Disordered or Disabled or Neither: Questioning the Pathologizing Language of Diagnosis
Bridgette Hamstead
For many autistic and ADHD people, the journey to diagnosis is a complicated one. It is often filled with relief, grief, anger, and deep reflection. Receiving a formal diagnosis can provide language, validation, and access to resources that were previously out of reach. It can help explain a lifetime of struggles and differences that felt confusing or painful. At the same time, the clinical frameworks that govern diagnosis are often deeply rooted in deficit-based thinking. They define neurodivergent people not by who we are, but by what we are presumed to lack. In order to access support, we must first be labeled as disordered.
This tension lies at the heart of a difficult truth. Many of us need a diagnosis to survive in systems that were not built for us, but the very act of being diagnosed often requires us to accept pathologizing language about our minds and bodies. In order to receive accommodations, disability benefits, or even basic recognition, we must be willing to describe ourselves in terms that frame our existence as abnormal. We are asked to prove impairment, to demonstrate dysfunction, to quantify the ways we fail to meet neurotypical expectations. This can be an incredibly painful process, especially for those of us who have spent our entire lives masking, compensating, and being told we are too much or not enough.
Autism and ADHD diagnoses are still largely shaped by clinical manuals like the DSM, which categorize these neurotypes as disorders. Autism Spectrum Disorder. Attention Deficit Hyperactivity Disorder. The language itself communicates a medicalized view that assumes something is wrong with us. It positions neurodivergence as a deviation from a normative baseline and defines it through what we supposedly cannot do. Difficulty with social communication. Poor attention span. Impaired executive functioning. Repetitive behaviors. These descriptions may capture certain realities, but they do so through a narrow and often harmful lens. They describe our traits without context, stripping them of meaning, history, culture, and adaptation.
What is often missing from these frameworks is an understanding of how much of what is labeled as disordered behavior is actually a response to inaccessible environments. For example, difficulty concentrating in a loud, chaotic classroom is not simply a symptom of ADHD. It is a rational response to sensory overwhelm. Struggling with small talk or reading social cues is not a broken skill set. It reflects a different way of engaging with communication, often in systems that reward surface-level interactions over authenticity. Repetitive movements or stimming behaviors are not meaningless tics. They are tools for regulation and self-expression. When these traits are removed from context and reduced to deficits, they become pathologized in ways that ignore the impact of environment, trauma, and systemic exclusion.
The pathologizing of neurodivergence also has serious implications for self-concept. Many autistic and ADHD adults who are diagnosed later in life must confront years or even decades of internalized shame. Being told that you have a disorder can reinforce the belief that you are broken or defective, even if the diagnosis also brings clarity. Some people find comfort in the medical model and appreciate having a name for their experience. Others find it limiting and damaging, especially when it reinforces stereotypes or ignores their strengths. There is no single right way to relate to a diagnosis, but there is an urgent need to question the frameworks that define us through pathology.
The social model of disability offers an alternative perspective. Instead of viewing disability as a flaw within the individual, the social model locates disability in the barriers and attitudes of the surrounding environment. From this view, autistic and ADHD people are not inherently disordered. We are disabled by systems that fail to accommodate our needs, respect our communication styles, or design spaces that honor sensory diversity. This framework does not deny that we have real struggles. Rather, it contextualizes those struggles within a broader landscape of structural ableism and exclusion. It allows us to see our challenges not as personal failures, but as the result of a world that was not made for us.
At the same time, not everyone identifies as disabled. Some neurodivergent people reject both the disorder label and the disability framework altogether. They may view their neurotype as a natural variation of human experience, not something that needs to be fixed or accommodated. Others identify strongly with disability as a political identity and find solidarity in the broader disability justice movement. These differing perspectives can create tension within the neurodivergent community, especially when it comes to advocacy and language. Some people want to reclaim the word disorder. Others want to discard it completely. Some need the diagnosis for survival. Others find it retraumatizing. There is no consensus, and that is okay.
What matters most is that neurodivergent people have the right to define our own experiences. We should not be forced to choose between being pathologized or being invisible. We should not have to adopt disempowering language in order to access care, recognition, or support. Clinicians, educators, employers, and policymakers must be willing to listen to the voices of those most affected and to question the frameworks they have long relied on. Diagnosis can be a useful tool, but it should never be the only one. And it should never come at the cost of our dignity.
Moving forward, we must create new ways of understanding neurodivergence that are rooted in affirmation, agency, and complexity. We need language that acknowledges our struggles without reducing us to them. We need systems that support us without requiring us to prove we are broken. We need to center lived experience in research, policy, and care. And we need to trust neurodivergent people to speak for ourselves, even when our truths challenge long-held assumptions.
A more just and accurate understanding of neurodivergence requires moving beyond rigid diagnostic categories and deficit-based labels. Instead of forcing people into narrow definitions that reduce their experiences to symptoms, we must build frameworks that reflect the full complexity of neurodivergent lives. This means centering the voices of autistic and ADHD people, acknowledging the impact of ableist systems, and creating language and structures rooted in respect, flexibility, and care. The question is not whether we fit within the confines of disorder or disability, but whether the systems that define us are capable of evolving. True equity will only come when we are free to define ourselves without needing to be pathologized in order to be seen.