Epistemic Violence: How the Search for Knowledge Has Harmed the Autistic Community.

What is Epistemology?

To understand how epistemic violence impacts the mental health of Autistic Individuals, it's helpful to start with the philosophy of "epistemology". The term "epistemology" comes from Greek epistēmē (meaning “knowledge”) and logos (“reason” or "study"). In philosophy, epistemology is the study of the nature, origin and limits of human knowledge. It takes fundamental questions about what knowledge is, how we come to know things, and what it means for something to be "true" or "justified" (Steup and Neta, 2005; Martinich and Stroll, 2019).

Epistemology shapes how knowledge is produced and recognised, especially in research and professional practice. In traditional Western contexts, epistemology has often prioritised objectivity and the idea that researchers can, and should, remove their own biases and subjectivity from the process. However, knowledge is never produced in a vacuum. Values, perspectives, culture, and power structures of those who define 'valid' and 'objective' knowledge deeply influence whose voices are heard and whose are silenced (Botha, 2021; Lechêne, 2024).

What is Epistemic Violence?

The concept of epistemic injustice was introduced by postcolonial scholar Gayatri Chakravorty Spivak, who examined how colonial powers systematically silenced the voices of colonised people, denying them the ability to represent themselves and rendering their knowledge invisible or illegitimate (Brunner, 2023). Spivak's work highlights how this silencing is entangled with other forms of violence, both direct and structural, and is maintained through the dominance of the Eurocentric and androcentric educational system (Brunner, 2023) of the West.

Building on this foundation, philosopher Miranda Fricker (2007) formalised the idea of epistemic injustice by identifying how marginalised individuals can be wronged as knowers through testimonial injustice (not being believed) and hermeneutical injustice (having one's experiences misunderstood), focusing on individual biases and social power dynamics. Kristie Dotson (2011) expanded the conversation by defining epistemic violence as the systemic and structural patterns of ignorance that harm marginalised groups by excluding their perspectives from dominant institutional (government, academia). Scholars likeAllie Bunch (2015) applied these concepts to analyse how epistemic violence functions in processes of othering, while Sarah Bufkin (2024) critiqued Fricker's approach for overlooking the material and structural aspects of racism, advocating for a broader, more systemic understanding of epistemic injustice. In summary, epistemic violence is the systematic silencing or devaluing of marginalised voices, evolving from Spivak's postcolonial critique to Fricker's and Dotson's philosophical analyses, and further developed by scholars examining its real-world impacts (Bunch, 2015; Townsend & Lupin, 2021; Brunner, 2023)

Epistemic Violence against autistic people can often appear in many forms, from clinicians dismissing self-reported experiences as mere symptoms of anxiety, to researchers and policymakers excluding autistic voices from conversations about autism. This violence also manifests when academic studies pathologise autistic traits without valuing alternative perspectives, or when public and media discourse consistently stigmatise and stereotype, erasing the diversity of autistic experiences. At its most extreme, institutional practices, such as the use of aversive interventions (behavioural techniques that use unpleasant or painful stimuli, like electric shocks or time-outs, to suppress unwanted behaviours) are justified by ignoring the testimonies of those most affected. In each case, the harm lies not simply in disagreement, but in the systematic silencing or devaluing of autistic people's knowledge and lived experiences (Botha et al., 2020; Ymous et al., 2020; Kristina & Barunčić, 2020; ;Botha, 2021b; Botha & Cage, 2022)

Where does Epistemic Violence take place?

Epistemic Violence is not limited to a single moment or setting. It can happen at any point where knowledge is exchanged, interpreted, or valued. For autistic people, it often occurs in everyday interactions and institutional processes. A substantial body of research highlights systemic barriers in academia where non-autistic researchers often dominate and interpret findings about autism with little or no input from autistic individuals (Botha, 2021a; Bakker et al., 2023; Gurbuz et al., 2018).

This exclusion is not merely an oversight but reflects deeper structural issues within our society. Research has documented how the construction of "objectivity" in the name of science is often used to sideline autistic experiences, especially when autistic perspectives challenge the status quo (Pellicano et al., 2019; Botha & Cage, 2022). Dehumanising and stigmatising research narratives are not only acts of epistemic violence in themselves, but also facilitate broader social exclusion and the permissibility of further harm against autistic people. Autism Europe (2015) highlights how negative perceptions and a lack of understanding can increase the risk of abuse and social marginalisation for autistic individuals. Guldberg (2016) and Stone (2022) show that when research frames autism in a pathologising or deficit-focused way, it perpetuates stereotypes, fosters stigmatisation, and positions autistic people as less valuable and less competent, which can lead their voices to be dismissed or ignored in both research and society. As Botha (2021) and others have argued, this research based violence is endemic, perpetuating a cycle where autistic voices are devalued or erased in the very spaces where their knowledge could drive meaningful change, which reinforces exclusion and have real-world consequences, including discrimination, lack of support, and negative mental health outcomes for autistic people.

Trickle Down Violence

This cycle of trickle-down violence against autistic people often begins in research and policy. Historically, autism research has been dominated by non autistic voices and deficit-based modalities, framing autism as a problem to be solved rather than a difference to be understood. This pathologising approach is profound in early behavioural interventions, such as those developed by Ivar Lovaas, who described autistic children as "not people in the psychological sense" and justified physical punishment as a means of "constructing a person" (The Autistic Advocate, 2020). Such dehumanising rhetoric has left a legacy that shapes policy decisions, funding priorities and clinical practices.

However, the origin of autism research is inseparable from some of the darkest chapters of the twentieth century. During the Nazi era, clinicians like Hans Asperger contributed to diagnostic frameworks that aligned with eugenic ideologies, describing autistic children in terms that justified their exclusion or elimination (Sheffer, 2018; Czech, 2018; Slagstad, 2019). Asperger's work, while sometimes portrayed as protective, was complicit in the Nazi regime's racial hygiene policies. Children who were deemed "untreatable" or "burdensome" were sent to the killing centres like Spiegelgrund, where many were murdered as part of the Aktion T4 program, a systematic campaign that killed hundreds of thousands of disabled people, including those we would now recognise as historic (Sheffer, 2018).

This legacy of dehumanising and deficit-focused research does not remain confined to just journals or policy documents. It flows directly into the mainstream media, shaping how autism is represented to the wider public. The media often draws on the language and frameworks established by researchers and policymakers, amplifying stereotypes and pathologising narratives about autistic people (Wigmore, 2024; Karaminis et al., 2022). For example, films like Rain Man have cemented the "autistic savant" stereotype, when in reality, only a small percentage of autistic people have such skills (Roese et al., n.d.).

With other examples being news stories that may focus on meltdowns or aggression without explaining that these are responses to overwhelming situations, not intentional misbehaviour or inherent violence (National Autistic Society, 2020; Thinking Autism, 2021). This skewed coverage reinforces public fears and misconceptions, painting autistic individuals as unpredictable or burdensome (Hungerford et al., 2025). Such representations not only perpetuate stigma and discrimination in daily life, by consistently frame autism through a lens of deficiency and deviance. The media participates in the cycle of epistemic violence that deepens misunderstanding and marginalisation, perpetuating stigma and discrimination in daily life and silencing authentic voices, making it harder for autistic people to be heard, believed or understood both socially and within institutions.

The media's framing of autistic people significantly shapes public attitudes and institutional awareness, with major consequences for autistic individuals. Academic research has a plethora of studies finding that constant stereotyping and negative portrayals in news and entertainment media contribute to discrimination in schools, workplaces, and healthcare (Turnock et al., 2022; Karaminis et al., 2022; Jones et al., 2023; Zhou & Guan, 2024). For instance, studies have found that teachers influenced by deficit-based media narratives may underestimate autistic students' abilities and fail to provide appropriate support (Guldberg, 2016; Botha & Cage, 2022). In workplaces, misconceptions driven by the media about autistic behaviour and communication contribute to reluctance among employers to hire autistic individuals, perpetuating employment disparities (Stone, 2022; Botha & Cage, 2022). Within healthcare, clinicians may dismiss or misinterpret autistic people's reports of distress, attributing them to "just anxiety" or noncompliance, rather than recognising genuine need (Kentrou et al., 2024).

Research shows that media portrayals often reinforce pre-existing negative attitudes and stigma, which can result in autistic individuals and their families being stigmatised by schools, the general public, and even within their own families (Hungerford et al., 2025) These attitudes, shaped by media stereotypes, make it more difficult for autistic people to participate fully in community life and increase reluctance to disclose their diagnosis due to fear of stereotyping and exclusion, further exacerbating feelings of isolation and mental health harm (Jones, S. C. et al., 2023).

Trickling downwards, now we are beginning to see extreme cases that highlight how epistemic violence and systemic exclusion can result in profound harm for autistic people across employment, education, and social life.

In the workplace, a teacher with autism was unfairly dismissed after his diagnosis, despite previously excelling in his role. The school refused to make reasonable adjustments and threatened him with demotion, leading to a tribunal that found the school discriminated against him. He was awarded compensation for the unfair dismissal, discrimination arising from disability and victimisation related to his complaints (Martin Searle Solicitors, 2024). Other cases documented by the Trades Union Congress include autistic employees being subjected to bullying, denied access to essential equipment, and paid below minimum wage due to their diagnosis. In one example, an autistic green keeper endured years of ridicule, excessive workload, and physical abuse from a new supervisor, ultimately winning a tribunal claim for constructive dismissal and disability discrimination (Booth, 2014).

Workplace discrimination is further evidenced by research showing that autistic adults face significant barriers to employment, including a lack of reasonable adjustments, bullying and exclusion from career progress (Booth, 2014; Morris et al., 2025; Ezerins et al., 2023). These experiences often result in psychological distress, reduced self-confidence, and prolonged periods of unemployment (Dundon & Wilkinson, 2020; Cleary et al., 2023).

Socially, autistic individuals frequently experience bullying, isolation, and exclusion. Negative workplace cultures, lack of support, and persistent stereotypes contribute to high rates of mental health challenges and social withdrawal (Dundon & Wilkinson, 2020; Cleary et al., 2023). Disclosure of an autism diagnosis in the workplace is often fraught with fear of stigma and discrimination, leading many autistic adults to conceal their diagnosis (Romualdez et al., 2021).

These cases underscore how the dismissal or devaluation of autistic perceptives through epistemic violence, since the inception of what it means to be "Autistic", translates into real-world harm, from psychological trauma, educational exclusion, to loss of employment and social isolation.

The Haunting Truth: Consequences

Epistemic violence is only one of many injustices that autistic people face. It is compounded by a lack of cultural kindness and empathy, social barriers, wealth inequality, and systemic failures at every single level. Yet the consequences of these overlapping harms are perhaps most starkly revealed in the mental health crisis gripping the autistic community.

The statistics are sobering. Globally, autistic people make up around 1% or roughly 61.8 million people as of 2021 (World Health Organisation, 2023; Sherri Alms, 2025). Despite this, the scale and severity of the suicide crisis are vast. Recent global analyses reveal that autistic individuals are nearly three times more likely to die by suicide than non-autistic people. In 2021 alone, there were an estimated 13,400 excess suicide deaths among autistic people worldwide, accounting for 1.8% of all suicide deaths and resulting in 621,000 years of life lost, a health burden greater than that of cocaine use disorders, rabies, or testicular cancer for the general population (Sherri Alms, 2025). This is a staggering toll when considering that autistic people represent such a minute proportion of humanity.

The risk is not evenly distributed: autistic people without intellectual disabilities are more than five times as likely to die by suicide as non-autistic people, and autistic women face an even higher risk than autistic men (Newell, 2021; Sarris, 2022). In England, a study of coroners' inquests found that 10% of those who died by suicide had evidence of elevated autistic traits, an incidence 11 times higher than the national autism rate (Willgoss, n.d.). When family interviews were included, the proportion rose to 41%, or 19 times higher than would be expected based on population prevalence (Willgoss, n.d.).

The crisis begins in childhood. Research shows that over 35% of autistic children aged eight or younger have experienced suicidal thoughts, and nearly one in five have made a suicide plan. Among autistic adults, between 11% and 66% have contemplated suicide, and up to 35% have made a plan or attempted suicide at some point in their lives. Hospital records indicate that up to 15% of people hospitalised after a suicide attempt have a diagnosis of autism, despite autistic people comprising only about 1% of the UK population (Sherri Alms, 2025; Priory, 2025)

These numbers are not abstract. The autistic community is small, yet the scale of the suicide crisis that they face is immense. The disparity is not a coincidence, but a direct result of systemic failures.

From the suicide crisis to the severe and ongoing mental health crisis, the statistics continue to reveal the scale and depth of the problem. As of April 2025, there are 2025 autistic people and people with a learning disability detained in mental health hospitals in England, of whom 1,455 (72%) are autistic (National Autistic Society, 2025b). Among children and young people, the situation is even more dire: of the 240 under-18s in inpatient units, 230 (96%) are autistic (National Autistic Society, 2025b).

The number of autistic people without a learning disability detained in mental health hospitals has surged by 141% since 2015 (National Autistic Society, 2025a; National Autistic Society, 2025b). Despite the government aiming to reduce these numbers, the total has continued to rise, with the proportion of autistic people in these environments nearly doubling over the past decade (National Autistic Society, 2025a). These hospitals are widely recognised as inappropriate and often harmful for autistic people, with the average length of stay approaching five years (National Autistic Society, 2025a; National Autistic Society, 2025b). There continue to be alarming reports of overmedication, seclusion, and unnecessary restraint, all of which can have long-term psychological consequences (National Autistic Society, 2025a; National Autistic Society, 2025b).

Beyond institutionalisation, access to appropriate assessment and support is another major challenge. As of September 2024, over 204,000 people in England were waiting for an autism assessment, with 89% waiting more than 13 weeks, a 25% increase in a single year and a 96% increase over two years (National Autistic Society, 2024). This backlog leaves many without the support they need, exacerbating mental health difficulties and increasing the risk of crisis. Furthermore, this backlog almost certainly leads to an underestimation of reported statistics regarding the number of autistic people, especially those without a formal diagnosis. Large-scale studies and reports suggest that a significant proportion of autistic adults remain undiagnosed due to delays and barriers in accessing assessments and diagnostic services (National Autistic Society, 2024). This means that many autistic people are not represented in official statistics, leading to an underestimation of the true scale of the suicide and mental health crisis.

The evidence is unequivocal: Autistic people are among the most vulnerable and disadvantaged groups in society when it comes to mental health and well-being. The consequences of structural oppression are found within the statistics. This tragedy and social injustice are not the result of individual circumstances; they are deeply connected to the systemic issues that autistic people experience en masse and daily. A society that cannot produce untraumatised autistic people, instead consistently generates conditions that lead to widespread distress and trauma, with nearly 80% of autistic adults and 70% of autistic children experiencing mental health difficulties (Lever & Geurts, 2016; Lai et al., 2019).

Conclusion

Epistemic Injustice has undoubtedly played a significant role in shaping the current mental health crisis experienced by autistic people. In the quest for "objectivity", psychology and related disciplines have over the last 30 years systematically dissected, dismissed and devalued the autistic identity; in its wake, this approach has contributed to widespread misunderstanding, stigmatisation, and social exclusion, factors that have fueled this immense travesty (Chapman & Carel, 2022; Okoroji et al., 2023).

This dismissal means that autistic individuals are often not believed or taken seriously when they articulate their needs, distress, or experiences, especially around mental health. As a result, their accounts of anxiety, depression, or suicidality may be minimised or misinterpreted, leading to inadequate or inappropriate support and intervention (Wodziński & Moskalewicz, 2023). Moreover, the absence of autistic perspectives in research and policy has led to the proliferation of interventions and environments that do not meet autistic needs, exacerbating feelings of isolation, frustration and hopelessness (Chapman & Carel, 2022). This hermeneutical injustice, often perpetuated by societal impatience, has left autistic people "epistemically adrift" within society, struggling to make sense of their distress and often internalising negative societal messages (Chapman & Carel, 2022).

Ultimately, the impact of epistemic injustice is not abstract, it has contributed to lower levels of well-being, higher rates of mental health difficulties and a diminished capacity for autistic people to flourish, both individually and as a community. The deficit-based models, pathologisation of traits, and exclusion from research have prioritised objectivity at the expense of ethical responsibility to those whom they have studied. Such an approach raises serious ethical concerns, as research is fundamentally intended to benefit those it studies; instead, it has sought the seed for marginalisation and has resulted in harm.

This ethical shortfall underscores the urgent need for a shift towards participatory, inclusive research and stricter ethical consideration. Where autistic voices are included in the production of the knowledge of autism.

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