by landl0rd | 2025-07-17 14:32:01+00:00
The labeling of every little thing as a pathology is part of a broader trend. Nobody can be down for a few weeks, it must be a "depressive episode". If you feel nervous before a big test or presentation, you have "anxiety". It's an overcorrection from the under-diagnosing of the past, and a phenomenon reflective of the intensely political environment around funding for research and services. You could say it may have to do with increasing billables, you could say it's because sub-clinical cases might still benefit from a few sessions of therapy that are covered by insurance only with an insurance code, but whatever.

In the case of autism, "social awkwardness" used to fall under aspergers, a diagnosis that was removed over the protestations of many aspergers advocacy organizations in the DSM-V. See, the DSM-V was massively influenced by a lobbying effort or "intelligence" operation. They were hugely focused on things like eradicating any mention of "sub-clinical" autism or recovery criteria. The abolition of aspergers was a concerted effort to essentially force people with aspergers to fight the stigma suffered by "somebody who might have to wear adult diapers and maybe a head-restraining device." As the committee representatives claimed, "it was our belief that the best way to address stigma was to confront it across the spectrum. Why did we deserve protection that other autistic people did not receive?"

"This was... reflective of our commitment to 'cross-spectrum solidarity'." To be clear, this was an effort towards imposed "solidarity", where people with one disorder that often presented mildly enough they could make an attempt at passing for normal were forced to identify as and engage in activism on behalf of said adult-diaper-wearers if they wanted recognition, destigmatization, or access to services. It was an effort I can see only as malign to re-stigmatize or explicitly block "normalization" for those who could enjoy it.

Really, the consolidation of autism into one "spectrum" diagnosis involving a massively diverse constellation of systems was a political mistake not a scientific choice. It's one based fundamentally on presentation, not on etiology, despite dealing with a massively polygenic disease that appears to have many different potential causes. It only served to slow down efforts towards management and a cure (no surprise, given many "advocate" types continue to assert it is simply wrong that the world has norms in a tone similar to those deaf people who oppose cochlear implants.)

You can see this intellectual thread carried forward to recent times. A piece from 2023 reflects very similar sentiments, essentially saying that the consolidation of diagnoses is good because it "[protects] the most vulnerable": https://www.thetransmitter.org/spectrum/weaponized-heterogen...

Those who have a shot at a "normal" life passing as "normal" are, naturally, not considered. You can see this pretty easily in the basic framing of the issue as "access to services", services which Asperger's patients required and used much less. This was a transparent and explicit effort to lower chances of "normalcy" in an attempt to benefit those who didn't have a shot at it; the "solidarity" framing was, in that sense, completely honest. I see it as nothing less than ascientific and contemptible.

(Much of this information is drawn from a paper the two men who liased with the DSM-V committee wrote some years later and which may be found here: https://www.researchgate.net/publication/337112539_Lobbying_...)