Your assessment says you don’t have autism. You’re beyond crushed and feel more broken than ever. Here’s exactly what you should do next.
I myself received a very late life autism diagnosis almost four years ago.
Finally, everything in my life made sense!
I’d been gunning for that ultra-affirming diagnosis like mad, and the two-week wait for the results was agonizing.
I didn’t know what I was going to do if the results said I wasn’t on the Spectrum.
The first thing you should do, if the psychologist gives you a different diagnosis (you’ll likely get some diagnosis if it isn’t autism) is tell yourself, “This is just one person evaluating me. They could be wrong.”
Like medical doctors, psychologists who administer autism assessments could make a misdiagnosis.
Many skeptics don’t have faith in psychology and don’t see it as “real,” since there aren’t any blood markers or imaging tests that can confirm ASD.
Ironically, they’ll have faith in physical medicine, even though many diagnoses are made on the basis of exclusion rather than directly from test results (e.g., irritable bowel syndrome, fibromyalgia, atrophic cervicitis with contact spotting).
The absence of concrete testing for ASD in no way means a second opinion wouldn’t be worth it, just as in physical medicine, when my father sought multiple opinions regarding knee pain, for which each doctor gave him a different diagnosis.
Don’t let anyone talk you out of a second opinion, no matter how much it’ll cost.
In fact, my advice is to avoid telling anyone you’ll be seeking a second assessment from a different psychologist.
Why an Autism Diagnosis Is So Meaningful to You
Nobody has the right to attempt to invalidate this.
Finally knowing the reasons behind your past internal experiences and outward behaviors will provide you remarkable insight going forward so that you can more effectively carve out your future.
For many individuals, a self-diagnosis only just isn’t enough, such as with myself.
Furthermore, an official diagnosis can get you support you normally wouldn’t get, such as workplace accommodations, early seating on planes and being excused from jury duty.
However, even if you aren’t aiming to get support or perks, or intending on using an autism diagnosis as an excuse for behaviors that are off-putting, that formal stamp of diagnosis will still be empowering and incredibly validating.
This can be summed up in four words: I am not defective.
Why You Were Denied an Autism Diagnosis
Read your report thoroughly to find out why. It may not even be clarified, though, so you have every right to ask the examiner why they believe you fall short of the ASD criteria.
The reasons they cite should come straight from the DSM-V (psychiatric condition diagnostic manual).
If they give you reasons such as the following, they are very outdated in their thinking and not basing these reasons on formal diagnostic criteria set forth by the American Psychiatric Association:
- You’re married.
- You have kids.
- You’ve been in a professional line of work longstanding.
- You’ve always lived independently.
- You didn’t have an IEP during your primary school years.
- You don’t have a special interest.
- You denied having meltdowns and shutdowns.
- You gave the examiner eye contact.
- You claimed to have close friends.
How to Seek the Second Diagnosis
I was inspired to cover this topic by reading stories of denied diagnoses in autism threads.
The feeling of being crushed is absolutely real.
• These adults are left wondering if they don’t have ASD, then why are they so different?
• Why do they struggle with relationships or navigating social settings?
• The misdiagnosis of ADHD or only ADHD, or OCD or depression, doesn’t explain most of their internal challenges and outward manifestations of them.
Upon deciding to get my assessment, I knew right away that the examiner should be a woman.
If you’re a woman, my advice is to find a female examiner, even if the one who denied you the diagnosis was a woman.
It’s a fact that misdiagnosis more often happens with women.
Research, such as Kentrou et al, eClinicalMedicine, 2024) shows that autistic women report being misdiagnosed with other conditions before finally receiving an autism diagnosis significantly more often than do autistic men.
In this study, 31.7% of autistic women reported at least one perceived misdiagnosis compared with 16.7% of men, indicating higher misdiagnosis frequency and delayed recognition of autism in females.
But ultimately, whether you’re a woman or man, just make sure that the second examiner has experience assessing adults and, ideally, specializes only in adults.
Second, vet this potential examiner based on the reasons the first one gave for denying you the autism diagnosis.
In my case, I was pre-emptive in that, even before the assessment, I feared the denial (that’s just the way my mind works – perhaps fueled by autistic overthinking and over-analyzing).
I asked the clinic if the doctor I was considering had a lot of experience with assessing women (she did).
At the start of the assessment, I told her I give good eye contact (for the most part; there are glitches in navigating it), and that I’d had only two “meltdowns” in my life at around age 5 and 4 due to loud noise.
But there’s more: This clinic had a pricing tier based on the examiner’s experience. DO NOT GO CHEAP.
She was top tier because she had a doctorate in psychology. The other two had less formal training, and one was a doctoral student.
Extra Considerations
I don’t think it’s a wise idea, or necessary, to voluntarily disclose you had a previous assessment – unless this is asked of you. Honesty is always the best policy here.
Be open to the possibility that any diagnosis you got from the first evaluation will still hold, such as ADHD or OCD.
These conditions often come with autism. In my case, I missed the cut for ADHD, but OCD was detected – and since I met the criteria for Autism Spectrum Disorder, the mild OCD was “built into” that diagnosis, hence my solitary diagnosis of ASD.
If you don’t have the money or cognitive bandwidth to promptly arrange for the second opinion, that’s fine.
You may need some recharging time – time to process the blow, as well as save up money.
A Message to Neurotypicals
Why would anyone be devastated upon hearing they don’t have autism after all?
Shouldn’t they be relieved? Well, not if you’ve lived all your life as an Autist without realizing it.
It’s like being an alien from another planet and living your whole life on Earth – struggling to fit in – forever wondering why a disconnect exists and why “I think differently from others,” and then finally you realize, “I must be autistic! THAT explains it all!”
Imagine realizing you’ve found an explanation for a lifelong challenge, only to be told that explanation doesn’t apply.
There’s plenty of logic behind feeling crushed when you get denied a diagnosis you were hoping for.
