Why gatekeeping makes autism and ADHD diagnosis harder—and more harmful

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Have you ever felt like your life might finally make sense, if only someone would really listen?

Maybe you’ve spent years navigating anxiety, executive dysfunction, or sensory overwhelm, only to be told: “That’s just stress.” “You’re too articulate.” “You’re doing fine.” “That’s not what autism or ADHD looks like.”

It’s invalidating. It’s disorienting. And, unfortunately, neurodivergence diagnosis gatekeeping is more common than it should be.

Diagnosis Isn’t Just a Process—It’s a Privilege

Let’s be real: getting a formal autism or ADHD diagnosis as an adult? It’s often inaccessible, unaffordable, and emotionally exhausting.

Here’s a hypothetical examples.  After waiting 18 months to see a specialist, Maya, a 32-year-old nonbinary artist, was dismissed within 20 minutes because she “maintained eye contact” and held down a job. Never mind her lifelong struggles with shutdowns, masking, executive dysfunction, and sensory distress. She left the appointment feeling more confused—and more invisible—than ever.

If you don’t fit the narrow mold clinicians are taught—based on white, cis male children who are hyperactive or overtly socially “awkward”—you may be misdiagnosed or brushed off entirely. Especially if you’re a woman, trans, nonbinary, or a person of color.

The result? A system that gatekeeps care and invalidates experience—one that tells neurodivergents (NDs), “You’re not enough like them to count.”

Neurodivergence diagnosis gatekeeping not only delays support—it also chips away at trust in providers, and in ourselves.

The Cost of Being Undiagnosed

Before many even reach the point of seeking a diagnosis, they’ve often already paid a heavy emotional toll.

You might have grown up hearing that you were lazy, disorganized, too sensitive, too intense—or just “too much.” You may have spent your life trying to be “better,” without realizing that your struggles were linked to undiagnosed autism or ADHD.

Maybe you’ve over-apologized in every conversation, fearing you’ve said the “wrong thing.” Maybe you’ve masked every instinct to stim, fidget, or interrupt, just to “pass.” Or maybe you shut down emotionally after another failed attempt at socializing left you burnt out.

This is internalized ableism. It happens when our unmet needs are pathologized, and we start believing the problem lies with us—not with a world that wasn’t built for our brains.

Clinicians frequently miss neurodivergence because they diagnose only what they expect to see: anxiety, depression, trauma, maybe even borderline personality disorder. This is called diagnostic overshadowing, and it disproportionately affects people outside the “default” mold—especially those with intersectional identities.

So when people finally do seek answers, gatekeepers often tell them some version of: “This isn’t real.” “You’re overreacting.” “Try harder.”

The Power—and Controversy—of Online Self-Discovery

So where do people turn when the formal systems fail them?

More and more, it’s online spaces—where NDs are sharing their lived experiences with raw honesty and nuance. Social media, blogs, and forums have become places of recognition, healing, and validation.

Online, one person might realize their lifelong “clumsiness” was motor skills difference related to autism. Another might discover that their chronic procrastination and overwhelm weren’t moral failings—they were ADHD-related executive dysfunction.

Community validation can be life-changing. Many describe the moment they first encountered ND  voices and thought, “Wait. That’s me.” It was the first time their story had ever made sense.

Critics of self-diagnosis argue it’s reckless or misinformed. But most people who self-identify do so carefully—after years of struggling without answers, devouring research, and often feeling gaslit by medical professionals.

Self-diagnosis, in this context, isn’t attention-seeking. It’s a form of survival. It’s what happens when neurodivergence diagnosis gatekeeping makes formal recognition unattainable.

What If We Let Neurodivergent People Define Themselves?

Here’s a radical thought: What if we trusted people to know themselves?

Gatekeeping assumes there’s one “real” way to be autistic or ADHD. But neurodivergence doesn’t look one way. It can be masked. It can be internalized. It can show up in emotional meltdowns or in frozen shutdowns, in hyperfixation or burnout.

What if the focus shifted from proving you’re “disabled enough” to simply being understood?

We don’t need fewer people claiming their neurodivergence—we need systems that meet people where they’re at. That means:

• Training clinicians in diverse neurodivergent presentations
• Reducing wait times and cost barriers
• Listening to lived experiences as valid data
• Creating neuroaffirming, not pathologizing, care models

The current system doesn’t just gatekeep diagnoses. It gatekeeps recognition, healing, adaptation, and transformation.

Final Thoughts

If you’ve ever wondered whether you might be autistic or ADHD, but were met with doubt or dismissal—know this: your experiences are valid, and you deserve support.

Gatekeeping helps no one. But sharing our stories? That changes everything.

Have you experienced gatekeeping around autism or ADHD diagnosis? What helped you move forward—or what support do you still need?