Autism workshop/seminar/discussion magnum opus coursus.

Designed by Lisa Be for Project Vortex

As you may know, I’m doing research at a lab at Harvard where I focus on autistic women. One thing I’ve learned is there are lots of easy, objective tests we can give ourselves to determine if we have biological markers for autism. I’m excited to share those with you so we don’t have to have any more discussions about everyone asking themselves do I have or don’t I?

I also notice the news that will help women the most is very slow to get to the public. So I’m offering a workshop to give autistic women groundbreaking research into their lives right now. The workshop will meet once a week for ten weeks, starting this week. Here are some topics we’ll cover:

  1. Use the same techniques that labs do to quickly diagnose female subjects for autism. It’s easy and fun. You can try it out on everyone.
  2. Question people who say they improve executive function. Science says only two things work, and they’re really weird things.
  3. What to do about a speech delay when research shows it’s more important to decrease the mother’s stress levels than get a kid into speech therapy.
  4. Don’t look for friends, look for special interests, the friends will follow. Neurotypical girls make friends their special interest; no wonder we were lost in junior high.
  5. Find out the one thing autistic women do that makes all camouflaging fail. But also, does this mean we can all stop trying to mask?
  6. The biggest problem autistic women have is emotional isolation. If an autistic woman isn’t feeling that then her kids are; understanding why helps you understand what drives you.

We’ll also have a discussion board to talk about any topic that interests you as it relates to women and autism. I’ll drop in each day to shed some light — or some tears — because it’s always in the free-for-all where I learn the most.

Closeup you see that we’ve all had to navigate the world in similar ways as autistic girls and women — knowing there was something wrong but we didn’t know what. Some researchers call us the lost generation of autism but talking with you all makes me feel like the found generation.

People are joining from all over the world, so the meeting times accommodate a range of time zones:

Tuesday 9pm Eastern
Wednesday 8am Eastern
Thursday 5pm Eastern

The deadline to sign up is this weekend. The cost is $150.

Sign up here.

And one more thing. I’m going to send videos of me and my friends talking about autism. This video is me with Caitlin. You get it without even signing up; in the middle she talks about a group of autistic women we created a few years ago that was so transformative to her. How could you listen to that and not sign up now? Really?


During Hurricane Ian millions of gallons of pig feces whooshed across North Carolina. Pig poop gets my attention. I raised my kids on a hog farm and the water was too contaminated to drink due to decades of farming with gestation crates: a birthing invention of factory farms that is a stacked storage system to get the most pigs per acre.

In past years Hurricane Florence and Hurricane Matthew sent feces flying so we know which problems ensue: human sickness, contaminated drinking water, rivers, plants and fish. There’s a race issue as well. The farm owners are white and their pig shit lands on property Black people own.

We don’t see many politicians taking up this cause. The pork lobby owns North Carolina. The only other state with significant hog operations is Iowa, and you can’t win a presidential primary if you trash talk pigs.

But California sidestepped the fact that pork producers don’t live in their state and 68% of voters said California should not permit the sale of pork from gestation crate farms. Many attempts to control the pork producers have failed, so whiners dismissed this one as The Bacon Apocalypse, but attorneys shepherded the law through two appeals, and this week the Supreme Court will hear the case.

The state of California will argue that gestation crates are the worst example of animal confinement. The crates don’t allow any movement for pregnant pigs; they can stand or sit but cannot turn around for most of their life. I hope California also adds something about how pigs have an intense social-emotional life and a higher IQ than dogs.

But like all legal matters, conversation will probably stick to money. The pork industry will invoke interstate commerce laws to say replacing gestation crates with moderately larger pens is too big a burden on businesses outside of California. The Court will use the Pike Test to determine if the consumer’s moral cost of eating ill-begotten pork outweighs the producer’s financial cost of reconfiguring crates to be larger.

The cost argument only works because the meatpacking industry controls farmers, and only the few financially independent hog farmers could study the cost of switching from gestation crates. But also, universities capable of producing this research are funded by gestation crate manufacturers.

My son discovered this problem first-hand. Our farm switched from gestation crates to free-range farrowing while he was growing up. The farmer had a degree in hog genetics and we collected data for nine years using a (mostly) scientific method which at the time was annoying, but created a data set like no other in the US.

The switchover was financially successful. There were fewer sows per acre, but each sow had a larger number of healthy piglets and the herd no longer required an antibiotic regimen. There were also huge cost savings for labor, because gestation crates have to be cleaned constantly and it’s disgusting work.

More dramatically, unlike their dull, inert created counterparts, free-range piglets at two-months could run around the pen in little groups like puppies. They were fun and curious and could always make their way back to their mom when she called.

In high school my son wanted to work with a professor to see if he might like being a scientist. So he gathered qualitative and quantitative data from 100 sows and more than 1000 piglets and presented it to agriculture departments at universities. Even though there is no data set that comes close to this in quantity or quality, there were no takers.

One professor said that for a study on this topic he would need comparable data for hogs in a state-of-the art gestation crate system and hogs out of crates with equivalent conditions. The key: state-of-the-art. All hog research from academia must be funded by the manufacturers of gestation crate systems.

My son didn’t get to work with a professor, but he did have a good answer for the college essay prompt: Write about a time you failed. And today he’s studying psychology, because he realized the question of why gestation crates have not been outlawed is clear. But the question of how farmers cope with daily abuse when they’re so close to their animals is a much harder question to answer.

No one has devised a perfect questionnaire for determining a narcissist, which is why the New York Times makes the argument for cutting narcissism from the DSM.

We know what narcissism looks like: pompous clowns who are sad on the inside, treat people like shit wherever they go, and perhaps most importantly, have no idea that they look this way to other people.

That sounds like autism to me. Not all autism, but the version of autism where there is the most focus on knowing information and least focus on understanding people.

The narcissist wants people to see when they are right and the narcissist wants people to listen to them, but the narcissist does not want to listen to other people. The narcissist does not notice other peoples’ feelings, but if the narcissist’s feelings are hurt and they get angry.

That sounds like autism as well. Not all autism. But people with autism who I don’t like.

When the narcissist is having a terrible time in life, they might seem to change, but the narcissist does not have enough personal insight to change. They might seem to understand that they are all about themselves, but they don’t really understand.

This is everyone with autism: We think we see ourselves and we think we are managing the parts of our personality that are anti-social. But if we could do that, autism would be curable.

We go to therapy to complain about a parent or partner or terrible dates. And therapists need a word to describe people who are transgressive. Narcissism is a word that enables people to empathize with how hard it is to live with the person.

Except that every time I coach someone with autism, they bring up the word narcissist to describe someone in their life. But autism is genetic, and it can’t be that everyone in the family has autism except the narcissist parent. Really. Autism is genetic. The parent has autism too.

Sculptures by Laurent Craste remind me of autistic men with high IQs who can’t understand themselves, or other people, and let their rage and anger destroy the people they love. I grew up with a father like this and attracted men like this. I know what it’s like to live in fear. They have periodic urges to change but it’s clearly impossible for them.

People with narcissism have the same type of brain as people with autism: very high IQ with unpredictable dips in certain areas. People more numerically gifted are more stubborn and rigid. People less numerically gifted are better at camouflaging those autistic traits. Narcissism, then, is the numerically gifted version of autism.

Why is this important? Because people with autism marry other people with autism. We are drawn to each other because it’s genetic so autism feels familiar to us. Also, we don’t play normal dating games so neurotypical people screen us out of their dating pool; we’re too weird.

So you and your partner have autism. You are not diagnosed because the mental health profession has no idea what they’re doing with autism. They are not trained well in diagnostics and they miss it all the time. So you really need to recognize autism yourself. Luckily it runs in families so if you have one person you can catch everyone. There is never one person with autism. Really. I swear.

You will both always have autism, but if you understand your autism you can use it more effectively. For example autistic people are competitive because we don’t understand how to be valuable to people outside of logical ranking systems. You and your partner both have this trait. But your partner is more competitive than you and less good at masking it.

At some point in the dating process you liked that you’re both winners. And everyone was on good behavior so no one noticed that you are low-conflict and your partner is high-conflict. But the truth is you’ll do anything to avoid conflict. So you give in. And the high-conflict person sees that and assumes they’ll get what they want.

Your partner doesn’t have to change for your relationship to change. You can decide to face conflict and establish boundaries. For example, someone can blame you for whatever goes wrong, but you don’t have to accept that as truth. The person can pick fights with you but you don’t have to take the bait. You could leave, but that won’t change the fact that you don’t deal well with boundaries or conflict. And it won’t change that people with autism marry people with autism.

So consider that narcissist is really the word for “autistic person I hate.” And you can make things better by managing your own autism more effectively. Give it a try. If nothing else, the number-one complaint about people with narcissism is they blame everyone else for their problems.

My 9/11 post: Why everyone should watch the Queen’s funeral live

People watching the moon landing on television at a cafe in Milan in 1969

My son told me they read a study about the unreliability of memory in his psychology class. He said people who were at the World Trade Center when the Twin Towers fell reported they learned about the towers falling from television.

I asked him what is unreliable about that? I told him even though the first tower literally fell on me, I thought a bomb had been dropped. I was completely covered in dust and no one thought I had mental capacity to know more about what had happened. I didn’t learn that the towers fell until the evening of September 11. I didn’t learn about it on TV only because I had gauze covering my eyes and someone had to tell me what happened. Read more

I tell Z I’m going to my garden next to our building. He doesn’t respond. So I sing to him. We have determined that he tunes me out most of the time, but he doesn’t if I sing to him. He tells me not to take it personally but regular talking is really uninteresting to him sonically. Read more

Melissa wants you to know that she did not edit the post about how doctors are the most annoying of all the professional women I coach. I did not, in fact, write that in the post. Melissa points out that it’s what I was trying to write, but I got distracted piling on all the links she’d normally be taking out. Read more

Z’s hearing is still deteriorating from the car crash. I think he might be ready to call it quits on cello.

I have a hard time knowing what to say because it’s all so sad. I have to stop myself from becoming  Julie Andrews, tossing out desperate suggestions.
Read more

Is medical school worth it for women?

Surgical Ceramics by Beccy Ridsdel

Women who are really good at school think a great way to celebrate that is to go to medical school. People admire you! It’s great money! And there’s flexible hours for moms!

But this is what really happens to women who go into medicine: The majority will not work full-time after having children. And once that happens, their co-workers will treat them like crap and they will not make nearly enough money to put up with the stress of variable hours and disrespect.

Women physicians are mentally behind women in other professions. Instead of learning from women in other professions, female physicians think they they will have better outcomes because they worked so hard to control everything by:

  • Considering family planning when selecting a specialty
  • Specifically avoiding surgery, due to the lifestyle required of surgical trainees
  • Planning pregnancies around training stage and timing of specialty exams
  • Delaying childbearing despite age-related fertility pressure

But none of this matters because female doctors constantly underestimate the time constraints demanded by their profession.

Part-time schedules undermine the second spouse. The second spouse can’t stay home because there is not enough money. And that spouse cannot work full-time because full-time professional jobs — including full-time medical jobs — require full-time support at home. And women working full-time — especially doctors — don’t have that support.

Flexible hours disrupt family division of labor. When female doctors accept  flexible schedules or a shortened work week the high pay can’t make up for the disorder. An office provides stimulation, guidance, and a sense of belonging, and at home professionals establish clear divisions of family labor. But “family-friendly” policies blur boundaries and home becomes the place in which there is too much to do in too little time — especially for reduced-hour physicians.

Part-time is a mirage at high levels. Law firms famously offered top women the option to go part-time, cut their salaries in half, and the women kept working long hours. The corollary in medicine is women who have sub-specialties work more than forty hours a week  even when they are part-time.

People who are great at their work like to work full-time. Those who devote most of their time to work don’t want to work with people who are working part time. If someone makes work their highest priority why should they have to work with someone who does not make work their highest priority?

You might say that everyone should be working part-time in their work and part-time as parents. But a lot of people get pleasure from picking one thing and doing it really well. For example, full-time moms are way better at their job than part-time moms.

Quitting is healthier than going part-time. You, too, would be happier doing one thing well; when you work part-time and parent-part time you end up losing the identity you forged as a high performer at work and you create weak ties in the work arena and the parenting arena. Going part-time you don’t feel happiness from gaining flexility, you feel pain from losing the opportunity to be admired for doing something well.

Leaving work is a logical choice for women. Economist Claudia Goldin finds that from 1985 to 1995 only 30 percent of women who graduated college worked full-time when they had children. Since 1995, this group decreased their workforce participation.

This decrease in participation is due to an increase in social status. And the effect is worldwide.LH When women have more power they leave the workforce in favor of being at home.

Few men want to give necessary support for a full-time partner. Everyone has the option of working full-time and having children, but you must partner with someone who is capable and willing to stay at home full-time and provide the type of emotional and logistical support necessary for performing a high-paying full-time job. Few men are available because unlike women, men do not leave the workforce when they gain power.

If you care about money you should skip medical school. Remember how I told you that other professional women are decades ahead of you? Women applying to MBA programs understand that most will not be working full-time, and they understand the benefits of an MBA program are limited given their biological clock. Therefore women go to business school earlier than men, and schools have no choice but to accept women earlier or they won’t have any women.

Women applying to medical school should do the same sort of planning. If you don’t have a subspecialty you’re unlikely to work full-time after you have kids. If that’s the case, you’d be better off financially becoming a physician’s assistant instead of a doctor.

An MD is like a diamond ring — signifies a high-end passage to the next stage of life. As soon as women become the majority, salaries go down. Look at the legal profession. Women outnumbered men, salaries went down. The same pattern is already happening in medicine. Women are the majority of graduates, and in specialties where women dominate the pay rate plummets.

But there’s good news! Most women don’t go into medicine for the money. The money is nice, but you expect that you’ll have a spouse making money. Women go into medicine for the prestige. That’s why it’s so easy for them to plan from the outset to go part-time and not even crunch numbers to see if it’s worth it.

So maybe my first premise is wrong. No woman can make part-time work come out well. But doctors actually are different from the other women. Because a doctor holds on to the prestigious title no matter where she is, even if she stays home taking care of kids.

Most frequently unspoken thought while talking to a therapist: Just fucking tell me what to do! A good therapist is a sounding board but a good career coach tells you your best career path. The best career coaches know the right answers because they see patterns, and autistic people are the best at seeing patterns. That’s right. When you look for a career coach, look for someone autistic. Read more

I spend half my life trying to not offend people. My safe space is the comments section here on my blog where the only social rule is: be interesting. I’m especially grateful to people who disagree with me; it’s out of control for me to chase someone around arguing with them in person, but in the comments people think: She’s so responsive! Read more