“A Healthy Zebra Not a Sick Horse”: A Cultural Case Study of an Autistic Individual in the USA

Social communication is a key domain at the intersection of culture, medicine, and psychiatry, particularly when communication is medicalized in diagnoses like “autism spectrum disorder” (ASD). Clinicians and scholars debate dominant medical model discourses of autism as well as grassroots neurodiversity perspectives. Increasing influence of neurodiversity perspectives has yielded increasing clinical and communication science studies considering diversity (not deficit) in communication. This cultural case study considers how one autistic young man in the USA orchestrates twenty-first-century discourses about autism, reflecting on his experiences with communication, social disconnect, and sensory sensitivities. His case illustrates how autistic-led concepts such as the “double-empathy problem,” increased attention to sensory-social components of autism, and the changing role of the Internet have substantially reconfigured the voices that autistic adults orchestrate compared with those explicated by previous scholars. These reconfigurations align with changes in medical models of autism that blur and blend with neurodiversity models. His efforts to build supportive, autistic-led spaces provide models for authentic interaction and reveal new tools for forming biosocial autistic community. This cultural case study therefore reinforces the need to avoid one-size-fits-all approaches, and the importance of a person-centered approach to meet the needs of everyone within the community.