In April 2023, I spoke in front of the United Nations about autism. I asked people to imagine what it is like for medical professionals to have to hide their autism, even though their autistic traits play a significant role in the very reason they are so adept at medicine.Policy: Autistic perspectives on Policy and Advocacy (Part 4) | United Nations
When I was diagnosed with autism, I was very open about it. My autism was an answer to why I was good at my work, and it helped me reframe who I was. I had autistic friends who I admired and who liked and accepted me for who I was. Also, I worked for myself, so it just never occurred to me that my autism was something I needed to hide.
Autistic doctors in fiction
Although many people like the TV show, The Good Doctor, I have never been a fan. Perhaps that is because I don’t find it relatable. I certainly do not get the pictures in my mind as Shaun Murphy (the Good Doctor) does. My brain goes through different categories and conditions and narrows the options field until I reach a conclusion.
Dr. House’s thinking is probably more accurate of what happens for me. Although I don’t come across as a jerk, I would say in the same way that someone without autism would not think of House as autistic; if you met me, you might not think I am autistic until you got to know me better.
The experiences of autistic doctors
So when I came across a paper on the experiences of autistic doctors, I was fascinated to read the accounts of other autistic medical professionals. As awareness grows of how autism presents in adults without intellectual or language disability, more and more doctors realize that they are autistic. Autistic characteristics are well suited for medical careers—attention to detail, pattern recognition, and a conscientious work ethic.The experiences of autistic doctors: a cross-sectional study (Shaw et al., 2023)
Most of us go into family medicine, psychiatry, or anesthesiology—this is true of me. The mean diagnosis age is 36, so half of those interviewed were over 36.The experiences of autistic doctors: a cross-sectional study (Shaw et al., 2023)
Disclosing autism as a medical professional
Many autistic doctors do not get help from their employers, professional supervisors, and colleagues because they suspect that disclosing their autism will not be in their best interest and that they will not receive the help they seek. They believe their employers, supervisors, and colleagues will not understand them and may even come to think less of them.Supporting autistic doctors in primary care: challenging the myths and misconceptions (Doherty, Johnson and Buckley, 2021)
Although I am upfront about being autistic, about one-third of autistic doctors don’t disclose that they are. Half of the doctors asked for accommodations but only half of those who asked received them. Like myself, two-thirds prefer to be called ‘autistic doctor’ instead of ‘doctor with autism’. The doctors who prefer to be called ‘doctor with autism’ were more likely to view autism as a disability.
Autistic doctors & suicide
A sense of aloneness—of being the only person at work with autism—appears to be heavily related to suicidal ideation. Medical professionals have the highest rates of suicidal ideation among autistics that I am aware of. 77% of doctors have contemplated suicide, 24% have attempted suicide, and 49% have self-harmed.The experiences of autistic doctors: a cross-sectional study (Shaw et al., 2023)
Mental health was poor with high rates of suicidal ideation, self-harm, and prior suicide attempts. Despite inhospitable environments, most were persevering and working successfully. Viewing autism as a disorder was associated with prior suicide attempts.The experiences of autistic doctors: a cross-sectional study (Shaw et al., 2023)
In recent years, there has been increasing acceptance of the neurodiversity paradigm, which challenges this pathologizing approach with the recognition that autism is not an inherent flaw or disordered way of being. This paradigm shift has allowed autistics previously unaware of their autism to understand who they are.
A neurodiversity-affirmative approach to autism may lead to a more positive self-identity and improved mental health. Furthermore, providing adequate supports and improving awareness of autistic medical professionals may promote inclusion in the medical workforce.The experiences of autistic doctors: a cross-sectional study (Shaw et al., 2023)
Support for autistic medical professionals
There are a diverse group of autistic healthcare workers worldwide. While disclosing autism is shown to be of benefit to mental health, it comes with risks of being ill-treated and possibly not getting accommodations.
Supports like Autistic Doctors International (ADI) provide access to a support group of medical professionals. ADI started as a group of 7 peers and has grown to 700.
We represent a group of over 700 autistic medical doctors with a shared vision. We believe that autistic doctors bring a variety of strengths to healthcare, including an array of benefits for autistic patients.
So although autistic medical professionals can feel highly burdened and alone in their field, and disclosing their autism may have consequences, we see more autistic medical professionals who are transparent about their neurodivergence. Hopefully, resources for quality support will become more readily available in the future. Embrace Autism seeks to research, support, educate and advocate for autistics.