that autism and Asperger’s disorder are meaningfully distinct entities that require separate labels. People with these disorders show many more similarities than differences, and there is little to suggest that they diverge in terms of etiology, treatment needs or prognosis“. Despite this, there have been debates ever since about the loss of the Asperger category. Mandy wrote that “While the DSM-IV distinction between autism and Asperger’s disorder almost certainly lacked validity, it probably did have some utility.” Some of those diagnosed, and their parents, accepted the diagnosis and found it useful. It more recently came to light that any association with Asperger was to be rejected for reasons associated with the man himself.
Interestingly, only 13 years ago, concerns were not about over-diagnosis but possible under-diagnosis of less apparent autism: “the bar for an ASD diagnosis has been raised by DSM-5, and that many people who would previously have met criteria will now be excluded from the autistic spectrum” (Mandy, 2013).
Some media outlets quickly framed the interview in terms of overdiagnosis, even though Frith did not explicitly make that claim. The Daily Mail ran an article and poll, “Is autism being over-diagnosed, as top expert claims?” Again, Frith did not make this specific claim in TES. It’s difficult to establish the expertise of Daily Mail readers in neurodevelopment matters, but a large majority responded “Yes” to the hardly neutral question.
Graphs propagated on social media with claims of overdiagnosis. In all of this, few bother to concern themselves with what ‘overdiagnosis’ actually means. According to Brodersen, et al (2018), “Broadly, overdiagnosis means making people patients unnecessarily, by identifying problems that were never going to cause harm or by medicalising ordinary life experiences through expanded definitions of diseases. Overdiagnosis has two major causes: overdetection and overdefinition of disease. While the forms of overdiagnosis differ, the consequences are the same: diagnoses that ultimately cause more harm than benefit.”
On the first point (“making people patients unnecessarily, by identifying problems that were never going to cause harm“), there is very little evidence of this when it comes to autism. Autism is already associated with many adverse mental health, physical health, and social and lifestyle outcomes that do cause harm (French et al, 2026, in press), and non-diagnosis of ASD can sustain these harms or associated inappropriate treatments.
On the second point (“by medicalising ordinary life experiences through expanded definitions of diseases”), rather than medicalising normal autistic experience, an autism diagnosis can provide an explanatory and legitimising framework for autistic people and for parents, teachers, and others. Studies also suggest that, despite possible negatives such as stigma or diagnostic overshadowing, the perceived benefits of diagnosis are often greater than the harms (Huang et al., 2023; Jacobs et al., 2018). It is important to note that medication is generally not offered for the core features of autism, but many autistic people are offered medication for co-occurring conditions or specific associated symptoms.
It is important to acknowledge that there could be some overdiagnosis when it comes to autism, as with any condition. Overdiagnosis has been researched with a variety of conditions internationally (Jenniskens, et al, 2017), and there is strong evidence of overdiagnosis for some (e.g., thyroid cancer; Chen and Haymart, 2025). But ASD is not among the conditions with strong evidence for overdiagnosis. As Baron-Cohen said on Radio 4, the research does not support a claim that autism is broadly overdiagnosed in the United Kingdom; rather, research suggests that underdiagnosis and delayed diagnosis remain substantial, especially in females and adults (see O’Nions, et al, 2023). Frith’s claims may underplay improved awareness, especially among adults, women, and high-masking individuals (something she rejects) who have historically been overlooked. Many pursue or are referred for autism assessment in the context of school or educational concerns, or because of co-occurring mental health difficulties (NICE, 2011; NICE, 2014).
So where does this leave the label of ‘autism’? Frith wrote that she “would fight for that label to be limited” those who are “diagnosed in early childhood – usually before age three or age five”. In the UK, this would mean that the vast majority of people diagnosed would no longer be diagnosed with autism. According to one major study, this would include 79% of children diagnosed by age 14 (Hosozawa, et al, 2020). It is more difficult to find comparable data for adult diagnoses, but, considering the whole population, it is safe to say that the vast majority – especially females – would no longer have a diagnosis of autism, under Frith’s suggestion. They might instead, Frith suggests, receive a diagnosis of something like “oversensitivity” or “anxiety” (thus ignoring most of the ASD criteria that underlie their existing diagnoses, and the associated factors that research suggests are linked to ill health). This could inadvertently limit access to understanding and support for many, which might ultimately be an own goal for the field.
One possible influence on current debate is anchoring to much lower historical prevalence estimates, especially those derived from narrow populations and older diagnostic frameworks (Tversky & Kahneman, 1974; Furnham & Boo, 2011). It may look like we have adjusted too far from the anchor. The very low historical figures, focusing on young boys in a period of low access to information and assessment, may bias ideas about the ‘right’ proportion of autistic people today. Some associate the rise of diagnoses with the assessment process itself.
The Assessment Process
On the assessment process, Frith said: “I fear that the way assessments are made now may not be quite right. I get the sense that people are relying too much on detailed interviews that provide a lot of subjective experience, rather than on objective clinical observation. For example, observing the flow of a conversation to spot indicators of poor reciprocal interaction, say, in eye contact or body language. I would guess these are things that are difficult to mask.”
Interestingly, in discussing “How exactly is autism diagnosed?”, Frith relied on several qualified statements (“I have heard…”, “I fear…”, “I get the sense that…”, “I would guess…”, “I fear…” [again], “To me…”, and “…, in my view, …”.), which may reflect the tentative nature of interviews but contrasts with her emphasis on objectivity. This illustrates the challenges of conveying nuanced views in non-academic formats, where peer-reviewed precision is not feasible. But it may serve to generate speculation and multiply fear.
What is interesting here is that autism diagnosis tends to be an extensive process compared to other conditions. For an adult, it can take several hours over several weeks, involving multiple interviews, as well as observation throughout the interview with the person being assessed, plus a set of observed tasks. For children, the process is even longer. The whole process typically involves involves a team of professionals. The intervention offered, however, is often a reading list and perhaps a discussion group. With autism, there can be a striking mismatch between the length and specialist nature of assessment and the paucity of post-diagnostic support. In contrast, depression is often diagnosed and managed in primary care by general practitioners, sometimes with medication initiated immediately.
To sum up, it seems that comprehensive assessments using approved and validated processes with evidence-based criteria have revealed many more previously undetected autistic people, often female and no longer young children, but who struggled through this period without recognition. And yet the process often yields minimal post-diagnostic support. But the message is either “there are too many autistic people!” or “you aren’t really autistic!”. Assessment and diagnostic protocols can always be improved, and they should be. But perhaps the real issue lies in systemic failures. Rather than being frightened by rising numbers of diagnoses, perhaps we could disregard imaginary targets when it comes to autism prevalence. And rather than blaming ‘the spectrum’, perhaps we should be cautious about framing older, narrower presentations of autism as the benchmark for validity. Those with greatest need should of course receive the greatest support. But we should ultimately be led by evidence. This leads us to the next issue: subgrouping autism.
Subgrouping Autism
Autism can look very different from one person to another in terms of features and challenges, and this heterogeneity creates issues for conceptualisation, diagnosis, and intervention. To help resolve these quandaries, Frith proposed at least two subgroups: those diagnosed.early and with intellectual impairments, versus later-diagnosed (perhaps with “anxiety” and “hypersensitivity”). The second group are mainly adolescents and mainly women, she argues. She suggests that many in this later-diagnosed group may have real difficulties that are better understood and treated outside the autism label. Frith argued for restricting ‘autism’ to the early diagnosed (before five years old) and creating new labels for the latter.
Many have baulked at this suggestion, but several researchers and clinicians, such as Attwood and Baron-Cohen, have long argued that something important was lost with the removal of Asperger syndrome (which clearly needed to be renamed and reformulated). There have also been many arguments and much research in support of subgrouping, for enhancing diagnosis, support, and more targeted research, including by: Baron-Cohen in his Radio 4 interview and with coauthors Lai et al (2013), as well as Kamp-Becker (2024), Choi et al (2026), and Litman et al (2025).
Taking this latter work, Litman et al. identified four distinct and mutually exclusive subtypes of autism in their survey and genetic data from over 5,000 autistic individuals: 1) social/behavioural (social communication, repetitive behaviours, attention deficits, disruptive actions, and anxiety or mood issues but normal developmental milestone attainment; ~37%); 2) mixed with developmental delays (strong repetitive behaviours and some social communication problems, but delays in development; ~19%); 3) moderate challenges (mildest overall, with lower levels of difficulties across social, behavioural, attention, and developmental areas, but noticeably more challenges than people without autism; ~34%); and 4) broadly affected (high challenges in nearly everything, and often intellectual disability or other co-occurring conditions; 10%). Each of the four linked to unique genetic variations and brain development. Contrary to Frith’s claim, there was a consistent male predominance (75-80% males) in all groups in this research on 5,000 children and young adults with autism.
Recently, Lin et al (2026) argued that autism research has been held back by treating variability between autistic people as a nuisance to be averaged away, rather than as something meaningful in its own right. The authors argued that idiosyncrasy (“stable, person-specific neural, cognitive, and behavioural patterns”) should be treated as a core feature of autism, not just statistical noise. In other words, person-specific patterns in brain function, cognition, and behaviour should be treated as central to understanding autism.
Taken as a whole, research seems to suggest that there may be ‘many autisms’, just as there may be ‘many ME/CFSs’ (another condition with much in-fighting about what really constitutes ME or ME/CFS), and many ‘Long Covids’. Similar clusters of features can emerge from quite different biological mechanisms. But again, in the context of autism, according to Baron-Cohen and others, subgroups can still likely be seen in the context of a spectrum. Whatever terms are used, it seems that there are differences between subtypes identified by research, but there are also differences between all of these subtypes and those not diagnosed with autism. It seems that this is an empirical and modelling question, but one with significant implications, calling for care and skill both in the science and in its communication. Considering the research, while subgrouping is a promising direction, as Frith and others like Baron-Cohen advocate, a binary approach based on age of diagnosis seems unlikely to capture the heterogeneity revealed in studies such as those by Litman et al (2025).
It might also be said that there is power in measurement, categorisation and language, especially in medicine. The debate concerns who gets to define autistic experience. The slogan ‘nothing about us without us’ remains relevant here, including for those diagnosed later in life. This brings us to Frith’s next claim.
The Concept of Masking or Camouflaging
Autistic masking is something that those diagnosed after early childhood may be acutely aware of, because of the consequences of both not masking and masking. Masking has been defined as “the conscious or unconscious suppression of natural responses and adoption of alternatives across a range of domains including social interaction, sensory experience, cognition, movement, and behavior” (Pearson and Rose, 2021). Autistic masking or camouflaging (both terms as used, with the latter sometimes being seen as broader) has been particularly associated with females in the literature, in a similar way to how ‘autism’ has been associated with males.
In her interview, Frith dismissed the concept of autistic masking as having “no scientific basis” and merely “something we all do”. This stance contrasts with a growing body of research on masking, which suggests it has distinct implications for autistic individuals (see Dolan, 2026; Pearson and Rose, 2023). Frith remarked that, “I expect we could say we are all masking, all the time, trying to adapt to our society’s norms. So, from this point of view, I’m very critical of this idea.” She rejects masking as a factor when it comes to later diagnoses, stating her view that there is no cultural bias against identifying girls and women as autistic, and that they have not been unjustly overlooked. She compares the situation with psychopathy: “We know, for example, that psychopathy is overwhelmingly male. Do we ask whether psychopathic girls have been overlooked? I haven’t seen anything like that.” Frith’s assumption seems to be that if you can mask, you are not autistic, perhaps reflecting an old idea that autistic people lack a theory of mind, which has been found to be “empirically questionable and societally harmful” (Gernsbacher and Yergeau, 2019).
Again, Frith’s claim is unevidenced, which is unsurprising for an interview. But because of the complexities and myriad implications of the claim, it might be more responsibly made in a scientific paper than a seemingly authoritative commentary for educators and the public. Frith went further to claim that the exhaustion that people report as being associated with masking “could arise from lots of other causes”. The differential nature of autistic masking, and the consequences of masking, were almost completely dismissed.
Frith also expressed scepticism toward aids such as ear defenders, deeming them unproven or potentially counterproductive. Again, this seems to disregard at least some research showing that earmuffs, noise-cancelling headphones, and similar audio technologies can help some autistic children by reducing auditory distress, improving behaviour linked to auditory hyperreactivity, and in some cases reducing physiological stress (Pfeiffer, et al, 2019; Ikuta, et al, 2016; Zanin, et al, 2024). Ironically, the implication is that autistic people should tolerate overwhelming environments rather than use simple accommodations, which is a form of masking.
On reading this, I could only imagine the reactions of autistic people, the parents of autistic children, and partners of autistic adults. But first, let’s turn briefly to research. Firth’s “we are all masking, all the time” remark seems to overlook studies demonstrating masking’s distinctiveness in form, intensity, and consequences for autistic people (e.g., Alaghband-Rad, et al, 2023; Cook, et al, 2021; Khudiakova, et al, 2024; Klein, et al, 2025). In their systematic review, Alaghband-Rad, et al (2023) found a range of correlates of camouflaging, including gender, a universal finding, but also neuroanatomical. Kim and Bottema-Beutel (2019) found that camouflaging can have positive short-term impacts on social functioning but at the long-term cost of depression and exhaustion. They noted that “inability or decision not to camouflage may result in even greater loss of QoL [quality of life]. Researchers and practitioners should consider this double bind when promoting social functioning as an avenue for enhancing QoL.”
Of course, non-autistic people also adapt socially. But systematic reviews and qualitative analyses reveal autistic masking as conscious and unconscious suppression of autistic behaviours and traits, including stimming, avoiding eye contact, and scripting responses, at significant physiological, cognitive, and emotional cost (Cook, et al, 2021; Klein, et al, 2025). Methods such as the Camouflaging Autistic Traits Questionnaire (CAT-Q) (Khudiakova, et al, 2024, Cancino-Barros, et al, 2025; Cremone, et al, 2023) quantify camouflaging, and studies have linked higher camouflaging to anxiety, depression, burnout, and suicidality. Again, suicidality is highly prevalent in autistic and possibly autistic people without co-occurring intellectual disability (Newell, et al, 2023). Camouflaging autistic traits, meanwhile, is associated with increased risk of lifetime suicidality (Cassidy et al, 2019).
There is still much work to be done on masking or camouflaging (Khudiakova, et al, 2024), but to dismiss it as “unscientific” echoes debates concerning the validation of subjective symptoms in conditions like ME/CFS (e.g., fatigue, brain fog, orthostatic intolerance, dizziness, exercise intolerance, post-exertional malaise) (see Ponting, 2024). Communication on these matters has to be approached with precision, even – or especially – in an interview, acknowledging the state of science without outright rejection. In ordinary debates, what can be said without evidence can be dismissed without evidence. But it’s not that simple with such a major figure. The personal weight of Frith’s opinion combined with the lack of expertise of many readers of TES but social media generally, are all relevant. Furthermore, the sequence of arguments from different specialists in contentious fields like autism research is significant; initial arguments are likely to have greater influence on public attitudes (see Haugtvedt and Wegener, 1994). As an interesting side note, there is some evidence that more senior researchers tend to cite older research (Gingras et al, 2008; Xu, et al, 2023), while younger authors are more likely to use new important concepts, and reference more recent and diverse works (Yu, et al, 2023).
For autistic people, masking may be described as a survival strategy under stigma. It’s a safety strategy with consequences that cannot be compared with those for non-autistic people (though there may be some similarities with masking among those diagnosed with ADHD). Dismissing masking, despite research, may contribute further to gender disparities and the mental health consequences of masking, as well as add to the social stigma via dismissal of masking by family, employers, and the public.
Conclusion
In reflecting on Professor Frith’s interview, it’s clear that her intent was to advocate for scientific rigour in a field grappling with rapid change. This is laudable, and her legacy in advancing autism research is profound. Yet, as I have outlined, several of her assertions risk overlooking, or at least not mentioning, emerging evidence on the spectrum’s utility, the corrective nature of rising diagnoses, and the realities of masking. These views contrast with research highlighting the spectrum’s role in fostering inclusion and validating diverse experiences, as well as studies linking masking to distinct costs like anxiety, depression, and suicidality. Advancing the field calls for blending scientific rigour with autistic-led insights, allowing for refinements such as evidence-based subgroups without unjustified gatekeeping.
I have chosen to speak openly about my autism because a later-life diagnosis provided answers to questions that had haunted me for years. Diagnosis served as an intervention in itself. Before that, I was treated for PTSD through therapy, without resolution. Noise-cancelling earphones helped, but the autism lens connected the dots. Many aspects of the spectrum, including but not limited to sensory sensitivities, were part of a broader profile that runs in my family. The spectrum reframed struggles that prior searches and diagnoses had not explained. Far from pathologising or making me a patient, it normalised my experiences within a particular framework, led to tailored adaptations and interventions that I developed myself, and even to my discharge from clinical services (though I later developed ME/CFS, which may be more common among autistics; see Grant et al., 2022).
Diagnosis also made sense of my younger years, and this is profoundly important for healing from trauma. From a young age, I learned communication and social norms deliberately and effortfully, almost as a form of performance. That helped me traverse difficult environments at the time, but it may also have come at a long-term cost. Since autism often runs in families, diagnosis has also helped me in other ways in my family context.
By sharing this, I aim to counter narratives dismissing later diagnoses; for me, autism was the last consideration. I actually sought truth, not a label. I remain unattached to the word itself. But understanding the pattern has been life-changing.
As someone navigating this from my own perspective, I hope this article fosters balanced discourse, respecting pioneers while ensuring “nothing about us without us”. With real lives in the balance, influential perspectives can most helpfully promote understanding over division. Embracing diversity of thought and experience can enrich us all, if we listen and adapt.
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Note
This is a personal reflection based on lived experience and research; consult appropriately qualified and accredited professionals for advice.
Humanistic Systems 