Embracing and rejecting the medicalization of autism in Italy

Abstract

Medicalization is increasingly recognized as a bidirectional process, with patients and their families as agents. The paper considers the specific case of the medicalization of autism in Italy, from the point of view of parents of autistic people with different levels of support needs. Through reporting and comparing results of two independently conducted qualitative studies, this paper aims to analyze how parents embrace and resist the medicalization of autism in their everyday lives and in healthcare contexts. Both studies involved participant-observation with services that targeted autistic people and interviews with parents, professionals, and autistic people. Results show that parents of autistic people both embrace and resist medicalization. While parents (sometimes ambivalently) accept the responsibilization inherent in their engagement with interventions (a sort of "therapeutization" of life) and reject lay expertise by deferring to experts' knowledge, they also resist the application of medical labels, language and practices in various ways in their everyday lives. Both embracing and resisting medicalization can be useful for achieving overarching social goals of being a good parent, helping their children, and pursuing respect and social harmony. Medicalization derives not only from the cultural dominance of medical discourses, which seems to incorporate resistance to medicalization stances, but also from the absence of continuity and coordination of services, particularly in the Italian context of public (but increasingly privatizing) health and welfare services.

Keywords: Autism; Biological citizenship; Medicalization; Parents; Somatic expertise.