Medical misogyny is causing a mental health crisis among autistic women

“How did you get diagnosed, then? Through an internet quiz?”

On the surface, he was asking a question. But the airiness of it, and the smirk that somehow radiated through the phone made it clear to me that he thought he already knew the answer. I didn’t expect the validity of my autism diagnosis to be questioned by a doctor, of all people, during an occupational health appointment — but looking back, I shouldn’t have been so surprised. After all, since when have women ever been taken seriously by doctors?

A 2019 study found that 1 in 2 women (52%) believe that gender discrimination negatively impacts their medical care, while nearly a third of women said they felt a need to “prove” the legitimacy of their medical concerns and symptoms for their doctors. Despite having my autism diagnosis for over ten years, I was put into a position where I felt the need to ‘prove’ myself to this occupational health doctor, and the sad part, is that I was one of the lucky ones.

Tatum Spears, 30, recently went viral on Twitter after sharing her own story of medical misogyny on Twitter — with her thread, which recounts her experience of being dismissed by a male psychiatrist over autism, being viewed over 2 million times.

Tatum had expressed her suspicions to her psychologist once before, but was “dismissed” by him, with the psychologist claiming she couldn’t be autistic because she was “socially engaged in the phone call” and “didn’t talk in a monotone voice.”

“I was crushed beyond belief,” Tatum recalled. “His invalidation and dismissal devastated me.” But she persevered. “​​Over the course of eight months, I read peer-reviewed articles, learned about ASD, took nearly a dozen assessments, and they all said the same thing,” she explained to GLAMOUR. “They said that these assessments weren’t meant to serve as a diagnostic tool, but if the results are consistently high, I should mention it to a medical professional.”

This led to Tatum raising it again, but said he “once again refused to assess me.” She said, “His reasons for this were based on a rigidly incomplete and unforgiving “symptom” list that sounded like it was from the 1990’s.” When she explained to the psychiatrist that the reason she had enhanced communication skills was because of her performing arts experience, extensive therapy, and an advanced reading age, he responded by suggesting that she had Narcissistic Personality Disorder.

“From the moment he’d said the word “narcissism,” he had a smirk of derision on his face and in his voice,” she recalled. “At this point, I was tired of being verbally beaten down by a man who has spent a cumulative hour speaking with me over the last ten months.”

It’s exceptionally rare for autistic women to even get diagnosed with autism in childhood: if at all. According to the National Autistic Society, the ratio between diagnosed autism in men vs women ranges from 2:1 to 16:1, with the most up-to-date ratio being 3:1. But even then, while 50% of autistic boys are diagnosed before age 11, only 20% of autistic girls are diagnosed before that age. And even when they are identified as autistic, they gain support and diagnosis significantly later than autistic males do.