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Mental Health Stigma

How Suspicion Feeds Stigma Against Neurodivergent People

Neurodivergent people must face the irrational fear of fakery.

Key points

  • Stigma against neurodivergent people leads to isolation and fear.
  • One pervasive, irrational fear is that neurodivergent people are faking their diagnoses to gain benefits.
  • This fear causes actual harm to neurodivergent people in the workplace, at school, and home.

If you are neurodivergent, then you likely have experienced stigma.

Perhaps you've heard your friends or coworkers use neurodiversity as a metaphor to describe undesirable behavior. For example, "My boss is totally bipolar. I never know what she's going to say."

These words cause stigma by feeding negative stereotypes about neurodiversity and by creating a hostile environment for neurodivergent people.

In turn, these stereotypes and hostile environments can make neurodivergent people afraid to disclose neurodiversity at work, with family, or with friends. This fear can make a person feel isolated and lonely.

I define stigma against neurodivergent people as a process that creates negative stereotyping and isolation. It is typically based on the irrational fear of undesirable behavior such as irresponsibility, instability, or violence.

Nissor / Pixabay
Source: Nissor / Pixabay

Stigma also works internally on disabled people, creating feelings of isolation and shame.

As stigmatized people, neurodivergent people can feel alone, ostracized, and afraid, even among family. Research shows that these feelings create greater problems, such as a fear of seeking help and a fear of disclosing one's neurodivergence.

Fear of disclosure, in turn, can lead to masking and can cause serious psychological harm.

Stigma also harms neurodivergent people by affecting their ability to get jobs, housing, healthcare, and more.

Let's take a look at one irrational fear that causes stigma: The fear neurodivergent people are faking their diagnoses.

Medical documentation is not legally required to prove you're neurodivergent.

In the United States, we take for granted that a neurodivergent person, or any disabled person, must provide extensive medical documentation if they need accommodations at work, at school, or in public areas.

However, medical documentation is not actually required by law.

Surprised?

As law professor Kat Macfarlane explains, the Americans with Disabilities Act (ADA) never intended to require medical documentation.

Right now, employers, colleges, and organizations can legally grant accommodations to people who need them without the invasive and humiliating medical records process.

But they are permitted to ask for these things, and usually they do.

Requiring medical records creates a barrier to accommodations for neurodivergent people. Far too many are unable to get the high levels of medical documentation required by gatekeepers.

For example, one such gatekeeper is the Scholastic Aptitude Test (SAT), which is required for college admissions. To get accommodations for the SAT, neurodivergent students must provide extensive psychological testing records.

But, this testing can cost thousands of dollars to acquire. Plus, the testing is deeply personal, revealing far more than a person's testing accommodations needs.

Why do organizations require such extensive documentation? They are suspicious of neurodivergent people.

Fear of the "disability con" is prevalent.

If you're thinking, "Well, we can't just hand out SAT accommodations like candy," then you are not alone. Many people believe that we must lock down accommodations to prevent abuse by people faking disabilities.

But this fear of fakery is irrational because it is extremely rare. Law professor Doron Dorfman devised a way to talk about this irrational fear. He calls it the "fear of the disability con."

Despite extensive research showing that fakery is rare, the disability con stereotype is prevalent, and it creates barriers for neurodivergent people who need accommodations.

As a professor, I've had neurodivergent students tell me that they hide their accommodations from their fellow students for fear of being ostracized. Professors tell students outright that they suspect neurodivergent students will cheat, which I detail in my post for The Chronicle of Higher Education.

Every time you hear someone say, "ADHD is so overdiagnosed," you are watching the irrational fear of fakery in action. (ADHD is not overdiagnosed.) And those words harm every person with ADHD by stigmatizing the diagnosis.

Let's push back against stigma.

The stigma against neurodivergent people is fed by the fear that neurodivergent people are faking it to get special treatment, such as extra time on the SATs, flexible work schedules, or other benefits that neurotypical people might want, too.

(My solution? Give everyone extra time and flexible work schedules. The SATs aren't testing speediness, and flexible schedules are humane.)

Neurodiversity (as I define it) is the normal variation in human neurological function, emphasizing normal.

This means that autism, anxiety, attention-deficit/hyperactivity disorder (ADHD), and all other neurodivergences are normal, real, and far more common than we think. We all have friends, family, and colleagues who are neurodivergent, but because of stigma, they are afraid to tell us.

To combat the stigma against neurodivergent people, we can work together to push back against the notion that neurodiversity, in all of its beautiful variation, is deserving of suspicion.

References

Bruce G. Link and Jo C. Phelan, “Conceptualizing Stigma,” Annual Review of Sociology 27, no. 1 (August 2001): 367, https://doi.org/10.1146/annurev.soc.27.1.363.

Macfarlane, Katherine. “Disability Without Documentation.” Fordham Law Review 90, no. 1 (2021): 59–102.

Dorfman, Doron. “Fear of the Disability Con: Perceptions of Fraud and Special Rights Discourse.” Law and Society Review 53, no. 4 (December 2019): 1051–91. https://doi.org/10.1111/lasr.12437.

Daniel F. Connor, M. D. “Problems of Overdiagnosis and Overprescribing in ADHD,” Psychiatric Times Vol 28 No 8, 28 (August 11, 2011). https://www.psychiatrictimes.com/view/problems-overdiagnosis-and-overprescribing-adhd.

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