When a medical professional tells me I’m probably autistic, I’m not surprised. I’ve suspected it for over a year now. This diagnosis isn’t even the main reason why I’m here. I’m in this office because my sister was just diagnosed with bipolar disorder and I think I might have it too.
I am sitting in a comfy chair in front of the large brown desk that the medical professional is sitting behind. She has a bookshelf with a bunch of books about psychology, like all of the other mental health professionals I’ve been to. But at the end of this meeting, she will hand me a card that says she’s a physician assistant. I’ve never met a PA who prescribed brain medication before, and I will wonder where the physician who she’s supposed to be assisting is. But that’s not important.
The important part is that she ends up confirming my suspicions, both about my bipolar symptoms and my autistic symptoms. I tell her that I think I might be bipolar and since I’m already here, I figure I might as well get evaluated for autism too. She asks why I suspect these conditions, and I pull out my phone and dutifully read things off from the lists I’ve created in Google Docs that detail my symptoms. She leaves the room and comes back with a few sheets of paper, and she goes down the lists on them and asks me some questions.
Eventually, she diagnoses me with cyclothymic disorder, which is a milder version of bipolar. She also tells me very diplomatically that based on the way I’ve answered her questions and “based on having me here today,” she thinks that “autism is a reasonable diagnosis.” I guess this is a euphemism for saying, “You scored high on this autism questionnaire and I’ve noticed that you have a hard time with eye contact,” or something. I appreciate that she’s trying to be nice about it and not just outright saying that I suck at eye contact or that I seem socially awkward. But part of me wonders whether it would really be so bad if she just acknowledged these difficulties of mine in a polite way.
She says that autism is a reasonable diagnosis and if I want, I can go to a neuropsychiatric clinic too in order to do more testing. I am not interested in undergoing rigorous testing to confirm something I already know, so I don’t take her up on it. (I’ve since gone to get tested, and you can read about my subpar experience here.) I didn’t need her to confirm this, necessarily, but it’s nice to have support from a medical professional that I can use as my “autistic card” if someone doesn’t believe that I’m on the spectrum. She says I am probably autistic. “But,” she says later in the session, “you’re obviously very high-functioning.” She says this as though it is a compliment.
At the beginning of our meeting, she asked me what medications I was on. I told her I was taking testosterone. She asked, “Because of a testosterone deficiency?” I told her yes, figuring that it was technically correct. “Okay. How was it discovered?”
I said, “Through, uh…through me being transgender.”
She grew very flustered and apologized more than once. She told me, “I couldn’t even tell. I mean, that’s a good thing, right?” She said this as she gestured toward me with an open palm, as though I was sure to agree.
“I guess so, for safety reasons if nothing else,” I replied. She didn’t seem to know what to do with that response, and we moved on.
She is not alone in her ideas about autistic people or trans people. I have no idea why many people seem to think that my pride in myself as a trans and autistic person should be based on never seeming like either of those things. They want to show me how accepting they are, because I am able to “pass,” or because I seem “high-functioning.” I am able to pretend to be normal, sometimes. And they think it is such a compliment to acknowledge that and pat me on the back for it.
But it doesn’t feel like a compliment. The word “passing” leaves a bad taste in my mouth. “High-functioning” tastes like disinfectant, like I am being poisoned and sprayed clean of my struggles, not to mention the thousands of microscopic quirks that make me who I am. Both of them taste how I imagine medieval food did when cooks in a castle would use spices to disguise the fact that they were serving rotten meat to the nobles. You can season me so my taste is more pleasing to you, but my real flavor is still underneath. And why would you disguise my flavor when I’m not even rotten? I taste just as good as the food you’re used to, I promise.
I may be an acquired taste, but I’m told that I’m pretty great by a select few. And I taste my best when I can season myself with the words that make me most comfortable. But I am often not at my best, because I disguise myself so people won’t judge me for how I naturally am and limit my opportunities in life. And sometimes people look at this half-me, this false, flickering image filled with static and white noise, and they praise me for it. They like that I stretch their minds, but only just enough that they’re still in their comfort zone.
But if I had my way, I would be fully myself and force them out of that comfort zone, the way I’ve been forced out of mine my entire life. I wouldn’t pretend to be normal. I would be as obviously trans and autistic and mentally ill as I want to be, and I wouldn’t hide from them. I would tell them that it’s not a compliment to say that I don’t seem like myself. And I would tell them that if they can’t handle my natural flavor, they can hand me over to someone who has learned to appreciate it.