Autistic, hysteric: Inequity in health care for autistic people assigned female at birth in the United Kingdom

When the Double Empathy Problem affects communication with medical professionals, the consequences can be dire. This is evidenced by the significantly reduced life expectancy of Autistic people compared to our non-Autistic peers and the far poorer physical and mental health we experience on almost every metric. At the same time, people assigned female at birth (AFAB)38 are known to experience a ‘gender health gap’ in modern medicine. We consider this to be at least in part due to centuries of medical misogyny, where much of what ailed women was attributed to ‘hysteria’ and their reproductive organs. These days, women in the UK have longer life expectancies than men but spend more of their life in poor health or chronic pain with conditions left undiagnosed for longer. This is particularly pronounced within the specialisms of gynaecological and reproductive care. For those from racialized and additionally minoritized groups, the health gap is even greater. In this chapter we – a collective of Autistic AFAB researchers39 from the UK – explore how the Double Empathy Problem intersects with structural misogyny within health care, leading to dangerously inadequate services for Autistic AFAB people and an urgent need for more research.