Autism: Difference vs Disorder Part 2

Hello Dazzle! Thanks for coming and hanging out with me today, I’m glad that you are here. Today I want to talk some more regarding this idea of Autism being a difference rather then a Disorder. I am going to assume that you have read the first part, which you can read here: Autism: Difference vs Disorder. Once you’ve read that, we can get into what I wanted to talk about today. I feel that it is important to further expand on the connection between Autism being considered a Disorder and it also being considered a disability. Because this connection is fundamentally important when we consider if we are ready to have the diagnosis of Autism removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM).

We need to start by taking a look at history. The first DSM, created in 1952, established that homosexuality was a mental disorder. This decision was based off the premise that the majority of people in society at the time considered being gay to be an abnormal state being, largely due to Christian held beliefs. LGBTQ+ activists were able to get the American Psychiatric Association (APA) to remove homosexuality from the DSM by first creating a small shift in public opinion; largely within the LGBTQ+ community itself. The movement then had to face the APA directly by protesting at their panels and challenging the basis of the diagnosis. All of these efforts resulted in the APA removing homosexuality from the DSM in 1973. [1] [2] [3] [4]

So, why is the history of homosexuality relevant to the topic at hand? Because this is the only movement in history that has any parallel to what the Neurodivergent movement is currently attempting to do with their declaration that Autism is not a disorder, but rather a variation of Normal. Thus, the history of how homosexuality was removed from the DSM and the after effects can be used as a guide for those currently fighting to effect change for those with the Autism diagnosis. It is important to learn from history so that we can better shape our future.

There are two important things that this history tells us: the first is that the LGBTQ+ activists had to challenge the APA directly and that having homosexuality removed from the DSM did not remove the stigma or discrimination from society. This means that it would be to the Neurodivergent community’s benefit to convert society to their cause before making their challenge against the DSM. If society were more in agreement with the movement, there would be less discrimination left for the Autistic individuals to face after the diagnosis was removed from the DSM.

Looking at the history of the LGBTQ+ movement, we can see that there was much work that has been done after the diagnosis of homosexuality was removed from the DSM. The first thing that they had to do was establish laws that protected them from discrimination. The Neurodivergent movement should expect that they will also need these types of anti-discrimination laws in place to protect them. However, it would be of benefit to have those laws in place prior to loosing the protections currently afforded them by the disability laws.

There are many differences between what the Neurodivergent movement is facing and what the LGBTQ+ activists faced 50 years ago. The first, primary difference being that the medical terminology and diagnostic criteria standards were not well established in the 1970’s nor were they as founded upon science. This means that facing the APA to challenge the diagnosis within the DSM will be one that requires both social and scientific support. It will currently be difficult to demonstrate that having Autism doesn’t create distress, disfunction or danger. However, if the movement can change society’s opinion and get society to view them as a variation of normal then it is possible to change this data over time.

The other important difference between the LGBTQ+ movement 50 years ago and Neurodivergent movement now is the legal landscape. In 1973 Section 504 of the Rehabilitation Act made it illegal to discriminate against those with disability. [7] Then in 1990 the American Disability Act was signed into law which furthered the protections and the benefits that were given to those with a disability. [7] [8] It is important to understand that every disability given protections and benefits under the American Disability Act has a corresponding medical diagnosis. Without a medical diagnosis, a person cannot qualify as having a disability.

Currently, as things stand right now, having Autism allows a person to claim disability status under Section 12: Mental Disorders. [9] More Specifically, it is listed as Section 12.10 Autism spectrum disorder. [9] Looking at the criteria listed within this section, it is clear that a medical diagnosis of the disorder is required, an assessment of how the disorder impacts the individual must be completed by a health care professional and dysfunction must be demonstrated within the medical documentation. [9] Great, so what does any of that mean?

What this means is that if the diagnosis of Autism is removed from the DSM, those individuals with Autism will no longer have a diagnosis that qualifies us as being people with disabilities. This means that we will no longer be protected from discrimination nor qualify for benefits because we will no longer be disabled people. People who are considered a variation of normal cannot claim disability because they are normal and thus do not need assistance nor protection.

I urge those within the Neurodivergent movement who are seeking to remove the label of disorder to bide their time. Because if we ask ourselves if we are ready for that label to be removed, along with all the supports and benefits it affords us, we must see that society is not yet ready to treat us as normal. And until society is able to treat us as normal, we will continue to struggle. Because the truth is that removing a label does not remove the discrimination nor the barriers that society has created for us. Let us learn that lesson from the LGBTQ+ movement that 50 years ago removed their label of disorder and continue to fight against discrimination today.

As someone who works to ensure that individuals can function well within their communities, I continue to use the word Disorder to describe my Autism. I do this, as a medical professional, to uphold the medical authority that provides the foundation for the legal protections and benefits that are afforded to us through the disability laws. While I understand that there are many out there that believe that the term Disorder is offensive to those with Autism, I urge you to consider the larger picture. The legal and social implications of the removal of this label from the medical arena are profound. We are not yet ready to accommodate those who are supported by disability benefits and we are not yet able to protect those who are currently shielded by the disability umbrella. While this is not a perfect shield, it is the only one that we have.

Well, that’s about it for my rambling today. Thanks for coming and spending some time with me. If you like what you read, click on that like button. It really does help! Until we talk again, you take care of yourselves!

Sources and Additional Reading

  1. How LGBTQ+ Activists Got “Homosexuality” out of the DSM
  2. Out of DSM: Depathologizing Homosexuality
  3. “Gay Is Good”: History of Homosexuality in the DSM and Modern Psychiatry
  4. #FlashbackFriday — Today in 1973, the APA Removed Homosexuality From List of Mental Illnesses
  5. The Removal of Homosexuality from the DSM: Its Impact on Today’s Marriage Equality Debate
  6. Are You Saying Homosexuality Is Normal?
  7. The History of the Americans with Disabilities Act
  8. Americans with Disabilities Act
  9. Disability Evaluation Under Social Security

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