Quietly Autistic at Last

# 17 - Why “High-Functioning” Misses the Point - Especially for Late-Diagnosed Women

Dr. Allison Sucamele Episode 17

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“You’re so high-functioning.”

It’s a phrase many late-diagnosed autistic women hear when they finally share their diagnosis - often offered as reassurance, praise, or disbelief. And almost always, it misses the point.

In this episode of Quietly Autistic at Last, we unpack why the term high-functioning doesn’t just fall short, it actively obscures the lived reality of autistic women diagnosed later in life. We explore the psychology beneath the label, including masking, nervous system survival, grief, identity, and why appearing “fine” often comes at an invisible cost.

Drawing on research around autistic burnout, camouflaging, minority stress, the Double Empathy Problem, and Polyvagal Theory, this episode reframes functioning labels for what they really measure: not wellbeing, but how much pain someone can carry without making others uncomfortable.

This conversation is honest, affirming, and grounded in both lived experience and science - a reminder that competence does not cancel need, and survival is not the same as thriving.

References & Further Reading

  • Unmasking Autism – Devon Price
  • Divergent Mind – Jenara Nerenberg
  • Raymaker et al. (AASPIRE): Research on autistic burnout
  • Hull et al.: Studies on masking and camouflaging in autistic women
  • Milton, D.: The Double Empathy Problem
  • Botha, M.: Minority stress in autistic adults
  • Stephen Porges: Polyvagal Theory
  • National Autistic Society: Why functioning labels are harmful

Autism-Affirming Resources

Mental Health Resources

If this episode brings up distress, grief, or overwhelm, support is available:

  • U.S. & Canada: Call or text 988 (Suicide & Crisis Lifeline)
  • UK & ROI: Samaritans – 116 123
  • Australia: Lifeline – 13 11 14
  • Or visit: https://findahelpline.com
    for global support

Brief Disclaimer

Autism is experienced differently by every individual. The perspectives shared in this episode reflect one autistic lived experience and interpretation of research, not a universal autistic narrative. Listening with curiosity and self-compassion is encouraged.

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