The Backlash Is Coordinated
Who benefits from the overdiagnosis narrative, and what the movement has to do about it
In the last two years, the word overdiagnosis has appeared in health policy documents, newspaper editorials, parliamentary testimony, think tank reports, and government reviews across three continents with a frequency and consistency that requires explanation. The word travels the same route in each country it lands: a concern is raised, usually by a government minister or a right-aligned policy organization, about the dramatic rise in autism and ADHD diagnoses; that concern is framed as fiscal, sometimes as clinical, occasionally as about the welfare of children themselves; and the proposed remedy, however it’s dressed, involves making diagnosis harder to obtain, reducing access to the supports that diagnosis unlocks, or reshaping eligibility in ways that exclude people who were previously included. The word overdiagnosis is doing political work, and it is doing that work in multiple countries at the same time.
That synchrony is what the Neurodiversity Justice Framework requires us to name first, before we examine any of the individual policy moves or rhetorical campaigns. A scattered cultural backlash looks different from this. Scattered backlash produces inconsistent targets, variable rhetoric, and policy responses that don’t converge. What’s been happening since roughly 2024 is convergent: the same framing, the same economic rationale, the same move to locate the problem in diagnostic excess rather than in systems that were never built for neurodivergent people, surfacing in the United Kingdom, the United States, and Australia in the same period. That convergence has a structure, and the structure becomes visible when you’re willing to look at who benefits.
What Overdiagnosis Actually Means, and What It’s Being Made to Mean
Overdiagnosis, as a clinical concept, describes a genuine phenomenon: the identification of a condition in a person who would never have experienced symptoms or harm from that condition, and whose treatment therefore produces net harm rather than net benefit. In oncology, for example, there are real debates about overdiagnosis of certain slow-growing cancers, where aggressive treatment of something that would never have caused the patient harm produces significant treatment-related harm instead. As a clinical concern, overdiagnosis is worth taking seriously in contexts where it actually applies.
Applied to autism and ADHD, the overdiagnosis framing does something categorically different. Autism and ADHD are not conditions that produce harm only when they’re identified; they’re neurological profiles that shape how a person processes the world across every domain of their life, whether or not anyone has ever named what they’re experiencing. An autistic person who doesn’t have a diagnosis is not less autistic; they’re autistic without access to language, framework, supports, or accommodations that might make their life substantially more navigable. The harm runs through the absence of identification, not through the identification itself.
That distinction matters more than it might appear. A genuine overdiagnosis concern in the clinical sense asks: are we treating people for conditions they don’t actually have, in ways that harm them? The overdiagnosis concern being deployed in current policy debates asks something entirely different: are too many people obtaining diagnoses that make them eligible for expensive supports? Those are not the same question, and conflating them, which is precisely what the overdiagnosis framing does, makes a fiscal concern sound like a clinical one. That rhetorical move is what’s driving the campaign.
The 32 clinicians and researchers who published a rebuttal in the British Medical Journal in response to the UK government’s review framing made exactly this point. The evidence does not support an overdiagnosis claim for autism or ADHD in the clinical sense. What the evidence supports is a historically dramatic expansion of identification, driven by better diagnostic tools, broader awareness, increased access to assessment for groups previously excluded from it, and in some cases the creation of support systems that gave people a reason to seek identification they’d been avoiding. More people being correctly identified as autistic or ADHD is not overdiagnosis. Calling it overdiagnosis is a choice with policy consequences.
The United Kingdom: A Review Built Backward From Its Conclusion
The UK review that has drawn the most sustained attention from advocates began not with a clinical question but with a minister’s stated concern. Health Secretary Wes Streeting, in the months preceding the formal review announcement, raised alarm about the rise in sickness benefit claims linked to autism, ADHD, and mental health diagnoses, noting that the number of working-age people claiming incapacity benefit had reached 4.4 million. The word he used to frame the problem was overdiagnosis. He has since walked that language back, telling journalists he regretted the framing. But the review, led by Professor Peter Fonagy and co-chaired by Sir Simon Wessely, is still running on the question that word organized: whether autism and ADHD are being diagnosed too readily.
The Wessely co-chairmanship alarmed neurodivergent advocates and many clinicians immediately, because Wessely is closely associated with a contested position on chronic fatigue syndrome and medically unexplained symptoms that autistic and chronically ill communities have documented, extensively and across decades, as producing significant harm to patients. His presence in the co-chair position of a review explicitly investigating whether neurodivergent conditions are overdiagnosed reads as a signal about what the review is looking for. Reviews are structured by the questions they’re designed to answer, and the question this one was given, framed by a health secretary who was simultaneously presiding over a welfare reform effort targeting exactly the benefit categories that autism and ADHD diagnoses unlock, was not neutral.
The review is due to report in summer 2026. It has been commissioned alongside a parallel effort to reform Personal Independence Payment eligibility, and the timing of those two processes running together is worth holding: a review finding that concludes autism and ADHD are overdiagnosed would provide policy cover for tightened eligibility criteria, reducing the number of people whose diagnoses entitle them to financial support. The 32 experts who published in the BMJ understood this. Their intervention was political, because the review itself was political dressed in clinical language.
Alongside the review, a Policy Exchange report released in late 2025 argued that mental illness and neurodivergence in young people was stretching key public services to breaking point, that special educational needs costs were spiraling unsustainably, and that the rates of identification were implausible on their face. The National Autistic Society called the report poorly evidenced and said it couldn’t be wider of the mark. But the report’s circulation through media and policy circles wasn’t primarily about its evidence quality; it was about reinforcing a frame. The frame is: too many people have these diagnoses, the cost is unsustainable, and something must be done. The NAS rebuttal got substantially less media coverage than the initial report. That asymmetry in coverage is part of how the frame takes hold.
The United States: Dismantling Infrastructure Under Multiple Rationales
In the United States, the mechanisms are different but the direction is the same. The federal government has not, as of this writing, produced a review framed around overdiagnosis in the UK sense. What it has done is systematically dismantle the infrastructure through which neurodivergent people accessed research, support, and federal recognition, under a combination of rationales: DEI elimination, fiscal efficiency, government streamlining, and in some cases explicit hostility expressed through the statements of administration figures.
The Department of Government Efficiency’s cuts eliminated approximately eighty million dollars in autism research across the National Science Foundation, the Centers for Disease Control, and the National Institutes of Health. The Cybersecurity and Infrastructure Security Agency’s neurodiversity workforce pilot, a contract project designed to fill federal talent gaps by improving recruitment of autistic and neurodivergent workers, was terminated by the Department of Homeland Security on January 23, 2025, with no explanation offered in the public notice. The program had been running for years and had bipartisan origins; its termination was framed as consistent with the administration’s anti-DEI posture, meaning that a program explicitly designed to recognize and leverage neurological difference was categorized as a diversity, equity, and inclusion initiative and eliminated on that basis.
The Interagency Autism Coordinating Committee, the federal body responsible for coordinating autism research, policy, and service priorities across agencies, was effectively destabilized by the broader disruption to the agencies it depends on. The HHS budget proposals circulating in early 2026 included the elimination of the CDC’s dedicated autism public health programming and a nearly twenty percent reduction in autism research and prevention funding at the NCBDDD. The administration simultaneously proposed consolidating autism oversight into a new organizational structure, the Administration for a Healthy America, whose relationship to existing expertise and institutional knowledge is unclear and whose framing around autism is driven in significant part by Robert F. Kennedy Jr.’s stated interest in identifying the cause of autism, a framing that treats autism as a pathology to be traced and eliminated rather than a neurological profile to be supported.
