Autism as Disorder, Difference, and Identity: The Structural Incoherence of a Hybrid Framework

In the UK, autism is diagnosed with clinical tools, recognised in law as a disability, celebrated in public life as a difference, and explicitly rejected as a disease – all at the same time. This paper asks what happens when those four logics are held together in a single framework.

It argues that the result is structurally incoherent: institutions can move between disorder, disability, difference, and identity as it suits them, which keeps diagnostic authority intact while appearing inclusive. Diagnosis comes to function less as a neutral description and more as a rationing device. The cost falls disproportionately on those with higher support needs, who tend to be left medicalised, marginalised, or made structurally invisible.

The authors make the case for structural honesty – being explicit about what autism is taken to be, what counts as harm, and what outcomes systems are actually trying to achieve – without which autism policy risks remaining rhetorically progressive but structurally unaccountable.