For the females: Does anyone else have issues with tdocs that dismiss you entirely?

[Anodyne Oblivion]

Any time I finally get the nerve to talk about something that's been bothering me, I feel like I am not taken seriously.  The only thing I can figure is that I'm not sobbing in front of them or having a hissy fit, so they assume it's not a big deal.  I dont' know how other people act when they're in that room; I certainly show little emotion other than occasional pessimism and chronic irritation.  I have now brought up the ASD issue with FOUR counselors and everyone just dismisses me.  One gave me an ADHD questionnaire and never gave any others because he was already 'sure' it was ADHD before I even took it.  Nevermind the fact that I barely knew what he looked like on account of never looking anyone in the eye.  'Cause that's totally normal, right?   ..................

 

I don't know if it's a problem of no one taking me seriously or that they see the behaviours in me but don't think there's any point in an assessment so they don't move the conversation in that direction.  But I would think that having a PDD-NOS or ASD diagnosis would be helpful, no?  Or does it just not matter when you're in your 30s?  I've learned to cope.  Kind of.  I dunno.  I feel like my introversion is my downfall.  I have a "rich inner life" as they say, and almost everything is on the inside.  I was in torment for a very long time and no one suspected much because I do not act out.  I have no arrest record.  I was never suspended in school or got in fights (mostly because I put up a very intimidating persona and people weren't keen on finding out if it was a bluff or not.  It mostly wasn't.  So good for them I guess.)  I bury everything deep down because that's where I am.  And part of that is because I take a long time to process emotion.  So I have to give it time to rise to the surface; if it came out too soon, I'd say horrible things to people and later regret it. 

 

So do other women here find that they are commonly dismissed?  That you aren't taken seriously?  Even by other female tdocs?  Have you found a way to counter this?  How do I get them to take me seriously?

 

The furthest I've gotten was at my last appointment....she decided she'd 'read up' on sensory integration issues.  Which I guess is better than nothing.  But not much.

I finally got her to that point by highlighting the point that 2/3 of my siblings are on the spectrum (& I wouldn't be surprised if both parents are.  Father for sure.  His whole life has been spent imitating others because he has no idea what he's supposed to do.) and that I had a meltdown over normal (but loud) household noises that resulted in head bashing and nail digging because I couldn't handle it.  I told her I wasn't trying to hurt myself.  And she believed me (yay!).  And I explained that it's like when you stub your toe really hard and to help cope with the pain, you bite your hand.  It makes no sense on the surface, but in terms of overwhelming sensory input, it is less nonsensical.   Should I even have to explain myself?  Or is she just conversing with me and acknowledging what I'm saying? (rhetorical question)

 

I need to find a new place, but I'm so beaten from repeated failure.  Every new tdoc requires a rehashing of the misery I endured growing up and it triggers me.  And I go through all of it for nothing.  Because they're all the same.  Feckless chairwarmers that apparently know less about psychology than I do. 

 

I can't even think straight today.  Sorry if I'm rambling or if this is hard to read.

 

 

 

[Wooster]

I wonder if you'd have better luck with a neuropsych evaluation from someone who can do testing in addition to talking.

[Hadeharia]

My issues related to being on the autism spectrum were completely dismissed by my former therapist as well as other mental health professionals who saw me when I was in the hospital. This particular therapist diagnosed me with a personality disorder and declared that I had a hindsight bias when I told him about the autistic symptoms that I had as a child. Although I wouldn't say that she dismissed me, I was also misdiagnosed by a neuropsychologist who specializes in autism. She had her assistant administer a few general neuropsychological tests but didn't delve deeper by giving me tests that specifically determine whether or not someone is on the spectrum. She wasn't a bad neuropsychologist, but her assessment was incomplete.

I believe that being female prevents a lot of autistic women and girls from being properly diagnosed. I was misdiagnosed with several conditions before my autism was recognized for what it is. It can take a while to find an appropriately trained professional who's familiar with how autism manifests itself in adult women. The psychologist who diagnosed me didn't feel a need to test me because she seemed to think that I was a fairly obvious case, but I asked her to administer the ADOS so that I could have an official sheet to show people who questioned my diagnosis, and I'm glad that I decided to do that.

I wish you the best of luck. I hope that you're able to get an accurate diagnosis in the near future.

[Bam]

Even with the elevated interest & study on Autism in the past 20 years, it is still widely misunderstood as a whole. However you must admit the understanding has grown since the 'Refrigerator Mother' theory. Still, the information & understanding of Autism is few & far between.

 

The new ASD diagnosis was thought to help a bit on the different diagnosis of male & female Autistics; where it would more widely describe & diagnose different types of Autism. Thus, it being diagnosed a spectrum and not a list of specific symptoms & characteristics. It yet however, has not met it's future of having a wider diagnosed spectrum. ATM it seems as if professionals are still recognizing Autism as it's specific stereotypy & manners of a specific type of individual. And it just happens that that specific type of individual professionals are still going by, is a moderate manifestation of social & emotional deficits of a male child.

 

Basically, I completely understand. I have been dismissed many of times before I was seen to be on the Autism Spectrum. Being a young adult female, and getting by in life pretty damn good, professionals never took my daily social & intellectual struggles seriously. My odd social & emotional characteristics were often seen as schizotypal & anxious rather than developmental, even though with those symptoms I also had the 'typical' signs of early reading, sensory sensitivities & a different approach to verbal & physical communication.

 

I do hope someday all people on the spectrum will be recognized & helped with proper interventions for that individual. And even though the understanding is getting a bit closer, it is still a bit away from getting the time & attention it deserves.

[vondick]

Oh bejesus yes yes yes. Honestly I find this in a lot of medical areas. I never realized until I started hearing stories of my boyfriend visiting the doctor that I was treated entirely differently than him and so many people have been just- incredibly dismissive. Yes- dismissive, that's it.

 

In my assessment I tried to push really hard for them to look at the differential presentations of women on the spectrum. It wasn't mentioned at all, even though I provided them with pages and pages of information why I was there in the first place- instead I was told that I was "just a lovely girl who's a bit too hard on yourself". That's the impression I get a lot- like- oh.. muffin. And it doesn't matter how much I try to talk about how I'm not being taken seriously, honestly I think it just makes a lot of people take me even less seriously. Like everyone making judgements about me without taking my personal experience into account is MY fault. And we aren't talking I'm telling my therapist that the sky is green and I do the twist while flying here, they aren't performing some sort of necessary third party intervention that requires me to be rendered wrong. Just everyday dismissive attitudes.

 

When I first realized I was on the spectrum, and the reason why it was never caught was because I was a girl- and specifically because girls are socialized entirely differently, it blew my mind a bit. And really aided in turning me feminist, or rather letting me admit that. If you are a woman you are likely used to be treated like you are crazy, whether you have any actual difficulties with mental illness or not. So throw that in, and you are just going to be treated even less like you have anything worth saying. I was going to counseling to work on real things, and I left feeling like I'd just spent months being gas-lit.

[Bam]

It's so true how women present symptoms of ASD differently. There has been study after study rearing towards this topic. And it makes complete sense, girls & boys are taught different ways of socializing & coping.

 

For instance: If you move a child to a different school and a boy acts up to cope its "boys will be boys". When a girl acts up, it is seen as misguided.

 

When we are taught these kinds of ways of acting & coping at a young age, we will learn to act & cope differently. I don't understand why professionals fail to see how environment can change the presentation of ASDs.

[vondick]

I find a lot of people from all walks and life, man or woman, like to pass blindly by the differences in socialization, handling and punishment of the different genders.

 

Not to leave people out with the man and woman talk, but honestly I have yet to find someone who identifies as something in between who isn't strikingly more aware of the differences than most.

 

Honestly though, I find the differences absolutely fascinating when applied to the spectrum. Hands down, it's been the best tool I have when explaining to people that I am on the spectrum, even though I might not look like what they expect autistic to look like. As soon as I explain it a bit, everyone just stops, thinks, and says: "Now that you mention it, I've never met an autistic woman/girl." My grandmother, who is a teachers aide who worked exclusively with severely disabled/learning disabled and spectrum kids for over 15 years told me that she had never ever been assigned or seen an autistic female in all of her experience in multiple schools (almost 30 years). What does that say to you? Girls all over are being completely missed. And I might be able to pass (sort of laughably in a way that people either love me or just leave me alone) as normal, but I'm definitely still on the spectrum. And I feel like there are women all over the world in the same situation.

[Mirazh]

I'm not a woman but I was assigned female at birth and docs invariably consider me as such unless I Out myself to them.  Of course it's impossible to tell but I think many of them, though trying to be respectful, still see me as female regardless.  Eh.  Such is life for a trans person.

 

I do fit a lot more of the "autism with girls" symptoms and yeah I think a lot of that is perhaps tied to the socialization aspects of growing up being perceived as female, though I tended to try and assert in my friendships and similar to basically be treated as "one of the guys" anyway.  I do think this is why I wasn't diagnosed for so long.  I also sometimes wonder about guys who exhibit symptoms found more in autism in girls, if they exist (seems very possible to me,) if they're equally missed, because of the different presentation... I don't know.

 

I haven't experienced much (yet) with others not taking my autism specific symptoms seriously, at least from medical professionals, because it hasn't really been coming up yet beyond discussions with my pdoc who does take me seriously.  I've experienced it with people though, because I don't fit the more "classic symptoms" in some ways and they just seem to find it hard to believe that yes, I am actually autistic.

 

In other ways though I think it has lead to difficulties with medical professionals regarding, say, my BP or anxiety.  I can have difficulty telling what I am feeling and some of the earlier treatment I was receiving for anxiety was incredibly frustrating because I would be routinely asked to check in with what I was thinking/feeling.  CBT really helped me break a lot of that down though, and practice.

 

When I've had to check myself IP I can encounter plenty of issues, both in the check-in process and once I'm there.  I can be very direct, matter-of-fact, etc.  And I apparently have a lot of insight but seriously, a lot of it seems logical you know?  The first time I went IP they tried to send me home rather than admitting me, accusing me of not being ill enough to require an IP stay, though my pdoc had instructed me to check myself in.  It took a bit of advocacy and also saying that my pdoc had told me they could call her if they still had doubts, but they admitted me.  The second time I went IP I was a bit more cognizant of what I needed to say in order to get admitted, key words and all that, "I am a danger to myself," blah blah blah.  They still don't seem to know what to do with me.  The IP pdoc accused me of "mental masturbation" and I was flabbergasted, like seriously dude this is the glorious insight that my pdoc and gdoc and former therapist praised me for, it fucking helps me recognize when shit is getting really bad, it helps me override what my mood is telling me because I at least logically know that if I'm experiencing x, y, and z, it's time to contact the doctors, and follow their instructions, because that's what I'm supposed to do in that situation.  That second time as well they just seemed really floored at my matter-of-fact attitude about WHY I was there.  To me it was pretty fucking simple.  I entered a suicidally depressed episode, I needed a place to keep me safe while I had a medication adjustment, likely the divalproex since bumping up the dose had worked to eliminate depression in the past, based on at least two instances I know it takes about three/four days to kick in after the dose change.  (And in the back of my mind, if that didn't work, hey time to try something else, maybe bump the dose again, maybe add something on, whatever, part of the process right?)  And they just... didn't really seem to get it.  I was slapped with a Dx by the IP pdoc that my regular pdoc assures me I don't have, based on a few data points that are easily explained by my other diagnoses.  I was instructed to attend the group therapy sessions which I found boring because I'd learned all that shit in CBT already.  My request to the nurses running the groups about helping to keep me directed thanks to my ADHD and related issues led to a lecture on needing to pull my own weight and not expecting them to do everything for me (like seriously lady, I may have forgotten to add that reassurance in but SERIOUSLY?  I do try, fuck.  I try very hard.  I was asking for a bit of help, remind me if I'm talking too much and I'll instantly shut the fuck up, you know?)  Drove me bonkers.

 

I'm really not a fan of that ward and recently learned it's the only short-stay ward in the city.  I'm seriously hoping the next time I get a breakthrough episode I'll just be able to manage it at home while working closely with my pdoc, but of course if she tells me to go check in I'll follow her instruction in a heartbeat.  Because I trust her and she bloody well listens to me.

[Mirazh]

Note about socialization as a child and being trans:

 

This won't fit every trans person, but.  It would be incorrect to presume that because I was assigned female at birth that I was "socialized as a girl."  While yes the outward perception of myself by others definitely has an effect on how they correct me, encourage me, etc.  My inner sense of what I look to for role models of behaviour and who I identify with have always been different.  It can create an... interesting effect.

 

I think it's a combination of the pressure from the outside, and the fact that I identify as a very feminine guy, basically, that leads me to more of the "female with autism" symptoms than anything.  I've also wondered, as a carryover from some wondering with ADHD, if hormones might not also play something of a part in this, at least with adults, (which is something I'll get to test first-hand, eventually.  Just with me but anyway.  If there are differences from hormones I know it won't erase my years of inner and externally applied socialization stuff, but I am curious if there will be an effect on my symptoms since hormones are neurotransmitters and all.)

Edited October 20, 2013 by Mirazh