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Marie Martinsen's avatar

I’ve been on Substack but a month so imagine my surprise to find myself so noticed!

We may not agree on everything but I agree with you on several underlying points: The DSM and our current diagnostic understanding and categorization aren’t perfect, a diagnosis shouldn't exempt anyone from accountability for harmful behaviour, and people with very high support needs shouldn't be left out of conversations about neurodivergence.

However I am unclear on how your proposed method actually distinguishes between the people you're describing. You identify accommodation-seeking as potentially entitlement, late unmasking as potentially identity instability, and objections to criticism, etc. as evidence of the Cluster B pattern.

At the same time, you acknowledge that genuine autism and ADHD may be present.

So what evidence would distinguish a Level 1 autistic woman genuinely describing her disability and requesting appropriate accommodation from someone using autism as a shield for Cluster B pathology?

With only a month's worth of notes to go on, you don't know me terribly well. For example, I come from a very working-class family and I'm not of high socioeconomic status. So I'm also curious: what could any one of the women you've named here say or do that would cause you to conclude that your assessment of her needs updating? Is that possible? Or not?

My feed is also quite full of Level 1 autistic men, many of whom talk about late diagnosis and masking as well. If Cluster B pathology isn't the explanation there, is there an equivalent mechanism you think is driving that?

I'm asking sincerely, because if disagreement, defence, blocking, seeking support, identifying as disabled and requesting accommodation can all become further evidence for your hypothesis, I am unclear how the hypothesis remains falsifiable. What evidence could ever count against it?

Thanks — I’d be genuinely interested in your thoughts.

Ella Thompson's avatar

Hello, I was sent this to read and, although I’ve not been mentioned, have thoughts on this that I would like to discuss!

Whilst it appears you want to come across as fairly neutral, I’d like to highlight certain language that rang alarm bells for me. Referring to a woman making an article on backed scientific findings as “nearly gets to the problem” comes across as condescending, and a very common pattern for men to dismiss women’s voices.

Also you referring to the women writing about neurodivergence as “influencers” and not writers, or advocates. However, and even more alarming, is how you have worded your ‘findings’.

“The challenge here is that we’re finding it’s not a misdiagnosis at all!” is what you have written here. However you are not a doctor, have not conducted any scientific study, and have come to your own conclusion and stating it as factual evidence. Which actually goes against the peer-reviewed research: 1 in 3 autistic women report being misdiagnosed with a personality disorder before their autism was correctly identified. Meaning autism was the accurate diagnosis and the personality disorder label was the mistake. This is a reflection of gender bias in diagnostic criteria, and not on the women themselves who this post focuses on.

You’ve taken that finding and flipped it to mean the opposite of what the researchers found.

“it lines up with my own analysis that 1:3 women claiming autism are using it as a mask for their personality disorder”. what credentials do you have to identify personality disorders? What study did you conduct? Has it been peer reviewed and evidence backed?

You write “I’m not offering a diagnosis, but I’m seeing and naming patterns.” But you’ve just told your readers a named list of specific women displaying “clear Cluster B behaviors” Cluster B being four DSM personality disorders. Naming the diagnostic category and attaching it to real, named people is diagnosing by another name.

There is a difference between exploring whether there is a link, and posting an article positioning yourself as providing factual findings that actually provide more harm than education.

You may disagree with my points, and scientific research, which you can do as you are your own person, i’m just highlighting the issue that arises when you push these out as factual evidence! I’m not here to name call, or slander, and we can agree to disagree on these matters. I just wanted to highlight them!

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