Autistic doctors speak out against stigma

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When Dr. Tahleel Javed received a formal diagnosis for autism and ADHD at 27 years old, she felt shock, confusion and relief. Certain reactions began to make sense, like all the times when she felt overwhelmed by noise on the bus and missed her stop, or when she had a full-blown panic attack after a challenging conversation with her supervisor. “For as long as I can remember, I have not felt I belonged anywhere up until the diagnosis,” she wrote in an email.

Javed is a psychiatric doctor in the United Kingdom and has what is called “high-functioning autism,” meaning that she is able to live independently but may have trouble with sensory overload, communication or expressing emotions. Studies estimate that around 1% of doctors—primarily general practitioners and psychiatrists—are autistic. Many of them hide their diagnosis from their colleagues because they worry they will be stigmatized.

But as bias pushes the mental health of some autistic doctors to the brink, others are taking a big step to open up about their diagnoses and advocate for change.

“Compared to even when I was diagnosed a few years ago, I had never heard anything about neurodiversity,” says Dr. Sarah Bernard, a neurodivergent geriatrician in Australia. “And so it’s super exciting to see it become a hot topic.”

Bernard received her diagnosis when she was 38. Like Javed, she found a lot of clarity afterward. Taking a phone call or speaking with a patient in a busy room was something that depleted her energy. She also says she often felt misunderstood because her facial expressions didn’t always match what she was feeling. The thing she dreaded the most was job interviews, which tended to go poorly because of their unpredictability and focus on social norms.

Over the years, Bernard found techniques to mitigate these challenges. “I try to reduce the cognitive load by preparing a lot of scripts,” she says. She will often take phone calls in quiet places, consciously watch her expressions and pay attention to her tone of voice while speaking to others.

After Javed stepped forward with her diagnosis, she says she noticed that her peers would pay extra attention to her and constantly ask if she was OK. “That creates more anxiety,” she says. “We wish to be heard and accepted for who we are. But we don’t necessarily want to be pointed out.”

Others worry that being linked with a disorder may cost them their reputation as a reliable health care provider. “They’re already working so hard to get to where they are. And rocking the boat, sometimes, it’s just not worth it,” says Dr. Lawrence Fung, a psychiatrist and director of the Stanford Neurodiversity Project.

For instance, a UK-based general practitioner was released from their medical training program after they shared their condition. Their workplace issued the following statement, disclosed in a journal article in 2021:

“The panel regrets to learn of your recent diagnosis of ASD [autism spectrum disorder], but since this is a life-long developmental syndrome which causes permanent impairment of many of the competences required for independent practise as a GP, the panel cannot see how any workplace adaptations could now be put in place to successfully alter your outcome.”

It’s not required for individuals to disclose their diagnosis to an employer, but some may choose to do so given they are legally entitled, both in the US and the UK, to receive accommodations in the workplace. The aforementioned trainee has since been reinstated and received an apology after autism peer groups lobbied against the panel.

“There’s still a sort of old-school view sometimes that autistic people are sort of too disabled to be doctors, or that they’re not empathetic enough to be a psychiatrist,” says Conor Davidson, the clinical lead at the Leeds Autism Diagnostic Service in England.

Javed also mentions that her psychiatric patients are more comfortable with her when she’s open about her condition. “I felt that patients were able to connect with me in a better way,” she says. “Patients tend to give that godly position to doctors. But showing vulnerability as it is and then showing them that it could be one of your strengths is something that gives a lot of confidence to the patient.”

Autistic people are like square pegs,” Javed says. “If you try to hammer them in round holes, you will not get the peg across. You end up breaking it.” She recalls the sudden death of a doctor in one of her online autism support groups. They left a note that said three things: I don’t have hope for this community. Don’t disclose my identity. I’m done with this.

This spurred Javed to start a nonprofit called Society for Tourette’s, Autism and Neurodiversity.

Today, Autistic Doctors International (ADI), a peer support group, has over 600 members around the world. And they’re working to bring neurodiversity to the forefront.

“I had never heard of other autistic doctors until two years ago,” says Bernard, the Australian lead at ADI. When she first came across the organization in 2019, she was excited to learn there were enough autistic doctors in the world to form an online group. “It’s really validating to talk to others who have to juggle sensory overload and executive dysfunction and social differences in a health care workplace.”

In an effort to improve workplace policies, the organization also conducts research on the barriers autistic doctors face in health care. ADI recently partnered with the Royal College of Psychiatrists, the leading professional body in psychiatry in the UK, to raise awareness of neurodiversity.

In summer 2022, the Royal College revised its Equality Action Plan to highlight three priority areas for autistic doctors. The new plan emphasizes the importance of creating resources to help workplaces make adjustments for neurodiverse individuals, improve accessibility at training workshops and conferences, and use neutral language when talking about autism – such as calling it a condition rather than a disorder.

Autistic doctors say this is a sign that neurodiversity is becoming more accepted in the medical field, according to a response paper published by ADI. “There is slowly a shift to the medical world being a bit less deficit-focused and starting to recognize the positives and the strengths of autism and ADHD,” Bernard says.