Why “Rejection Sensitive Dysphoria” is Anti-Autistic and Needs to Be Retired
The term Rejection Sensitive Dysphoria (RSD) has become widely used in ADHD communities as a way to describe intense emotional reactions to perceived criticism or rejection. On the surface, it can feel validating—someone finally has a word for the flood of shame, hurt, and anger that can arise in social situations. But there’s a serious problem: RSD is fundamentally anti-autistic.
RSD Was Invented by a Cis White Man Who Rejects AuADHD
RSD was coined by Dr William Dodson, a medical professional featured in ADDitude Magazine, a publication that until very recently refused to acknowledge that someone could be diagnosed with both autism and ADHD (AuADHD). In fact, prior to updates in diagnostic practices, ADDitude only recognised ADHD or autism separately, reflecting the outdated 2013 DSM guidance that did not fully account for overlapping neurodivergences. You could only be diagnosed with one or the other. Dodson himself has publicly expressed scepticism about the legitimacy of an AuADHD diagnosis.
The problem isn’t just theoretical. When a single cis white man who dismisses neurodivergent intersectionality defines the emotional experience of an entire group, that framing shapes public perception in ways that erase autistic voices. RSD was never created to describe autistic experiences—it was designed to describe certain ADHD behaviours, with no acknowledgment of the nuanced ways autistic people experience social and emotional processing.
RSD Is Basically Autism, Repackaged
What many people who identify with RSD are actually describing is autistic lived experience:
Emotional flooding in response to perceived rejection
Intense shame, guilt, or anger in social situations
Difficulty regulating emotions in high-stakes social contexts
These are not inherently ADHD symptoms. They are classic features of autistic social-emotional experience. By labelling these reactions as RSD, we effectively misattribute autistic emotional responses to ADHD, further marginalising autistic voices and experiences.
A Personal Perspective: Why This Matters
When I was training as a psychotherapist, I was bullied for being autistic. One person on my course bullied me consistently for being really weird, and even told me that being an autistic psychotherapist was unethical. Experiences like this demonstrate how deeply embedded ableism is in mental health systems. By being open now about who we are—AuADHD—and our lived experience, I continue to challenge problematic terms like RSD.
This is not just personal; it’s political. The continued use of terms like RSD silences communities advocating for systemic change in both medical and mental health systems. It erases the voices of autistic and AuADHD people who are fighting for accurate recognition, better support, and an end to medical gatekeeping.
Why Continuing to Use RSD is a Problem
Erasure of Autistic Experience: Using RSD to describe something that is often autistic lived experience minimises the reality of autism. Autistic people already face widespread misunderstanding and dismissal of their emotions. RSD shifts the focus away from autism and onto ADHD, reinforcing systemic ignorance.
Medical Gatekeeping: Terms like RSD can influence clinicians to misdiagnose or overlook autism, especially in adults. When someone is struggling with intense social-emotional responses, they may be told “you have RSD” rather than “you are autistic,” perpetuating the medical bias against neurodivergent adults receiving an accurate diagnosis.
Commodification of Neurodivergence: Publications like ADDitude profit from popularising RSD. Meanwhile, autistic voices, especially those advocating for intersectional understanding of AuADHD, are sidelined.
We Need a Shift
It’s time to stop using RSD as a catch-all label for intense emotional responses to social rejection. Instead, we should:
Centre autistic voices in discussions of emotional regulation and social processing
Recognise that “floods of feelings” in response to rejection are a normal part of autistic experience, not a separate pathological ADHD symptom
And that rejection can be deeply harmful — it’s understandable to respond with dysregulation in such moments.
Promote understanding of AuADHD (Autism and ADHD diagnoses together) as a legitimate intersectional identity that cannot be simplified by a term invented by someone who denies its validity
RSD may feel validating in the moment, but it erases autistic lived experience. By speaking openly, sharing our realities, and challenging harmful terminology, we reclaim our experiences and fight for the change our communities desperately need.