If you are Autistic and you have had a bad experience in a medical setting, you are not unusual. You are in the majority.
Diagnostic overshadowing
Diagnostic overshadowing is what it is called when a clinician sees autism in your file and stops looking for anything else. The chest pain gets filed under anxiety. The abdominal pain gets filed under sensory. The neurological symptom gets filed under stimming. By the time the real thing is found, it has often been found late.
Pain gets disbelieved. Autistic people report and experience pain differently, and the tools clinicians use to assess pain were built on a non-Autistic presentation. We either show it in a way that looks exaggerated, or in a way that looks like we are not in pain at all, and both readings get us dismissed.
Pain gets disbelieved
Emergency departments are sensory catastrophes designed by people who have not considered what fluorescent light and noise and unpredictable waiting do to a person in crisis. Autistic people arriving at the ED in distress are sometimes restrained, sometimes sedated, sometimes sectioned, when what was happening was that the environment had overwhelmed a nervous system that came in already compromised.
Gendered and racialised bias compounds every one of these issues. Autistic women are more likely to be told their symptoms are anxiety. Autistic people of colour are more likely to be treated as dangerous rather than distressed. Autistic trans and non-binary people are more likely to be told their symptoms are about their gender identity.
If you are a clinician reading this, the adjustments are known. Dim light rooms. Written communication options. Advance scheduling. Longer appointment slots. Explicit trauma-informed practice around physical examination. Believe us when we describe our symptoms. Ask us about Autism-specific access needs on intake. Put it in the record.
If you are a clinician
None of this is expensive. All of it is overdue. The patient sitting across from you, in the appointment you are about to walk into, has probably tried to flag this before, and probably had it brushed past. You can be the one who does not.
