Are we over-diagnosing neurodivergence?
The number of neurodivergent brains hasn't changed. What's changed is how little room society leaves for us.
Published 1 September 2026. Written by Dr Chris Worfolk.
Is society over-diagnosing neurodivergence? It's a hot political topic right now, and in this article I want to answer that question properly. But if you don't want to wait, the answer is "no". This article is based on my video series on the same topic.
Some people are asking "why are we seeing such an increase in autism and ADHD diagnoses?" That's a good question to ask. Rates of identification have risen significantly. And there are three obvious answers to this question: have we historically been under-diagnosing, are rates actually increasing, or is it now being over-diagnosed?
I'm going to take each of these in turn.
Part 1: Have we historically been under-diagnosing?
The answer is yes, and the evidence for it is strong.
We decided neurodivergence was a boy thing
Initial research on autism in the Soviet Union identified both boys and girls with autism. But over time, autism and ADHD both became seen as a boy thing. It was assumed girls weren't neurodivergent. That's partly because boys tend to have an external presentation: they don't talk to anyone, play with trains all day, and bounce off the walls, to use a few stereotypes.
Researchers saw this, assumed it was a boy thing, and calibrated all of their diagnostic instruments to this external presentation. Which then reinforced the gender difference, because we were only diagnosing "boy" autism and ADHD, and weren't even looking at women and girls.
Social standards play a role too: boys are given more leeway to act out, while girls are more likely to be told to be polite, behave and focus on feelings.
Masking, and what it costs
This led to many women and girls masking their symptoms: spending huge amounts of effort covering up their autistic and ADHD traits so that nobody noticed.
The problem is that this takes a huge toll on our mental health. Many late diagnosed individuals have a long history of mental health issues: from treatment-resistant anxiety and depression to labels such as bipolar disorder and borderline personality disorder.
Today, we have a much better, but still incomplete, understanding of how neurodivergence presents in high-masking individuals, and in women and girls. We're also gaining a better understanding of how it presents in minorities, who may have to wear multiple masks at once to keep themselves safe.
All of this means that we've basically missed most of the neurodivergent individuals, because we weren't really looking at women and girls, nor at high-masking men and boys.
You couldn't be both autistic and ADHD
On top of that, until 2013, you couldn't be both autistic and ADHD, also known as AuDHD. Each one precluded the other. So even if your neurodivergence was picked up, you could only get one diagnosis — and often having both, which is around half of neurodivergent individuals, means you don't quite hit the criteria for either, because nobody knew what AuDHD looked like.
Awareness and stigma
Public awareness has also helped a lot. Many people simply never considered neurodivergence before, but now that more people have heard of it, more people are spotting the signs.
Stigma around neurodivergence is also reducing, so individuals are more likely to come forward and get a diagnosis now.
We missed it in women and girls. We missed it in minorities. We missed it in high-masking individuals. We missed it in AuDHD individuals. We have loads of catching up to do. Increased public awareness and reduced stigma is also causing more people to request an assessment, and that is why diagnostic rates are going through the roof.
Part 2: Could neurodivergence rates also be rising?
Here I want to be a bit more speculative, and talk about why neurodivergence rates may also be rising. Specifically, I want to make the case that the underlying prevalence of brain differences is not changing, but that more people are being pushed into the category of a "disorder" because society is disabling them.
There have always been neurodivergent individuals. Folklore stories make reference to children seemingly without emotions. It's not a new thing. But in modern society, it has become more of a problem, not less.
Disability as a modern invention
Michael Oliver talks about this in The Politics of Disablement: disability as a category only meaningfully appeared when we moved to industrialisation.
If we think about an agrarian society, things were much more flexible. In family groups and small communities, impairments and differences could easily be absorbed into the community. Life was also more active and yet also more routine: you worked on the farm, you never travelled abroad, you knew everyone in your life. It worked well for many neurodivergent individuals, and could easily cope with most differences.
Modern society is different, though. It's much more constraining. Most jobs in advanced economies require sitting still in school for the first twenty years of your life, then sitting still in an office while you talk to people on a video chat.
The clothing analogy
This isn't just a problem for brains. If we think about body shapes: when all clothes were handmade, you could be any size. But once mass production came in, clothes were made in standard sizes, and if you didn't have the correct body size, suddenly buying clothes became a whole lot harder because nobody makes anything in your size.
The same thing is happening to neurodivergent people: as we standardise the type of brain we need in society, more and more people fall outside of this box. It's not that people are changing or becoming more autistic or more ADHD, it's that what society will tolerate as normal is increasingly shrinking, pushing more and more people into the neurodivergent category.
If you want to deep dive into the philosophy of this, I recommend reading One-Dimensional Man by Herbert Marcuse. But only if you like philosophy books, because it is hard reading.
Modern society, then, is creating more disabled people — not because people are changing, but because society is becoming increasingly inflexible. The rate of difference in brains remains the same, but the rate at which society disables people is increasing.
Part 3: The case for over-diagnosis
The over-diagnosis argument comes in two main forms: that the diagnostic category has become so wide that everyone is included, and that TikTok diagnosis has led people to imagine they are neurodivergent. Neither holds up.
A note before this section: we're going to touch on suicide.
"Women are just socially anxious"
It's been suggested that women are simply socially anxious rather than autistic. We know this is not true because of the extensive research around masking. Women report they have the same internal experience as those with an external presentation, but keep it hidden. Camouflaging is measurable, it shows a consistent gender pattern, and higher camouflaging scores predict worse mental health outcomes.
"Mild autism isn't real autism"
Then there is this idea of "mild autism" that isn't the same as "real autism". This I find really frustrating, because it suggests that high-masking individuals have it easy. But I've lost count of the clients I have worked with who have multiple suicide attempts because they just couldn't take it any more. These are not the actions of someone who is a little bit anxious: these are people really hurting.
The funding concern is real
This argument does raise a meaningful issue, though, which is that as we diagnose more people, there is a real risk that the funding gets diluted. And if you have higher support needs, such as struggling with personal care or being non-speaking, or you are the parent of someone with these support needs, you are very understandably worried about such a dilution.
But it is also true that support needs are real and varied, and they don't map neatly onto how visible someone's autism is. Someone can appear to be coping and be in genuine danger. Recognising that doesn't take anything away from people with high daily care needs: it is challenging the idea that we can only offer limited support in one of the richest countries in the world.
"It's all TikTok diagnosis"
It's also worth being clear that people may be diagnosing themselves on TikTok. But to get a formal diagnosis you need to go to a clinical professional and be assessed. These assessments often involve either long waiting lists or a big expense to go private. Both the ICD and DSM definitions of autism and ADHD require impairment, so it is difficult to argue that "everyone is a little bit autistic now" when you have to prove you are disabled.
This phenomenon is much better explained by greater awareness and education. Because if you want to argue people are making it up, you have to explain how an entire generation of women and girls started imagining the same thing at the same time, in a highly coordinated way — and why so many of them are simultaneously in enough distress to try to kill themselves.
Research also supports the idea that self-diagnosis is often accurate: most adults who suspect they are autistic and go through assessment are confirmed. These labels remain meaningful measures of disability.
So, are we over-diagnosing neurodivergence?
No. We are still almost certainly under-diagnosing it, rates may continue to rise as society becomes less flexible, and the arguments for over-diagnosis do not survive contact with the evidence.
I want to close by saying this isn't a bad thing. Recognising more people doesn't mean more suffering: it means more understanding. And what we're learning is that the human race is more diverse, more interesting and more multi-talented than we thought. Neurodiversity, like genetic diversity, is something to celebrate as well as support.