Autistic Shame: Reflections on an Underrecognized Determinant of Autistic Mental Health

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Doherty, M. (2026). Autistic Shame: Reflections on an Underrecognized Determinant of Autistic Mental Health. Autism in Adulthood. https://doi.org/10.1177/25739581261479601

Publication date: 24 Aug 2026 Added to AutiHub: 26 Aug 2026 Type: Article Article language: English
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Publication authors
1
Publication authors identified as autistic
1 / 1 (100.0%)
  1. Mary Doherty *

Abstract

Shame is a deeply painful emotion that is underexplored in autism research and autistic community spaces. While we commonly discuss stigma, we rarely examine how it is embodied and experienced as shame. This perspective piece argues that shame is a critical, yet largely unrecognized, determinant of autistic mental health outcomes, operating as a hidden link between societal stigma and the elevated rates of depression, anxiety, self-harm, and suicidality among autistic adults. Drawing on research with autistic psychiatrists and personal experience as an autistic clinician–researcher, I trace how shame became visible as the overarching theme in my doctoral research – so pervasive it was initially invisible. The recognition of autistic shame has proven challenging to disseminate, with resistance to these findings illustrating the very dynamics being studied: when research exposes uncomfortable truths about shame, defensive responses often follow patterns described in Nathanson’s Compass of Shame. Autistic shame is the internalized sense of defectiveness tied specifically to one’s autistic identity and traits. It is externally imposed through lifelong exposure to neuronormative expectations where difference is misinterpreted as deficit. It manifests in multiple contexts: Reciprocally shaming social interactions, health care settings where autistic patients are dismissed and disbelieved, and community conflicts where heterogeneity is weaponized to silence advocacy. For autistic people, alexithymia can make shame difficult to recognize, though clues such as the desire to withdraw and experiences of rage may signal its presence. Addressing autistic shame requires explicit therapeutic attention, self-compassion practices adapted for autistic cognition, and neurodiversity-affirmative approaches that reframe difference rather than deficit. Understanding shame offers tangible pathways toward improved mental health and authentic autistic flourishing.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 12 Sep 2026 17:55.

Cited references
71
With a DOI
55
Without a DOI, from raw bibliography text
16
17 / 71 (23.9%) cited references include at least one author identified as autistic.
References with data to complete
7 / 71 (9.9%)
References with detected author names
64 / 71 (90.1%)
Without detected author names
7
Without a structured title
7
Without a stable identifier
16
References with raw author names still to review
7
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
204
From DOI or external metadata
204
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
7
118 / 204 (57.8%) names are linked to an author already present in AutiHub. 86 / 204 (42.2%) names are not yet linked.
Names linked to a person identified as autistic
37 / 204 (18.1%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 37 / 118 (31.4%). Distinct people identified as autistic: 14 / 165 (8.5%).
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