I have recently published a review essay on the politics of neurodiversity in New Formations. The link to the published piece is here.
Below is the preprint version for those who wish to read but do not have access to the journal.
- Robert Chapman, Empire of Normality: Neurodiversity and Capitalism, London, Pluto, 2023, 204pp; £14.99 paperback.
- Nick Walker, Neuroqueer Heresies: Notes on the Neurodiversity Paradigm, Autistic Empowerment, and Post-Normal Possibilities, Autonomous Press, 2021, 191pp; £15.99 paperback.
To get formally diagnosed as autistic as an adult in the UK, one must be referred by a GP. The referral will typically include a screening test, such as a short questionnaire, which will be evaluated via a specialist service (and may be rejected). If successful, you will be placed on a waiting list. Although the National Institute for Health and Care Excellence (NICE) guidance recommends a maximum wait of thirteen weeks, most people wait much longer, sometimes many years. When the time comes, you will be asked to complete an exhaustive questionnaire and then attend an hours-long interview with a qualified professional, with inquiries spanning from birth (caesarean birth is statistically linked to autism) to dietary preferences (many autistic people are restrictive eaters).
Although most autistic people do not consider autism to be a disorder or a disease, NICE recommends that diagnosis is based on the controversial Diagnostic and Statistical Manual of Mental Disorders (DSM) or the lesser-known International Classification of Diseases (ICD). Triangulating these two classification systems will typically generate diagnostic criteria including deficits in social communication (such as abnormalities in eye contact), deficits in social interaction (such as difficulties in making friends), and restricted or repetitive behaviour or interests (such as highly restricted, fixated interests that are abnormal in intensity or focus). If you demonstrate enough of these traits, then you may go home with a piece of paper confirming that you are officially neurodevelopmentally disordered and potentially disabled, thereby opening access to resources such as reasonable adjustments in the workplace and other legal protections. Although it is a process saturated with authority and power, the experience can feel overwhelmingly medical and administrative.
This assessment now brings with it another label. Unlike autism, neurodivergence is not a diagnostic category. There are no ‘symptoms’, no entry in the DSM. And so no one has the authority to confer or withhold its status onto any individual. Neurodiversity is instead a theory that there is a range of difference in brain functioning across the human population. That observation alone is not all that significant. But that changes when the concept is exposed to politics. Hair colour, the health of one’s intestinal villi, or other biological differences do not normally matter to that great game of who gets what, when, and how. But neurodiversity quickly runs into politics as a claim of recognition on the basis of different ‘brain wiring’: that we live in a world designed by and for the benefit of those with ‘normal’ brains; that those who deviate away from these ‘neurotypical’ values and institutions do not fit in and so suffer; and so the result is injustice on the basis of a human specificity, much like ethnicity, gender or race.
The idea of neurodiversity emerged alongside a new wave of digital connectivity in the 1990s, where unique communities were forming on the internet. Among these were groups of autistic adults who shared their life experiences, ranging from navigating social norms about eye contact to delving into their special interests. In 1997, the New York Times highlighted how these groups had coined the term ‘neurological pluralism’ as a new way of understanding the world, marking one of the concept’s first appearances beyond those internet communities. This term, born from discussions among autistics about their interactions with people considered ‘neurologically typical’, suggested a radical notion. What were previously considered social and communicative ‘deficits’ in autism diagnosis could instead be viewed as differences, as situated in the infinite variation of human minds. Some of this thinking was inspired by the ‘social model of disability’, through which it is argued that disablement is a social process rather than just an individual condition. Our physical environment and institutions frequently disable people from fully participating in them; they are the problem, not the impaired person. Autistic activists and thinkers used this approach to highlight how treating autism as a medical problem turned themselves into a neurological other, with autistic traits presented as ‘deficits’ in opposition to the perceived positive attributes of an imaginary normal. This comparison established an arbitrary standard that was deeply embedded within social structures, thereby producing unjust outcomes. The neurodiversity paradigm sought to turn this on its head.
Underlying this emerging paradigm was a transformative reimagining of autism not as a disorder but as a variant in the vast spectrum of human neurology — a different wiring of the brain, so to speak. Such a redefinition paved the way for including ADHD, dyslexia, and dyspraxia under the neurodiversity umbrella, with some advocating for the inclusion of schizophrenia and bipolar in more expansive definitions. In a time still influenced by beliefs that attributed autism to ‘refrigerator mothers’ — middle-class women too absorbed in their careers to provide their children with the nurturing warmth expected of a stay-at-home mum — this idea was revolutionary: diversity over deficits, difference over pathology, divergence over hierarchy.
These two books are significant landmarks in a second wave of neurodiversity theory that advances a more consciously critical neurodiversity politics built on a historical and structural critique of normality itself. Nick Walker’s Neuroqueer Heresies is a collection of essays and blogposts spanning a decade or so, presented more-or-less chronologically. Walker is best known for his 2011 essay on autistic liberation and a series of blogposts that clarify the basics of the neurodiversity paradigm, which helped pave the way for the field of neurodiversity studies. Written with a lacerating clarity, this collection is a major achievement in neurodiversity theory. If the first wave of neurodiversity theorists were inspired by the liberal wing of civil rights movements, then it is perhaps telling that Walker takes her inspiration from more radical thinkers like Audre Lorde. Walker argues that the neurodiversity paradigm is integral to overcoming a hierarchy of pathology that legitimises domination, dehumanisation, and, in the extreme, extermination, each based on deviating away from ‘normal’.
Since this collection proceeds in a rough chronology, one can observe how Walker’s analysis shifts over time. Of particular fascination and significance is his revised positioning on the biological underpinning of neurodiversity. Walker’s earlier work is adamant that neurodiversity is ‘a biological fact’ that refers to ‘the diversity of human minds, the infinite variation in neurocognitive functioning within our species’. This ‘fact’ underpins both a neurodiversity paradigm (a particular approach that foregrounds that biological difference) and a neurodiversity movement (those who politically organise around the recognition and rights of the neurodivergent). Walker’s initial insistence on biological difference reflects the first wave of neurodiversity theory, where this claim was common. Some early theorists defended the rigour and validity of neuroscientific approaches to autism because this expertise helped legitimise autism as a genetic condition rather than one caused by parenting or fixed with behavioural intervention. That neurodivergence is something innate is now commonly accepted. But that does not necessarily mean it is located within brains.
That ‘neuro-’ has become synonymous with the brain despite referring to the nervous system is connected to historical shifts in cultural understandings of the self. The ‘brain’ has become a metaphor for the individual: in the modern world, you are your brain. And your brain can be improved. We are told that learning a language or doing crosswords is a cerebral form of weightlifting. Or that eating salmon and broccoli will boost brain function. Optimising one’s brain is presented as an empowering way to enable personal enhancement, thereby aligning with cultural and political impulses for constant self-improvement and individual responsibility. Within this world there is choice: excel or fall behind, with all the implications that could entail. The biological essentialism of the neurodiversity paradigm offers respite or even an escape from this. Your ‘brain wiring’ is what it is.
Yet as Neuroqueer Heresies goes on, Walker’s commitment to biological difference starts to waver, as if he is slowly working to overcome the limitations of that position. Walker argues later in the book that it is a mistake to speak of ‘diversity among brains’ as it is ‘overly reductionist and essentialist’. Rather than using ‘brains’ as the point of difference, Walker returns to the proper meaning of neuro- as referring to the nervous system, in which a strong distinction between mind and body does not hold. We can instead think of neurodiversity as referring to ‘the full complexity of human cognition and the central role the nervous system plays in the embodied dance of consciousness’.
Recasting neurodiversity as a ‘diversity of embodiment’ is an integral step in developing a performative rather than biological foundation for the paradigm. If one can successfully and convincingly meet and maintain societal expectations without too much pain, then one is judged as ‘normal’. In doing so, one complies with dominant standards, thereby opening access to important resources such as certain jobs, some public spaces, and common romantic and social situations. Whether these people have ‘normal’ brains or not is no longer a relevant question. What matters is that they can fit in and so warrant the label of ‘neurotypical’ as a way of theorising their privileged access to resources.
On the flip side, there are neurodivergents, whose style of embodiment and communication might result in social rejection, discrimination, and worse. Consequently, they will struggle to access the resources readily available to neurotypicals, to the point of significant disablement. Consider dyslexia. It is likely that people have always been dyslexic. But this ‘word-blindness’ impairment was only systematically examined around 150 years ago. Only with the invention of universal education so to produce a generally skilled workforce have all members of society required the ability to quickly process written text. Without recognition of this impairment, mainstream schooling is likely to disable rather than enable a dyslexic child, where they may be written off as stupid or inattentive for their reading difficulties, thereby damaging their life-chances. One solution is to create a more enabling environment by providing accommodations and taking a strengths-based approach. The neurodiversity paradigm pushes this further by theorising that dyslexics and autistics, and others, have a shared interest in challenging neurotypical standards.
Walker pushes the logic of this argument furthest in the third and final section of the book on the concept of ‘neuroqueering’, an idea built in tandem with other theorists including Remi Yergeau. If queering means subverting and transforming heteronormative performance, then neuroqueering means subverting and transforming neuronormative performance. Neuroqueering can mean to be both neurodivergent and queer. But it can also mean to embody one’s neurodivergence in a way that can queer one’s performance of identity understood broadly. In other words, to neuroqueer is to own one’s weirdness, not just to be oneself but also as a political act.
Like Walker, Chapman’s Empire of Normality centres on subverting normality as a focus for neurodiversity theory. Chapman takes a historical approach to exploring the connection between neurodiversity and capitalism. One effect of the book is to flip the now well-worn story of neurodiversity on its head. Most of these now-traditional accounts start with the initial ‘discovery’ of a condition, and then map the resulting struggle: as experts seek to impose their new labels on unsuspecting people so to authorise interventions, those newly categorised people and their advocates find their voice to resist and remake those labels in ways that are less alienating and more empowering. Empire of Normality instead sets out an account of how a standard of normality — which could be read as neuronormativity or neurotypicality — was forged.
With a focus on developments in the UK and US, Chapman’s argument is that capitalism has always produced a standard of normality, but that the particular form of this standard shifts in relation to different regimes of accumulation, from early industrial capitalism to Fordism and beyond. This regulates the kind of standardised labour required by capital but also excludes those who cannot conform to its standards, whether that be an ability to read quickly and accurately or a capacity to stay focussed on repetitive and mundane tasks. This process creates and sustains a naturalised hierarchy which resulted in pathologising those unable to meet the standards of normality. The specific form of hierarchy depends on the capitalist regime of the time. So being ‘normal’ in a Fordist world of mass production and traditional family roles differs from being ‘normal’ in a post-Fordist world of knowledge economies and flexible labour. But the outcome is similar, with neurodivergents ‘caught between alienation and disablement’.
The birth of capitalism meant new relations with one’s body. Previously, difference in embodiment could be accommodated (or not) in local communities, with those people sometimes treated as religiously special or as curiosities. But in a world where everyone is dependent directly or indirectly on selling their labour, this was no longer viable as state regulation and classification of its population became more homogenous and systematic. Meanwhile, industrial capitalism requires the standardisation of labour, with people travelling to production sites and then completing a series of repetitive tasks in a consistent manner. Those with sufficiently different embodiments were disabled by these changes, thereby posing a problem because they did not work properly or at all. As England was industrialising, intellectuals and scientists started ranking or ordering mental capabilities through ideas such as phrenology or eugenics.
Although some of these ideas declined in popularity, they nevertheless contributed to an emerging consensus: that divergence from the norms of embodiment, which were sometimes worked out through plotting deviations from the statistical norm, were not in fact divergences at all but rather defects or pathologies. This ‘pathology paradigm’ (a term Chapman borrows from Walker) framed embodied difference as medical conditions that needed controlling, treatment, and curing. This consolidated a hierarchy between those normal and those not, with the former valorised as superior and preferable and the latter stigmatised as deviant. In practice, this meant early intervention as conventions around childhood milestones took hold and/or removing freedoms from those who were not cured or deemed incurable. The effects of the pathology paradigm extend beyond what we would now recognise as neurodiversity. Women were labelled as hysterical, Black protestors were deemed psychotic for acts of resistance, and homosexuality was treated as a ‘psychopathology’. It is likely that some of those experiences intersected with neurodivergence, but establishing exactly how is difficult.
Chapman sketches out ways this standard evolved as capitalism itself developed. The standard of normality became more restricted with the advent of Fordism for the same reasons that the associated division of labour was alienating and monotonous for both masculine work in the factory and feminised work in the home. While some could find solace and meaning in the mass availability of consumer goods, others could not. Those who could adapt and meet these societal expectations would be happier, fitter, more productive. Those who could not suffered. Meanwhile, post-Fordism was a ‘mass disabling event’. Autistic people are not always well equipped to the ‘sociality, hyper-flexibility, and emotional labour’ required by typically living life and working at increased speed and flexibility. Those with ADHD were increasingly disabled by an environment where we are all bombarded with information and distraction thanks to new technologies and digital connectivity.
By working through a radical notion of disability and rejecting biological essentialism, Walker and Chapman’s work represents a significant development of neurodiversity theory. This emphasis on understanding and subverting standards of normality as a means to work towards a ‘post-normal future’ is the logical utopian vision to emerge from this work, a world that not simply normalises weirdness but dissolves the category of normal altogether. A more immediate outcome of this vision is to develop the concept of neurodiversity beyond the ‘pathology paradigm’. This could entail, for example, moves to formalise neurodivergence self-assessment and access to disability services. Doing so would be consistent with the development of neurodiversity theory, as well as easing pressure on the NHS. It is estimated that there are 170,000 patients waiting for autism assessments on the NHS; some adults have reported waiting for over 8 years for an ADHD assessment. As well as being theoretically desirable, self-assessment may become necessary.
Formalised self-assessment of neurodivergence would likely produce new politics. Although the criticisms of the ‘pathology paradigm’ are convincing, medical authority remains central to how neurodiversity is currently related to in practice. Even putting aside thorny issues around access to the powerful stimulant drugs that are frequently prescribed for ADHD, the legitimacy of neurodiversity in practice is to some extent underpinned by the medical authority to assess someone as neurodevelopmentally disordered. When an employee turns up to work in the UK with an autism or ADHD diagnosis, corporations and public organisations are legally obliged to provide them with support in the form of reasonable adjustments, as set out by the Disability Act. Many of those organisations then find themselves able and willing to include neurodiversity on the Equality, Diversity, and Inclusion sections of their website.
To medicalise is to depoliticise, for better or for worse. Anti-woke far-right forces have so far largely steered clear of neurodiversity, despite it having many of the hallmarks of the kinds of ‘identity politics’ they are mobilising against. To de-medicalise may be to politicise. It is not difficult to imagine neurodiversity being next in the firing line, with arguments about those who are properly disabled by their genetic make-up as deserving recipients of resources, but those who have self-assessed their weirdness or brain-wiring as neurodivergent trolled as pretentious poseurs or victims of ideological indoctrination. Britain’s right-wing press reporting on how a ‘surge’ in autism and ADHD is leading to increasing disability benefit bills for taxpayers may indicate the direction of travel. The full implications of neurodiversity politics are indeed only just emerging.