The Impact of Intersectionality

Kimberlé Crenshaw’s work and insight into intersectionality impacted the world over.

Yet, we still see a lack of authentic understanding that creates barriers for those with marginalised intersectional characteristics.

There are many similarities between overt and covert racism and ableism- societal structures that prevent those of us who are ethnic minorities and disabled from living a fulfilling and meaningful life. I will explore the intersectionality of autism and race and the impact on mental health.

Firstly, medical and academic research is heavily Eurocentric. Therefore professionals will have innate biases, even internalised unconscious beliefs that may not be aware of. This leads to a flaw in treatment, but before that, a hurdle in accessing medical support.

Hidden disabilities like autism are still profoundly misunderstood and target of stereotypes, just like cultures and faiths. In the attempt to become a multicultural society, we lack the critique to question power imbalances and biases. When communication barriers are not addressed for both populations, then who so can we expect the compound barrier to be acknowledged? How autism presents in People of Colour differs from the typical white boy stereotype which leads to schools and health practitioners undermining our experiences and even dismissing our struggles. How do we communicate something that isn’t even tangible to professionals? Let’s not forget the angry or difficult  Black woman label that we get stuck with when we try to be affirmative or challenge perceptions. The consequences are more often than not at the detriment of the service user rather than an improvement for the service provider.

The result of decades of racism is generational racial trauma. This can and will manifest into a lack of confidence to seek help and stand up for one’s rights. Autistics already find identifying and asking for help very difficult, add that to the racial inferiority complex ingrained in one’s mindset, then how do we prosper, or even access care? Recently migrated communities have it worst because of the rise in populist culture in the UK where right-wing narratives have been given too much oxygen. Imagine how many autistic asylum seekers and refugees we need to support and don’t.

That takes me to my next point. The impact of incidents – ones that all of the population are at risk of- is far greater for autistics than neurotypicals. The way we perceive the world which such intensity, coupled with rejection sensitivity hurts our mental health. But then add the layer of race to that. It is known that People of Colour suffer more from multiple deprivations-  abuse, employment, education and medical care barriers. This number is even more disproportionate for Autistics of Colour.- and I don’t even mention gender, gender identity or sexual orientation in this! Depression and anxiety are common results for victims of racial abuse, discrimination and isolation, yet our care providers are unarmed with the empathy and understanding required to provide effective healing support.

Lastly, turning towards the various communities made up of rich cultures and diversity. It’s a sad truth that disability and mental health are still a point of stigma. Identifying hidden disabilities is extremely difficult due to ignorance and arrogance as well as fear of reputation. It is almost like colonisation has left such an inferiority complex in us that we much appear perfect to have value. However, no human can be perfect and we all need to be truthful to ourselves, support our communities and improve our understanding if we want to progress in life. Attributing autism as  bad fortune, ‘evil eye’, black magic, something that will be grown out of, or bad parenting will keep the world from benefitting from amazing Autistic humans who have already contributed to the evolution of civilisation

Life happens to us all, but the outcomes are dependent on one’s characteristics, privilege, and socioeconomic background. Employers, educators, health professionals and government policy all need to account for the disadvantage we, ethnic minority Autistics face, by changing how they operate.

Try Harder

The more I think about it, the more I am feeling pretty pissed off. In fact, I feel it in my gut! Sick with annoyance and helplessness.

You know when you just replay your day when you are trying to sleep? Well the penny just dropped at how awful it was for my psychiatrist to compare how HE managed his work load in his clinic to how I should be managing my work at home, showing me how to prioritise, and telling me everyone can find focus hard, especially working from home.

Good for him. Even I could prioritise my classes because I had a timetable that was pre-set, rigid and a whole day of routine planned around work & kids. He gave me atomoxetine which makes me sleepy and have headaches. So he said either lower dose over the next few weeks or “suck it up” and take psychotherapy seriously.

Where is the NHS booklet on ADHD I gave you? Erm what booklet? Oh is it my memory failing me or yours?

Not even an apology when he realised he had never mentioned to me before!

The reason he gave me medication to begin with was because I would have moaned for them so he just gave them. No ADHD diagnostic assessment that my mental health nurse told me about. Just Ritalin to prove me wrong that I don’t have ADHD because I complained to my GP about his colleague dismissing my request to be assessed for it after he diagnosed my ‘mild autism’. This doctor was trying to be careful with his words about my ADHD … because I took offence to the language used in my ASC diagnostic report from his colleague – so he drew me a pretty sketched linear graph showing the negative relationship between ADHD severity and age.

Thank you for highlighting that my frontal lobe has matured in my 36 years. But I still struggle and telling me to try harder isn’t going to help!

Apparently it’s my fault I can’t sleep because I don’t ‘allow’ myself these choices. It’s my fault that I don’t stick to the home timetable I have made myself. My fault I can’t focus or prioritise.

Well clearly these meds didn’t help you- stimulants – so nothing much I can do.

And this is him knowing the incredible complex domestic situation going on in the background. This is the same doctor who, in 2016, sent me away after talking at me for 20 minutes with beta blockers and advice to ditch the abusive husband to help my mental health (I was suicidal then).

A few months ago, he casually asks about self harm and suicidal thoughts. I told him straight out that the Ritalin was making think even more of self harm and before that in our first meeting I told him I do have suicidal thoughts. His response, well parental suicidal won’t have a good impact on the children, will it? He says to a suicide witness. 🤦🏽‍♀️

Privilege, Much?

Now why would I feel this is an episode of whyte male ableist middle class privilege?

  1. Knowing I have an autism diagnosis, and ADHD, the concept of executive dysfunction didn’t cross his brain! It’s a double whammy! Someone please show him this.
  2. Again more of him talking and assuming/telling me off rather than asking me questions 🙄 “When you are working from home, stick to your schedule and don’t, for example, go put the washing machine on.” There is lot to unpack in that one statement, pertaining to complete lack of understanding of female pressures, esp. brown females who are head of a household.
  3. The same doctor casually told me to end the abusive marriage and my problems will be solved. I had the referral to him due to extreme trauma and suspecting autism (2016). Had he any sort of cultural awareness, he would know how damaging and condescending that ‘diagnosis’ was.
  4.  I did talk about pressures even from my mum of my housekeeping, the role of being mum and the
  5. only adult in the house without structure or accountability and how I just get jammed with decision paralysis. Just write your list down, stick to your schedule…He mentioned some technique where you prioritise what’s on top of your paper file… haha he is assuming I have a neat pile! And what about electronic docs, files, work? How can I arrange that in a priority pile?!
  6. Clearly he has no clue of the interaction of ADHD behaviours with female hormones. Of course i have learned strategies, masking and have a grown my frontal lobe. But oestrogen levels also have an impact, regardless of age through menstrual cycle and then pre-menopause and menopause. Dr Amen explains it well here.

This is 2021, in the Western liberal and educated world. What will it take for an autistic woman to get real help! I finished writing feeling more angry than when I started but I needed to write it out. 😭😭🤬