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What happens when the system wasn’t designed for you?

The first time I approached a doctor about a medical transition, I was eighteen years old, and instead of listening to what I was saying, this cis, White, male GP instead questioned the validity of my gender dysphoria, prodding into whether I was ‘really sure’, as I was ‘still a young woman’

by Charles

As a queer, mixed-race, neurodivergent, transgender man from a small county town in the Northwest of England, my position – in the sense of both my literal location, and my place in society, thanks to the intersecting parts of my identity – puts me at a disadvantage within the patriarchal, colonialist constructs that inform most of modern Western medicine, and as a consequence, I have faced many obstacles on the road to medical diagnosis.

In a way, behind the denial and guilt, I have always known that I was on the autistic spectrum. As a child, I chewed on anything I could sink my teeth into simply because it “felt nice”. I was viciously bullied for rocking back and forth/squeaking/clapping when excited, and teased by what few friends I could keep for not wanting to talk about anything besides Spiderman. I cannot stand the texture of felt, or the sound of pencil on paper. Further into my adolescence, as a self-deprecating class clown with a flat voice and face, teachers would tell my parents that I was an incredibly bright, gifted student when I applied myself, but I had a tendency to get “distracted” in subjects I wasn’t so invested in.

All of this is evidence enough to most (officially diagnosed) autistic people in my life, who are usually surprised I ever thought I was neurotypical. However, I still feel uncomfortable using the labels of autistic/neurodivergent, because the one thing I lack, is an official piece of paper – from a likely allistic (non-autistic) psychologist – which confirms just how autistic I am. 

While self-diagnosis is a contentious subject, it is difficult for someone like me to be identified by a professional as autistic. Not only is assessment expensive, but most studies of autism, and therefore the basis upon which psychologists diagnose you with ASD, are centred around cisgender White men; Black and Brown children are identified as autistic proportionally less than White children, and because autistic traits are not monolithic, women and people assigned female at birth who exhibited different autistic traits than the norm are often omitted from these reports entirely. 

This same struggle is amplified for people of colour who experience any kind of gender incongruence. The first time I approached a doctor about a medical transition, I was eighteen years old, and instead of listening to what I was saying, this cis, White, male GP instead questioned the validity of my gender dysphoria, prodding into whether I was ‘really sure’, as I was ‘still a young woman’, and it had only been one year since I had started living publicly as a man. The appointment was invasive, humiliating, and left me doubting what I knew to be the truth.

If medical diagnosis must be the basis on which non-marginalised people validate us (though, it shouldn’t be), then we need professionals that understand what we are dealing with through their own lived experience; not just people of colour working in medical professions, but queer, trans, and neurodivergent people too. Were that the case, perhaps I, and people like me, would not have been subjected to so much stress and embarrassment that it left them with a long-lasting distrust of the doctor’s office/psychologist’s chair, and none of the diagnoses they were seeking, five years on. 

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This article was funded by The LGBT+ Futures: Equity Fund in partnership with the The National Lottery Community Fund.