Lindsey Mack's Substack

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Gatekeeping Autism Diagnosis: How Insurance Silences Adult Autism—and Capitalism Benefits

Gatekeeping Autism Diagnosis: How Insurance Silences Adult Autism—and Capitalism Benefits

The Real Reason Adults Are Now Denied Access and How the System Benefits from Their Silence

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Lindsey Mackereth
Jul 02, 2025
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Lindsey Mack's Substack
Lindsey Mack's Substack
Gatekeeping Autism Diagnosis: How Insurance Silences Adult Autism—and Capitalism Benefits
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a card with a picture of a man on it next to a stethos
Photo by Marek Studzinski on Unsplash

“Why didn’t anyone notice?”

As a licensed therapist who specializes in adult autism assessment and leads a team of evaluators, I hear this question from many late-diagnosed autistic adults—whether in their 20s, 40s, or even later. It’s far from rhetorical; it carries grief, anger, and deep reflection. Looking back on years marked by misdiagnosis, anxiety, burnout, and self-blame, many realize their experience wasn’t just personal oversight—it was systemic. And a major player in that system? Insurance companies.

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