From Diagnosis to Abolition: What Neurodivergent People Can Teach About Building Free Futures
Bridgette Hamstead
Diagnosis is not liberation. For many of us, it was never meant to be.
For decades, neurodivergent people, especially those who are multiply marginalized, have been navigating systems that wield diagnosis as a tool of control. While access to diagnostic labels can bring clarity, community, or accommodations, we must not mistake that access for freedom. In fact, we must name what diagnosis so often represents: a gatekeeping apparatus of the state, a medicalized sorting mechanism, and a deeply racialized, gendered, and classed lens through which some are offered support while others are surveilled, institutionalized, criminalized, or erased. In the current landscape of psychiatric care and behavioral intervention, diagnosis is more often used to justify the distribution of services in a scarcity-based system than to offer holistic, liberatory support. Diagnosis, as it is practiced today, is not neutral, it is embedded in carceral logic, extractive economics, and white supremacist ideals of what counts as normal, valuable, and sane.
To move from diagnosis to abolition, we have to begin by listening to neurodivergent people who have survived these systems, not just passed through them. Psychiatric survivors, mad activists, and disabled organizers have long warned us that the systems of care we are told to trust are often indistinguishable from the systems of punishment we are told to fear. Psychiatric incarceration, forced treatment, restraint and seclusion, behavior modification programs, and compliance-based therapies are not aberrations, they are central features of a system designed to contain, normalize, and disappear those who resist or do not conform. For those of us who grew up in special education classrooms, group homes, or under intensive behavioral plans, the line between help and harm was never clear. Often, it wasn’t a line at all, it was a loop. A looping hallway of referrals, suspensions, labels, and diagnoses that followed us through every institution we entered. From schools to clinics to prisons to shelters, the state knew our names not because we were supported, but because we were flagged.
Abolitionist thinking invites us to imagine something radically different. It does not mean the absence of care; it means the absence of coercive systems masquerading as care. Abolition is not the void. It is the presence of practices that make carceral institutions obsolete. For neurodivergent people, this looks like community-based supports rooted in interdependence, peer-led mental health care, housing-first models, harm reduction, universal access to communication and mobility tools, trauma-informed crisis response, and economic justice that removes the conditions of forced institutionalization. Abolition, in this context, asks: What would it take to live in a world where diagnosis is no longer needed to access dignity? What would it mean to build support systems that don't require a label to believe someone, help someone, or keep someone alive?
The truth is, many neurodivergent people already live inside abolitionist practice. We build mutual aid networks when services fail us. We crowdsource mental health support in group chats and late-night Zoom calls. We resist behaviorism by honoring stim, silence, or shutdown. We protect each other in public when someone is overwhelmed and afraid. We translate for one another in the face of bureaucratic cruelty. We tell the truth about what it means to live through systems that pathologize our difference and then punish us for not being able to perform normal. These are not just survival strategies. They are abolitionist blueprints.
Disability justice, as articulated by leaders like Patty Berne, Mia Mingus, and the late Stacey Park Milbern, reminds us that interdependence is not a burden, it is the architecture of collective liberation. Neurodiversity justice must follow this lead. If we continue to focus only on diagnostic access, we will build a future in which some neurodivergent people are given proximity to privilege while others are funneled deeper into carceral and medical control. If we instead center the knowledge of those most targeted by these systems, Black, Indigenous, queer and trans, low-income, institutionalized, and psychiatric survivor communities, we begin to build something that does not rely on diagnosis to function. We begin to understand that access is not just about accommodations, it is about undoing the conditions that make so many of us vulnerable in the first place.
To be clear, this is not a call to shame those who found diagnosis meaningful. Many of us have. Naming our neurotype can be a relief, a reclamation, a form of orientation in a world that has kept us confused about who we are. But relief is not the same as freedom. Diagnosis is not justice. And any justice worth its name must account for the structural, systemic realities that shape who gets diagnosed, who gets believed, who gets blamed, and who gets left behind.
In abolitionist work, we are often told to "imagine a world without prisons." For those of us doing neurodiversity justice work, the invitation is the same. Can we imagine a world where neurodivergent people are not labeled in order to be protected? Where safety is not predicated on compliance? Where no one is medicated against their will, restrained for stimming, arrested for wandering, institutionalized for surviving? Can we imagine care without control?
It is possible, but only if we are willing to name the systems that harm us, even when they claim to help. Only if we are brave enough to question the frameworks we’ve been told are neutral. Only if we let the most impacted among us lead. The path from diagnosis to abolition is not a straight line. It is a practice. A movement. A future we are already building, together, in the spaces we create when the institutions fail us.
Let us keep building. Not for legitimacy. Not for access to the table. But for something much more radical: our freedom. Our future. Ourselves.
Reflection Questions
How has diagnosis shown up in your life, as a gateway to support, a source of harm, a mixed experience, or something else entirely? What did you gain from it, and what did it cost?
In what ways have you seen systems use diagnosis as a justification for control, exclusion, or containment rather than support?
What does abolition mean to you when applied to psychiatric institutions, special education, or behavioral interventions?
Have you ever had to build care outside of formal systems, through peer support, mutual aid, or community organizing? What worked? What was missing?
What would a world look like where people didn’t need to be diagnosed in order to access dignity, support, or safety?
How does whiteness, class status, or gender expression influence who is offered diagnosis with compassion, and who is labeled as disruptive, resistant, or pathological?
How do you hold complexity when a system (like diagnosis) has helped you personally but harms others? What do accountability and nuance look like in that tension?
If we didn’t need diagnosis to access services, what might support systems look like instead? Who would design them? Who would benefit?
What carceral logics, like surveillance, behavioral compliance, or forced treatment, still exist in spaces that claim to be inclusive or supportive of neurodivergent people?
What are some abolitionist practices you're already participating in, knowingly or not? How might you deepen or expand them?