In the previous post I talked about my autism diagnosis, which arrived at fifty-one. Here I want to add two reflections that matter to me: one uncomfortable, about how I got there, and one practical, for anyone asking themselves questions about who they are.
The privilege of a diagnosis
Let's start with a concrete fact: I paid for my assessment out of pocket, just over 500 euros, at a private clinic. Not because I wanted to skip a queue, but because within Italy's National Health Service (SSN) a diagnostic pathway for autism in adulthood is, in practice, almost nonexistent. Services are designed for childhood development; past that threshold, an adult who suspects they might be autistic runs into endless waiting lists, staff untrained in how autism presents in adults, or simply nothing at all. At best, you get bounced from one clinic to another.
I could afford those 500 euros, and that makes me privileged. But a diagnosis shouldn't be a luxury good. For those without that means, the question "am I autistic?" goes unanswered for years, or forever. And left unanswered too are the anxiety, depression and burnout that often pile up on top of a way of functioning that was never recognized, with human and economic costs that end up falling on everyone anyway.
I understand the SSN has enormous priorities: oncology, emergency care, chronic illness. But mental health isn't a nice-to-have, and research even less so. In Italy, public healthcare and research have been ground down by decades of cuts, precarious employment and brain drain, and the responsibility for that is shared across the board: every government has had a hand in it, regardless of color. And here's where, as a citizen, I want to say something plainly: the political factions that take turns in power, whether they call themselves center-left, center or right, have for a long time answered to the needs of oligarchies, not to those of the people. It's not about rooting for one team over another; it's that as long as we keep handing a blank check to those who've shown they don't care about public healthcare and research, the results will always be the same. Mental health that's accessible to everyone gets won by demanding it, by informing yourself, by pushing from below, not by renewing trust in those who dismantle it.
You don't need a diagnosis to start taking care of yourself
Second reflection, more practical and more important. A formal diagnosis has value: it gives things a name, it opens doors (where they exist), it brings order. But it isn't a prerequisite for starting to understand and treat yourself better. If you recognize yourself in some of these traits, what I've learned about how I function holds true even without an official stamp: reducing sensory overload, communicating your needs explicitly, respecting recovery time after social situations, no longer reading as moral failings what are actually neurological characteristics. All of this you can start doing right now.
The internet, if you pick the right sources, is full of solid resources. Here are a few to start with:
- National Autistic Society: autism.org.uk: the UK's leading autism charity, with evidence-based information, guidance on what an adult diagnosis involves, and a directory of assessment services. Useful for understanding what's out there, publicly or privately, near you.
- Autistic Self Advocacy Network (ASAN): autisticadvocacy.org: an advocacy organisation run by and for autistic people, built around the motto "Nothing About Us Without Us," grounded firmly in the neurodiversity paradigm.
- Embrace Autism: embrace-autism.com: founded by autistic people, hosting free versions of the main self-screening tools: RAADS-R (Ritvo Autism and Asperger Diagnostic Scale, Revised), AQ (Autism Spectrum Quotient) and CAT-Q (Camouflaging Autistic Traits Questionnaire), this last one specifically about masking. A caveat: these are screening and self-knowledge tools, not diagnosis. But they're a solid starting point for figuring out whether it's worth digging further.
- Autistic UK: autisticuk.org: a grassroots, autistic-led organisation campaigning on rights and running local groups across the UK. Similar peer-led communities exist in many other countries.
To these I'd add books: there are now plenty, written by autistic adults diagnosed late in life, and reading experiences similar to your own is often worth more than ten clinical papers.
The point is this: understanding yourself doesn't require permission. A diagnosis, if and when it arrives, confirms or corrects; but the work of understanding how you function and building yourself a life compatible with your nervous system, you can start today, for free (or nearly), on your own or with the help of a community. It took me thirty years to get here. I hope whoever's reading this takes less.