What is a diagnosis actually for, and when does it really help you?
Moin!
Many adults spend years fighting to get a diagnosis.
But the real question is: what actually changes afterwards?
For a long time, ADHD and autism were considered opposites — if you had one, you supposedly couldn’t have the other. That was back when people still distinguished between “early childhood autism” and “Asperger’s autism.”
Today, all of that is outdated.
Of course, ADHD and Autism Spectrum Disorder can exist separately, with only minor overlaps between them.
My own diagnosis from 2016 still said “Asperger’s.” But the diagnostic report also states that the clinician lacked the tools to fully assess ADHD, while noting that quite a few things suggested that both might be present.
She simply didn’t have all the questionnaires and other diagnostic instruments needed for a complete ADHD assessment, nor did she have the specialist expertise required for it.
By now, I am convinced that I have a combination of autism and ADHD.
Do I somehow not have ADHD simply because I never received an official diagnosis?
Someone sceptical might ask exactly that.
No.
That would be a bit like saying you need a doctor to tell you that your leg is broken even though it is obviously broken.
Yes, okay — ADHD and autism are not nearly as obvious to recognise, whether by people on the spectrum themselves, doctors or psychologists, unless someone has actually been trained and specialised in the field.
And hardly anyone specialises in both.
But it is similar to many other things: usually, you are the first person who knows that something is going on with you, whether it is a characteristic, a condition, an illness or an injury.
Maybe you don’t have a name for it yet, so you begin studying it yourself in greater depth.
Do you need a doctor to tell you that you have a flu-like infection?
Usually not.
Do you need a doctor to know whether you need glasses or hearing assistance?
Not necessarily.
So when do you need a specialist ADHD diagnosis?
When you genuinely need medication in order to manage everyday life.
ADHS und oder Autismus und warum auch noch queer.pdf
ADHD medication is only available with a recognised diagnosis.
Are there medications specifically for people on the autism spectrum?
No.
So what do you actually need these diagnoses for?
Ah yes.
For example, to apply for a Grad der Behinderung, Germany’s official disability rating.
Right. There was that.
And if you manage to receive a GdB of 50 or higher and are therefore legally classified as severely disabled, what does that actually give you?
Protection against dismissal?
Forget it.
In my own experience, that only offers meaningful protection in very specific employment situations. Employers can still find ways to get rid of you.
From my personal experience, it is not genuine protection.
But perhaps you need assistance, support or someone to accompany you because of the difficulties you face, while still being able to work and earn money with that support?
Then yes — a diagnosis can become genuinely relevant.
Who needs that kind of support?
Often, the people who truly need it are so restricted by the non-autistic world around them that they may also make use of legal assistance or voluntary support arrangements through a power of attorney.
The fact is that more than 85 percent of diagnosed people on the spectrum do not have a job in the conventional labour market.
But if, like me, you mask and compensate so effectively, and if you are specialised enough in your field that you can comparatively easily find work, then you may not need these more extensive occupational integration services.
And you would probably struggle to qualify for them anyway.
So what does the disability rating give you then?
Not much beyond certain tax advantages, plus the ability to state that you cannot work more than eight hours and to refuse overtime.
ADHD & Autism in German Social Law — and in the Social and Healthcare System
Oh yes — and if you are married or living with a partner in what German social law calls a Bedarfsgemeinschaft, a household whose members are financially assessed together, and the other person earns enough money that you are excluded from benefits, then being severely disabled does not necessarily help you at all.
And by that point, you may already have exhausted sickness benefits and your year of unemployment insurance benefits.
You can no longer simply continue being signed off as unable to work indefinitely.
The Jobcenter may not care whether you are effectively impossible to place in employment because of ADHD and/or autism, even when — as happens so often — you receive Bürgergeld, Germany’s basic income support.
And yes, I’ve been there.
I’ve been through all of this.
And yes, I know the German Social Code — the Sozialgesetzbücher, or SGBs — inside and out.
I could professionally offer freelance coaching and support in this area.
Obviously, I cannot present that service as legal advice from a lawyer or legal professional — that distinction has to be made clear.
But I can still offer practical coaching, guidance and accompaniment.
ADHS und oder Autismus und warum auch noch queer.pdf
ADHD & Autism — What Does Any of This Have to Do With Being Queer?
It is not unusual for people in the AuDHD spectrum to also be queer in one way or another.
That might mean not seeing yourself as straight in terms of sexual orientation, and/or not experiencing your physical sex as fully corresponding with your sense of identity.
That places you somewhere within the queer spectrum.
In my own case, this was something that only became clear — and increasingly clear — later in life.
Statistical surveys and field research have repeatedly found that many transgender people are also somewhere within the AuDHD spectrum.
But why?
People like us tend to question almost everything.
That includes conventional ideas about gender identity and the ways in which our social environment teaches us what we are supposedly meant to be.
And we do not only question what comes from outside.
We also question ourselves, often very critically.
Sometimes, what emerges from that process is the realisation that the gender we were socially raised into, and/or the sexual orientation and preferences expected of us, do not actually match who we are.
And at some point, we may stop caring what other people think about us if the alternative is continuing to conform to a social image that does not fit.
Instead, we want to live and exist as we actually are.
For some of us, that includes wanting and receiving hormone therapy in order to suppress sexual drive.
For others, it means seeking hormone therapy in order to bring the body into closer alignment with our neurological and psychological sense of identity — whether through transition or through a form of embodiment that better reflects non-binarity.
If you want to read more about this, take a look around my Substack profile.
You’ll find several articles exploring these subjects there.
And more will follow.