“Autistic Person” vs “Person with Autism”: What’s the Difference? | A Neurodivergent Therapist’s POV
As the mental health field updates its understanding of autism to be more affirming, more and more adults are realizing that they’re autistic – leading to a growing community of late-diagnosed neurodivergent people. Let’s explore the difference between identity-first and person-first language, and why many members of the Autistic community prefer identity-first language.
What is Autism?
Autism is a neurotype, or a type of brain-body system. According to Embrace Autism (an online source of high-quality information on autism, founded by autistic researchers Dr. Natalie Engelbrecht and Eva Silvertant), autism is:
“a neurodevelopmental difference characterized by alterations in social functioning, hypersensitivity to stimuli, repetitive behaviors, and deep interests—often combined with advanced cognitive & perceptive abilities”
Autism can encompass traits such as:
preference for routines & familiarity
monotropism (tendency to focus attention on a small number of interests, which uses up much of the brain’s processing resources at a given time)
sensory differences (due to highly sensitive nervous system)
special interests & strong passions
natural tendency to recognize patterns and analyze/create systems
social differences (difficulty reading neurotypical, aka non-autistic or allistic, social cues)
differences in processing speed and style
difficulty switching tasks or starting new tasks (due to autistic inertia, the tendency to want to remain in a constant state)
divergent, out-of-the-box thinking
Formal Diagnosis vs. Self-Diagnosis/Identification: All Options are Valid
The journey of autistic discovery is complex and highly personal. There are several paths to understanding oneself, and each is equally valid.
A formal diagnosis from a qualified professional can provide a clear framework for understanding oneself and accessing support, such as workplace accommodations.
A diagnosis can be particularly validating for individuals who doubt their own experience or have an “imposter syndrome” part that wonders if they’re “really” autistic (and therefore if they have the right to request certain accommodations).
However, a formal diagnosis can also come with barriers.
…such as financial cost, the potential consequences of having a diagnosis on your medical record, and difficulty finding a neurodiversity-affirming assessor.
(Unfortunately, many mental health practitioners still hold outdated and harmful beliefs about autism, viewing it as a disorder that needs to be cured or fixed.)
Additionally, there are individuals whose autistic traits may get overlooked or misinterpreted by assessors due to the complex intersection with other identities, such as gender, race, culture, religion, ability/disability, and other neurotypes (ADHD, giftedness, dyslexia, OCD) and mental health conditions (anxiety, depression, PTSD, complex trauma) – making a formal diagnosis of autism even more complicated or out of reach.
Meanwhile, self-diagnosis/identification involves recognizing and embracing one’s autistic traits without seeking a formal diagnosis.
An equally valid option, this allows individuals to connect with their experiences, identities, and autistic community on their own terms.
Self-diagnosis has a high rate of accuracy among individuals who later receive a formal diagnosis.
Ultimately, the most important thing is following the path that feels right for you. Regardless of whether you’re autistic or not, or whether you have a formal diagnosis or not, know that you have the right to access accommodations and to advocate for your needs (sensory, emotional, physical, and more).
Is autism a type of neurodivergence?
Yes, autism falls under the vast umbrella of neurodivergence — a term describing individuals who think, communicate, process information, and navigate the world differently from what is considered “typical.”
Autism can overlap with ADHD, giftedness, high sensitivity, and other neurodivergent conditions.
Therefore, a person can be multiply neurodivergent; and they may choose to describe themselves in any number of ways:
“I’m autistic.”
“I’m neurodivergent.”
“I have an autism and ADHD diagnosis.”
“I’m autistic and ADHD, or AuDHD.”
“I’m highly sensitive, gifted, and neurodivergent.”
and so on…
Due to the challenges of being neurodivergent in a neurotypical world, autism can also co-occur with mental health conditions such as anxiety, depression, addiction, PTSD, and complex trauma.
Identity-First vs. Person-First Language
So, what’s the difference between saying “She’s autistic” vs. “She has autism?”
IDENTITY-FIRST LANGUAGE
Saying “She’s autistic” denotes a way of being that is inextricably linked to one’s sense of self.
In fact, the word “autism” is derived from a Greek word, autos, meaning “self.”
Many members of the autistic community prefer identity-first language (“I’m autistic” or “I’m an autistic person”), experiencing autism as an integral part of their identity.
The term can be written as “autistic” or “Autistic,” with the capitalized version reflecting a sense of Autistic culture and community.
PERSON-FIRST LANGUAGE
Saying “person with autism” denotes that autism is a condition separate from one’s sense of self. While this approach is often used, many members of the autistic community find it clunky or inaccurate, as if autism is simply a suitcase one carries rather than a fundamental aspect of one’s being.
Of course, there are autistic people who choose to describe themselves with person-first language: “I have autism.” Other variations include: “I’m on the spectrum,” “I’m diagnosed with autism,” or “I have an autism diagnosis.”
It’s essential to respect individual preferences. Typically, the best practice is to mirror the language that each person uses to describe their own identity – and to check in with them if you’re unsure (“how would you like me to refer to you?”).
Why is person-first language not generally preferred by the autistic community?
Phrases like “She has autism” can be compared to phrases like “She has a fever” or “She has panic attacks.”
They imply that the condition is an inconvenient occurrence, and something to be fixed or cured.
When a non-autistic (allistic) person describes someone else with person-first language – “She has autism” or “This person has autism” – it may come with a hushed tone of trying to downplay the other person’s autistic traits, with the underlying assumption that being autistic is “bad.” This is no doubt influenced by pathologizing messages about autism in mainstream media.
Many neurotypical people are unaware that folks in the Autistic community are comfortable, content, and even proud of their Autistic identity, and do not desire to become more “typical” or “normal.”
Bottom line: You are welcome to identify yourself in ways that feel most comfortable and authentic to you, whether that involves a specific label(s) or not.
The way you choose to identify may shift across time, as you come to understand yourself more deeply and connect with the people and communities who “get” you.
Looking for a neurodiversity-affirming, autistic therapist who can support you in navigating your neurodivergent experiences?
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About the Author
Liz Zhou is holistic trauma therapist providing virtual therapy services in Colorado. She helps highly sensitive, neurodivergent adults and couples heal from the past and connect with their authentic selves. Liz’s specialties include EMDR, IFS, psychedelic integration, and therapy intensives.
