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◆ Social science & medicine (1982)2026-09-13

Diagnosing employability: neurodiversity and the expansion of diagnosis into the workplace.

Maria Concetta Lo Bosco

原始摘要(英文原文)· Original abstract
This paper analyses the workplace as a critical site where overdiagnosis is institutionally reconfigured. Drawing on ethnographic fieldwork in three workspaces hosting technology startups and creative agencies in Lisbon, Portugal, including participant observation and in-depth interviews with twelve neurodivergent employees and three HR managers, the paper traces how the neurodiversity movement's ethos of "difference, not deficit" is absorbed into organisational governance. It explores how initiatives framed as inclusive often intensify institutional demands for formal diagnosis as a prerequisite for accommodations, recognition, and employability itself. For employees, diagnosis operates ambivalently as both a gateway to support and a mechanism of surveillance tying legitimacy to a medical label; for HR managers, diagnostic categories function as managerial tools that render difference legible, predictable, and optimisable. The paper identifies two institutional logics driving this expansion: a gatekeeping logic, in which diagnosis is still required to access protection, and a celebratory logic, largely absent from existing accounts of institutional diagnosis, in which certified difference is marketed as a productive organisational value, intensifying rather than easing diagnostic demand. Together, these logics extend theories of institutional classification to the workplace as a distinctive site and show that norms of able-bodiedness operate through incorporation as much as exclusion. Overdiagnosis thus emerges less as a matter of clinical excess than as a socio-institutional phenomenon. The Portuguese case offers a Southern European perspective on dynamics of diagnostic expansion examined primarily in Anglo-American contexts, with implications for identity, governance, and the definition of the legitimate worker.
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Diagnosing employability: neurodiversity and the expansion of diagnosis into the workplace. — 科研速览 Science Skim