Diagnosing Others, Hiding Self: Shame and Non-Disclosure Among Autistic Psychiatrists - An Interpretive Phenomenological Analysis

This publication is included in the Autistic Autism Scholarship Project. four authors of this publication are identified as autistic in the project.

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Doherty, M., Chown, N., Martin, N., Grosjean, B., Chaplin, E., Dolezal, L., & Shaw, S. C. (2026). Diagnosing Others, Hiding Self: Shame and Non-Disclosure Among Autistic Psychiatrists - An Interpretive Phenomenological Analysis [Preprint]. openRxiv. https://doi.org/10.64898/2026.07.13.26357917

Publication date: 15 Jul 2026 Added to AutiHub: 24 Sep 2026 Type: Preprint Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
7
Publication authors identified as autistic
4 / 7 (57.1%)
  1. Mary Doherty *
  2. Nicholas Chown *
  3. Nicola Martin
  4. Bernadette Grosjean *
  1. Eddie Chaplin
  2. Luna Dolezal
  3. Sebastian C.K. Shaw *

Abstract

Abstract Autistic psychiatrists occupy a paradoxical position: trained to recognise and assess autism in others, yet navigating a professional culture in which their own autistic identity remains largely concealed. Despite growing visibility of autistic clinicians, the barriers autistic psychiatrists face to formal diagnosis and professional disclosure remain unexplored. This study used interpretive phenomenological analysis to examine the experiences of seven autistic psychiatrists in relation to diagnosis and disclosure. Data were generated through in-depth interviews and Retzinger’s framework for identifying shame in discourse was applied as an analytical tool within the interpretive process. Shame emerged as the overarching theme across the dataset, operating through four group experiential themes. Its origins lay in childhood experiences of difference and perceived defectiveness, transmitted through family, peers, and the broader social environment. In professional life, shame was sustained and amplified by colleagues’ misconceptions about autism, anticipated loss of credibility, and the deficit-based diagnostic criteria – which rendered self-recognition difficult and made formal diagnosis a perceived professional liability. Critically, shame did not only create barriers: it functioned as an override mechanism, rendering the known benefits of disclosure – to participants themselves, to colleagues, and to patients – insufficient to translate into action. This override function was not explained by fear of discrimination or rational career protection alone; it reflected shame’s operation as an internal prohibition, dissociated from its original social source and persisting even where stigma had been intellectually processed and rejected. These findings reposition shame not as one barrier among many but as the organising force through which all barriers operate. Interventions aimed at increasing disclosure by raising awareness of its benefits misread the operative mechanism. Creating conditions in which autistic psychiatrists can make decisions about their identities freely requires naming and addressing shame – in research, in clinical training, and in the culture of psychiatry.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

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: 2 Oct 2026 01:40.

Cited references
44
With a DOI
40
Without a DOI, from raw bibliography text
4
21 / 44 (47.7%) cited references include at least one author identified as autistic.
References with data to complete
5 / 44 (11.4%)
References with detected author names
39 / 44 (88.6%)
Without detected author names
5
Without a structured title
4
Without a stable identifier
4
References with raw author names still to review
4
References with external metadata lookup issues
0
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
482
From DOI or external metadata
482
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
14
159 / 482 (33.0%) names are linked to an author already present in AutiHub. 323 / 482 (67.0%) names are not yet linked.
Names linked to a person identified as autistic
53 / 482 (11.0%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 53 / 159 (33.3%). Distinct people identified as autistic: 23 / 436 (5.3%).
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