What It Means—or Can Mean—to Be an Autistic Psychiatrist

There are likely many factors that prevent psychiatrists from recognizing their own autistic diagnosis, said Doherty, the study’s lead author. Primary among them is the fact that diagnostic criteria focus on the deficits patients may experience, which could feel unfamiliar to a successful psychiatrist.

Doherty started ADI in 2019 simply as a Facebook group, but it quickly grew. “I remember when I was so excited that we had 30 members,” Doherty said. “Now, we have over 1,000.”

After she received her own autism diagnosis, Doherty said she essentially lived two lives—one in which she was a physician, and another in which she was open with her family and close friends about her diagnosis. Many ADI members are living similarly due largely to the pervasiveness of stereotypes and ableism.

“There is a very real and genuine fear of repercussions,” Doherty said. ADI members have been fired from their jobs as physicians or kicked out of medical school solely because of their diagnoses. ADI’s future research will explore why autistic psychiatrists do not disclose their diagnoses to their colleagues, what autistic psychiatrists can teach the field about autism, and the implications of receiving mental health care for autistic people.

“I have colleagues who are wonderful psychiatrists,” Grosjean said. “They’re published, they have numerous accolades, and yet they are terrified of coming out as autistic.”

But as Doherty and her colleagues published in their study, and as autistic psychiatrists have realized themselves, there are huge benefits to recognizing oneself as autistic. Stacy Greeter, M.D., said that receiving a formal autism diagnosis helped her immensely. She finally understood why she had some sensory problems, for example, and felt more confident adjusting her environment to meet her needs.

Greeter was diagnosed with ADHD as a child but, like many autistic women, did not receive her autism diagnosis until she was an adult. She works with adults and children in a private practice that has offices in Sarasota and Tampa, Florida. Sometimes other psychiatrists will reach out to her to feel less alone because they can’t be open about their own diagnosis of autism.

“I love being an autistic psychiatrist, but I know not everyone has a positive experience, unfortunately,” Greeter said. “Being openly autistic makes me feel empowered to make a difference to my patients.”

Greeter said people don’t always believe that she’s autistic, an experience that Grosjean echoed. “Many people assume that if you are empathetic and compassionate, you can’t be autistic, and that’s how we end up with a lot of missed diagnoses,” Greeter said. Without a diagnosis, “we deprive people of the gift of self-knowledge and improved self-care.”

In contrast to the stereotype that autistic people are not empathetic, Greeter and Grosjean described being uniquely able to connect with autistic patients whom their colleagues deemed difficult. They explain this phenomenon as the “double empathy problem,” a theory developed by Damian Milton, Ph.D., who suggests that people with autism do not actually lack empathy, as non-autistic people may assume. Rather, there is simply a problem with understanding and communication between people of different neurotypes. Autistic people can often understand each other with ease.

“Traditionally, the assumption is that whenever there is a misunderstanding or miscommunication, the fault is on the part of the autistic person,” Doherty said. “But the double empathy problem explains that nonautistic people have just as much difficulty understanding autistic people as might be the other way around. In fact, autistic people understand each other much better than you might think.”

That’s why, according to Grosjean, it’s so important to foster a neurodiverse workforce to help address the needs of the growing population of autistic adult patients. Greeter added: “My favorite part of finally having my formal diagnosis is being able to tell my patients who are autistic and ADHD, especially the little ones. It can be so powerful for them to have an open and self-accepting role model.” ■