Aucademy Aucademy Uncategorized

Why “Autism Is Not A Spectrum” – But Not For the Reasons You May Have Heard

By Dr Chloe Farahar | Autistic Researcher, Project Manager for Learning Disability and Autism at Kent and Medway Mental Health NHS Trust, and Founder of Aucademy CIC

The Spectrum Was Never Fit For Purpose – And Uta Frith Still Doesn’t Understand Why…

Frith, in her recent TES interview, claims the spectrum has “collapsed” because it includes too many people. She is “frightened” by rising diagnoses. She questions masking is even a thing preventing many from being recognised as Autistic. She wants autism restricted to a smaller, more easily observable group. She proposes “contraindicators” – including the ability to converse smoothly – that would rule out the majority of Autistic women, people of colour, and late-diagnosed adults.

Simply put: this interview is not just scientifically outdated. It is actively harmful. And I can’t decide if Frith was being lazy, ignorant, or purposely incendiary in her interview, claiming as she did that there is no evidence or science for many of our experiences.

First, I need to say: I actually agree with Frith! She is right that the “autism spectrum” is not a useful concept. I have thought this for years, and I have published on why. But I argue this from a fundamentally different position to Dame Uta Frith, and that difference matters enormously for the lives of Autistic people.

Let’s pick apart her opinions one-by-one, shall we?

The Wrong Reasons to Reject the Spectrum

Frith is right that Wing’s “spectrum” has failed. But she is wrong about why. The spectrum failed not because it became too inclusive, but because it was never a remotely adequate framework to begin with. It was always perceived (and I have tried to find an image in the literature to work out why!) as a flattened, linear continuum – running from “severe” to “mild”, from “low-functioning” to “high-functioning”, even latterly from “male autism” to “female autism” – that told us nothing about how any individual Autistic person actually lived and experienced their life.

My work, published in the Oxford University Press Collection Beyond Autistic Stereotypes (Farahar, in print 2026), proposes an entirely different framework: the Three-Dimensional Autistic Space. Rather than placing Autistic people on a linear line, this framework recognises that Autistic experience exists across three dimensions – internal (what is not visible to outsiders), external (what observers can see), and temporal (how our experience changes across time, context, and environment). This is precisely why a single diagnosis in early childhood cannot – and should not – be treated as the definitive account of a person’s Autisticness across their lifetime.

Webpage on the Three Dimensional Autistic Space

The spectrum’s failure was never that it included too many of us. It was that it was designed by non-Autistic observers, looking into the Autistic space from the outside, and only seeing what was immediately visible to their bias. This “outsiders-looking-in” phenomenon explains the historical “invisibility” of Autistic women, Autistic people of colour, and those of us whose internality – the richness of our inner Autistic lives – was simply not in the biased telescopes of researchers like Frith.

Frith simply doesn’t seem to like to read the work by Autistic researchers:

“…people still hang on to the idea that there is something that unites all the people who are diagnosed as [A]utistic. I don’t believe that any more.”

Well, Uta, I do. We are Autistic because, as Trauma Geek explains:

“Innate Autistic traits are neural hyper-connection, monotropism, and bottom-up processing.”

More on Trauma Geek’s definition:

Innate Autistic traits are natural characteristics that Autistic people are born with:

Neural hyper-connection: Autistic brains often have more connections between different brain regions, which can create deep thinking and notice patterns others might miss.

Monotropism: This means focusing intensely on one thing at a time, like shining a powerful spotlight rather than a dimmer light over many areas. This can create deep expertise and passionate interests.

Bottom-up processing: Autistic people often process information by starting with details first, then building up to the bigger picture. Most non-Autistic people do the opposite.

We are Autistic, based on community definitions of our experiences.

We are Autistic because our monotropic, interest-based model of mind (Murray, et al., 2005), impacts our sensory processing, and we have an Autistic pragmatic language, highlighting that we Autistic people have pragmatic language abilities, we just process meaning differently to non-Autistic people (Cullen, 2018), which explains the double empathy problem, demonstrating there is a translation breakdown between Autistic and non-Autistic communication and exchanges (Milton, 2012), and the variation within our community outside of these innate connections are because we exist in the Three-Dimensional Autistic Space, with our Autistic experiences – internal and external – fluctuating across time, the Autistic space placing, as it does, all Autistic people (discovered and undiscovered) in a humanising space away from the binary and obsolete spectrum.

“Frightened” by Our Numbers

Frith says the rate of later diagnoses is “just frightening”. I propose a different interpretation. When more people are discovering they are Autistic, particularly those who were historically excluded from diagnosis – women, people of colour, those of us who mask, those who were written off as “anxious” or “difficult” – this is not a crisis of overdiagnosis. This is a correction of decades of systematic underdiagnosis rooted in racial, gender, and class bias.

My chapter in the Routledge International Handbook of Critical Autism Studies (Farahar, 2022) argues how Autistic identity, culture, community and space are protective factors for wellbeing. The evidence is clear: discovering one’s Autistic identity – particularly through community rather than purely clinical process – is associated with reduced internalised ableism, improved self-worth, and better mental health outcomes (Botha, 2020; Botha & Frost, 2020). Every late-discovered person who finds out who they are is not a problem to be solved. They are a person finally finding the language for their experience, and potentially finding their community.

Frith is frightened by our numbers. I would ask: why? What is the cost to non-Autistic society of more of us knowing ourselves?

As I commented on LinkedIn:

“She claims to be frightened by the number of us. Good. This means people who benefit from the neuronormative society are worried that with so many of us working out we’re Autistic things will have to change.

Things will and are changing.

We will keep fighting for better lives for those of us less likely to be employed, and more likely to die by suicide.

We will keep fighting for those in our community who do not currently (maybe ever) share a reciprocal communication, with or without a learning disability, to be humanised and get services and support they deserve.

People like Frith don’t want us Autistic people making the changes.

I refuse to ever view Autistic people the way obsolete “autism” researchers do. We all deserve better.”

Masking: Where Is your Evidence, Exactly, Uta?

Perhaps the most egregious claim in the entire interview is that masking has “no scientific basis”. I would invite Frith to read the House of Lords Autism Act 2009 and New Strategy report (2025), which explicitly references masking and camouflaging as well-evidenced phenomena that contribute to later diagnosis, particularly in women. I would invite her to read NHS England’s own guidance on autism-informed inpatient care, which discusses masking directly. I would invite her to engage with the substantial body of published research on masking (Hull et al., 2017; Pearson & Rose, 2021) – none of which is referenced in her TES interview.

There is more than adequate scientific basis for masking. The evidence is there. To claim otherwise is not rigour – it is a failure to engage with a large body of work simply because much of it was produced by, or in partnership with, Autistic researchers.

And this raises the deepest problem with Frith’s interview. She presents her personal impressions – “I expect we could say we are all masking, all the time” – as though they carry scientific weight, whilst dismissing the lived accounts of thousands of Autistic people as scientifically unfounded. This is, quite simply, a double standard. It also demonstrates she hasn’t picked up our research in the last 10 years – masking is nothing like she seems to think: it’s an unconscious, learnt, trauma response we develop early in Autistic life.

The Dangerous Logic of “Contraindicators”

Frith proposes that smooth conversation is a “contraindicator” for autism diagnosis. If a person converses easily with you, she suggests, they are probably not Autistic. This is one of the most dangerous things in the entire interview.

The entire premise rests on an understanding of communication that was challenged – with rigorous evidence – by Dr Damian Milton in his foundational 2012 paper on the Double Empathy Problem. Milton, an Autistic academic, demonstrated that communication breakdown between Autistic and non-Autistic people is mutual. It is not a deficit located in the Autistic person. A non-Autistic clinician interviewing an Autistic person may find the conversation flows perfectly well – because the Autistic person has spent their life learning to communicate across a neurological divide, because masking is precisely the adaptation to neurotypical social norms that Frith simultaneously dismisses and uses as evidence.

Frith’s “contraindicators” framework would systematically exclude from diagnosis the very people who have historically been most harmed by missing recognition: masked Autistic adults, particularly women, but also many men and non-binary people, who have spent decades unconsciously suppressing their Autistic ways of being at enormous cost to their mental health, their energy, and their sense of self as a means of coping with the trauma of being Autistic in a non-Autistic world. These are the people most likely to present as conversationally fluent in a clinical interview. These are also the people most likely to die by suicide (Cassidy et al., 2014).

I note, too, that Frith’s framework of “contraindicators” reproduces exactly the gendered and racialised assumptions that have driven decades of missed and dismissed diagnoses. When she questions whether there is really a “cultural bias against identifying girls and women as Autistic”, comparing this, bizarrely, to psychopathy rates in men, she reveals a fundamental misunderstanding of the structural and cultural mechanisms through which diagnostic bias operates.

There is extensive evidence – not just anecdote – that the diagnostic tools, the behavioural checklists, the presentation criteria, were developed almost exclusively from research on white boys (Loomes et al., 2017; Russell et al., 2022), and this narrow telescopic view is perpetuated ad infinitum. That is not a coincidence. That is the “culture of autism” – the pathological paradigm – in operation. Frith is far behind us Autistic natural and professional researchers: we’ve already read the Swedish study that shows the binary (agreed, problematic framing, as it does not include non-binary or trans people) male-female ratio of Autistic people is equal – Frith is still quoting old ratios of 4:1 and 3:1!

Where Are the Autistic Theorists?

Read the entire TES interview. Notice what is absent. There is not a single mention of an Autistic researcher. Not Damian Milton and the Double Empathy Problem. Not Dinah Murray and Fergus Murray’s Monotropism theory – developed by Autistic people, for Autistic people, to explain Autistic cognition from the inside. Not Rachel Cullen’s Autistic Language Hypothesis. Not the growing body of Participatory Autism Research. Not the work of the Autistic Self Advocacy Network. Not my own work, or the work of any of the other Autistic academics currently reshaping how we understand Autistic experience.

https://aucademy.co.uk/theories-about-autistic-experience/

This absence is not incidental. It reflects a research paradigm – the one Frith helped build – that has consistently treated Autistic people as objects of study rather than producers of knowledge. In my presentation Theories of “Autism” and Autistic Theories of Autistic Experience (Farahar, 2022), I set out the contrast directly: on one side, neurotypical deficit theories – behavioural, biological, cognitive – that look at Autistic people from the outside; on the other, Autistic theories developed by Autistic people from lived expertise, which offer entirely richer and more accurate accounts of how we actually experience the world.

The field has moved. Frith has not.

The Culture of “Autism” and the Harm It Causes

In my 2022 chapter in the Routledge International Handbook of Critical Autism Studies, I argue that there are two fundamentally different “cultures” of autism. The first – what I call the “culture of autism” – is the pathological paradigm: Autistic people as disordered, deficient, requiring intervention and cure. This is the culture Frith’s career has perpetuated, contributed to, and embedded themselves in. The second is Autistic culture: a neurodiversity paradigm, a cultural minority framework, in which Autistic identity, community, language, and space are recognised as the foundations of wellbeing.

The harm of the first culture is well-documented. It produces internalised self-stigma and negative self-worth (Botha & Frost, 2020). It leaves people in what I have described as “purgatory” – unable to belong to non-Autistic spaces (even when they mask), and simultaneously unable to find belonging in Autistic community, because they have been taught that being Autistic means being deficient. This is not a minor academic distinction. This is the difference between life and death for a significant number of Autistic people. Autistic people are disproportionately likely to experience suicidal ideation and to die by suicide (Hirvikoski et al., 2016; Cassidy et al., 2014). The pathological narrative – the one Frith continues to promote – contributes to this.

What We Actually Need

We do not need a narrowed, dehumanising diagnostic category. We do not need a scientist “frightened” by how many of us there are. We do not need the spectrum replaced with two crude groups and a set of “contraindicators” designed by a non-Autistic researcher based on her personal, unscientific impressions.

What we need is precisely what my work in the NHS Learning Disability and Autism Programme, and through Aucademy, is working towards: systems, services, and clinical frameworks that are built with Autistic people as decision-makers, not consultees. Frameworks that recognise the fluidity, dimensionality, and lived richness of Autistic experience. Discovery processes that account for masking, for late identification, for the systemic biases that have meant that for decades certain Autistic people – women, people of colour, those without accompanying learning disability – were not counted.

Uta Frith does not speak for this Autistic researcher, or for the Autistic community and their loved ones. Things are changing. We will keep fighting for better lives for those of us who are most marginalised – those of us less likely to be employed, more likely to die by suicide, more likely to be missed, dismissed, or misdiagnosed. We will keep fighting for those in our community who do not currently share reciprocal spoken communication, with or without a learning disability, to be humanised and to access the services and support they – we – deserve.

People like Frith don’t want Autistic people making the changes. But we are. And we will continue to do so.

References

Botha, M. (2020). Autistic community connectedness as a buffer against the minority stress of stigma. University of Surrey doctoral thesis.

Botha, M. & Frost, D. M. (2020). Extending the Minority Stress Model to understand mental health problems experienced by the Autistic population. Society and Mental Health, 10(1), 20–34.

Cassidy, S., Bradley, P., Robinson, J., Allison, C., McHugh, M. & Baron-Cohen, S. (2014). Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome attending a specialist diagnostic clinic. Lancet Psychiatry, 1(2), 142–147.

Farahar, C. (2022). Autistic identity, culture, community, and space for wellbeing. In D. Milton & S. Ryan (Eds.), The Routledge International Handbook of Critical Autism Studies (1st ed.). Routledge.

Farahar, C. (2026, in print). The Farahar and Foster Three-Dimensional Autistic Space: Dismantling the ‘autism spectrum’ and centring observer bias in the missing, dismissing, and misdiagnosis of Autistic people. In Herbert, R., Shaughnessy, N. & Williams, E. (Eds.), Beyond Autistic Stereotypes: New Perspectives on Identities, Gender, and Experience. Oxford University Press.

Fyfe, C., Winell, H., Dougherty, J., Gutmann, D. H., Kolevzon, A., Marrus, N., … & Sandin, S. (2026). Time trends in the male to female ratio for autism incidence: Population based, prospectively collected, birth cohort study. BMJ, 392. https://doi.org/10.1136/bmj-2025-084164

Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P. & Bolte, S. (2016). Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 208(3), 232–238.

House of Lords (2025). Time to Deliver: The Autism Act 2009 and the New Autism Strategy.

Milton, D. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887.

Murray, D., Lesser, M. & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139–156.

NHS England (2025). Autism-Informed Inpatient Care.

Aucademy Aucademy Autistic Resources, Explaining Autistic experience, Uncategorized

Autistic theories of Autistic experience

Find here explainer videos about the three Autistic-derived theories of Autistic experience: Monotropism theory (Dinah Murray), Double empathy problem (Damian Milton), and Autistic language hypothesis (Rachel Cullen):

Monotropism explainer video by Kieran Rose (The Autistic Advocate):

Double-empathy explainer video by Kieran Rose (The Autistic Advocate):

Reviewed by young people, double empathy explained:

Screenshot of the webpage from Frontiers for Young Minds: “Double Empathy: Why Autistic People Are Often Misunderstood”

Aucademy discussion on the double empathy problem from theory (Damian Milton), to evidence it occurs, to evidence of why it occurs (Rachel Cullen):

Aucademy discussion on the Autistic language hypothesis with Aucademy’s Rachel Cullen, educating Chloe and Annette:

Aucademy discussion explaining the monotropism theory with Fergus Murray & Tanya Adkin educating Aucademy’s Chloe and Ben:

autisticltd Guest Autistic blog posts

De-centering the ‘male’ Autistic experience

By Katie Munday (they / them)

Historically, being Autistic was considered a male childhood experience, with boys more readily diagnosed than girls. This trend is still prevalent in many areas of autism research but thankfully the gap between male and female diagnosis and realisation is slowly closing. As is the access to diagnosis and realisation for transgender, non-binary and gender divergent individuals.

There have been many reasons why many girls and women have been overlooked for diagnosis including (but not limited to); systemic misogyny and transphobia, autism research which favours ‘male’ traits and cultural gender stereotypes.

Systemic misogyny and transphobia

Misogyny across medical systems, which upholds ideas of female ‘hysteria’ and over-emotionality, means women are more likely to be disbelieved or wrongly diagnosed with personality differences and mental health issues. These diagnosis can then cause access issues to Autistic identification.

Professionals are not seeing the very real connection between what would be considered ‘disorders’ (what I prefer to call embodied self-preservation) and Autistic experience, which often includes consistent trauma. So, even when females are diagnosed with personality differences they are often overlooked for also being Autistic.

Access to diagnosis is also difficult for transgender and gender divergent individuals who wish to transition medically. Often these people are left to choose between being supported with their Autistic diagnosis or gender affirmation, but very rarely are they given the opportunity for help with both. Unfortunately, Autistic people are still seen as children who do not understand gender and therefore are not ‘really’ transgender. This infantilsation denies Autistic people gender affirming healthcare and many forgo an autism diagnosis so they can get help with the more immediate need of living their authentic gender.

Many people turn up to gender identity health clinics because they are confused by their gender and need help untangling it all, some of us live in gender flux and fluidity and this confusion should never mean punishment. All gender experiences are relevant, and all people should have access to gender affirming and diagnostic healthcare, this means creating more support for people of colour, queer people, physically Disabled people and all other marginalised groups.

Autism research which favours ‘male’ traits

Across 70 years of autism research the most researched group of people have been young white males. This means that all criteria for diagnosis, and the supposed ‘support’ which comes with it, is based on ‘male’ behaviours. Anyone who does not present these traits are not considered Autistic and may be misdiagnosed with another form of neurological difference.

The very few Autistic people who fit the stereotype of Rain Main and Sheldon Cooper have the privilege of far fewer barriers to diagnosis. However, girls and women, transgender and non-binary folk and males who do not show these traits are often overlooked as we do not live up to the standard of male stereotyped Autistic traits.

This is further complicated for those of us who are people of colour, physically Disabled, Queer and trans because our social ‘difficulties’ are often understood as a common ‘impairment’ of our other marginalised identities. This is a glowing indictment of the racism, ableism and queerphobia within medical systems but also within places of education, work and anywhere else we are seen as being ‘problematic’ or ‘too much.’

These male stereotypes are based around white western ideals of behaviours; giving eye contact, staying still, keeping quiet, but ideas of ‘appropriate’ behaviour vary across different cultures. There are many indigenous cultures, for example, which deem eye contact as incredibly rude, but this is not accounted for in white western medicine.

Autism research has focused on male stereotypes for so long that the idea of a ‘female autism phenotype’ has arisen. Not only does this create even more barriers for those of us outside the binary but it also continues to other female Autists, favouring males as the ‘real’ Autistics. (I could, and probably will, write a piece on the ‘female phenotype’ but I lack the spoons to write about that particularly misogynistic, racist and transphobic idea at the moment).

Cultural gender stereotypes

Criteria for diagnosis, which favours males and is steeped in misogyny, are based on the undeniable inequality that all of us who aren’t cisgender male face.

Girls and women are often overlooked as Autistic as they often (strangely!) fit western female stereotypes. Many of them are either quiet: “she’s so shy!” or very talkative: “they’re quite the chatter box!” These vast differences in communication, confidence and the need to talk are both seen as inherently female: potential non-speaking or hyper-verbal traits are often considered as just a ‘girl thing’ and therefore often overlooked.

In many Western cultures, girls are kept young, virtuous and innocent for as long as possible. This can run parallel with the interests of Autistic people who often stay loyal to their hobbies for longer than their neurotypical peers. This is often misunderstood and pathologised as developmental regression but it is just the lack of fear we have about enjoying what we enjoy loudly and proudly!

Heteronormativity also plays a big part in gender stereotypes; girls are to grow into women who have children with a man and keep the household. Girls are explicitly and implicitly told that they are to grow up to be the main caregiver of children, do all the housework and most times squeeze in a full or part time job. Due to this many women are exhausted beyond measure; this is considered a cultural norm and does not consider neurological differences.

As we know, burnout between neurotypical people and Autistic people are vastly different, add in the overwhelming responsibilities placed upon women and we are sure to suffer poor mental health. Unfortunately, these cultural norms feed into misogynistic medical systems, which suggest that mums simply need to ‘rest more’ or pop a few Xanax and carry on exactly as they are. There never seems to be any understanding that this burnout is due to being Autistic, as well as living in a garbage heteronormative world. Less still can it be seen for what it often is: an Autistic person raising other Autistic young people in a world that is simply not made to support or enrich us at all.

So how can we de-centre the ‘male’ Autistic experience?

Firstly, challenging oppression benefits us all and this is in no way a fight against men and boys who also deserve diagnosis, support and acceptance. I want to create a world in which we can all reach understanding and support earlier in our lives.

Unfortunately, systemic misogyny and transphobia, focusing on ‘male’ traits and cultural gender stereotypes are all reciprocally determinant, they reinforce each other and are a difficult cycle to break.

Difficult, but not impossible.

Change won’t come overnight. It comes from the writings of brilliant Autistic academics and those of us who continue to put pressure on politicians and policy makers, the advocates and activists who show up every damn day to fight our oppression.

No contributions from any of us who stand up to oppression is small – we are all part of a bigger movement to change systemic ableism, racism, transphobia and bigotry. We can change things through our anger, through our writing, for showing up for one another, through social media, protests, pride events, Autistic run conferences, supporting Autistic artists, activists and writers.

These acts can and will invoke change so that the Autistic kids of tomorrow have more of a chance at Autistic joy, pride and acceptance.