Diagnostic arbitrariness and NO, not everyone is "somewhere on the spectrum"

["Somewhere on the spectrum" here is "somewhere on the autism spectrum," or variants on the theme of claiming everyone to be a little bit autistic.]

Autism diagnosis can be pretty arbitrary. There isn't a blood test. There are genes that are associated with an increased probability of being autistic, but that's not the same thing as a gene "for autism" or a genetic test. We don't really ask about the internal experience of being autistic, either. Instead, we basically have a behavioral diagnosis: if you do X, Q, and W, but not A or B, then we're going to conclude that autism is the proper label. C makes us wonder if you might really have some other thing, but we won't rule out autism if you don't meet the rest of the criteria for that other thing. (Or, we shouldn't.)

Since autistic behavior is a subset of normal human behavior, this gets messy. Autistic people might tend to stim in characteristic ways, but everybody stims, and sometimes we're just getting in extra trouble for a way of stimming that is actually pretty common. Think about fiddling with a pen or pencil as an example of us getting in extra trouble for something most people will sometimes do.

That means edge problems. Where, exactly, are we putting the line between two neurotypes? The location of the line changes when we change the diagnostic criteria - that's always a big topic of discussion around DSM changes. Telling people who seem to be near an edge that they are definitely on one side or the other of that edge, based purely on external behavior, will lead to mistakes. Some of these mistakes will be harmful.

Any categorization scheme dealing with people has to deal with the reality that no two people are exactly alike. Not every single person is easy to classify. Our nervous systems didn't read the textbooks while wiring themselves! There are people who fit equally well (or equally poorly) in several categories. The problem there is with the textbooks, and the inevitable incompleteness of categorization systems. MASSIVE harm is done when people treat the problem of not fitting the classification system as being with us instead.


Oh, and let's not pretend that everyone diagnosing autism (or any other neurotype) actually understands the neurotypes they're diagnosing. Plus there's problems from people taking advantage of their positions of power, or otherwise acting in bad faith. Sometimes, things are intentionally done wrong.

Now, all of these issues are real. I've seen people use some combination of these issues to argue that everyone is somewhere on the spectrum, and that's where the problem is. "Some people are hard to classify" doesn't mean "everyone is hard to classify" or "everyone is somewhere on the spectrum for neurotype Y." On a similar note, "The person who diagnosed me incorrectly with X didn't understand X or my actual neurotype of Y" is different from "X doesn't really exist" or "Everyone is really Y." In each of those cases, the first statement is true. The second and third statements are not, and actually look a lot like diagnostic arbitrariness themselves. (They can certainly hurt people in similar ways to diagnostic arbitrariness around the edges of definitions.)