For many autistic people, navigating life without understanding why they feel different can be an isolating and painful experience. In Japan, where social harmony and conformity are deeply valued, this experience can be even more pronounced.
A new study sheds light on how late-diagnosed autistic adults in Japan make sense of their lives, revealing a persistent gap between public awareness and the lived reality of autism.
This study by Nanami Harada and colleagues, published in Autism (2025), explores the lived experiences of seven Japanese adults who received an autism diagnosis in their twenties or thirties.
Using in-depth interviews and thematic analysis, the researchers provide rare insight into how autism is perceived and managed within the unique social and cultural landscape of Japan.
The study found that all participants felt different and misunderstood throughout their lives. Many experienced bullying during school years and struggled to adapt to the workplace.
While receiving a diagnosis brought some relief and self-understanding, it also triggered mixed emotions, ranging from sadness and confusion to a sense of personal validation.
In Western countries, research increasingly includes autistic perspectives, yet studies from East Asia remain scarce.
Cultural expectations in Japan emphasize indirect communication and social conformity—traits that can conflict with autistic individuals’ natural communication styles. This mismatch may contribute to the intense stigma and misunderstanding faced by autistic people in Japanese society.
To investigate these issues, the researchers interviewed four women and three men between the ages of 34 and 46, all of whom had been clinically diagnosed with autism as adults.
Some also had a co-occurring diagnosis of ADHD. Participants were recruited through community connections and interviewed in a quiet university lab in Tokyo.
The interviews covered life experiences from childhood to adulthood, including education, employment, diagnosis, and relationships.
The researchers identified four core themes.
First, all participants reported feeling different from others since childhood, often without understanding why.
Several described being bullied for their academic success or for failing to conform socially. These experiences created lasting emotional scars.
Second, the path to diagnosis was often indirect. Some discovered autism through books or social media, while others sought help after experiencing mental health crises.
Diagnosis, for many, offered clarity but also introduced new challenges, such as confronting societal stigma or re-evaluating past experiences through a new lens.
Third, emotions surrounding the diagnosis were complex. While some participants welcomed the diagnosis as a way to make sense of lifelong struggles, others expressed discomfort or even shame.
One participant described feeling “inferior” and “resistant” after learning they were autistic, fearing discrimination and misunderstanding. Others found comfort in finally having an explanation for their differences.
The final theme was a strong desire for acceptance.
Most participants described negative reactions from family members who struggled to accept the diagnosis.
Some were advised by professionals to hide their diagnosis in the workplace, reinforcing the belief that being open about autism would lead to exclusion.
Disclosure often led to social rejection, job loss, or strained relationships. One participant noted that “many people seem to live their lives hiding it,” reflecting the pressure to mask autistic traits in order to fit in.
These findings underscore the significant mental health toll of navigating a society that often fails to understand or accommodate autism.
Participants reported burnout, anxiety, and depression, often resulting from the pressure to appear “normal.”
One participant experienced such severe exhaustion from masking her differences that she was hospitalized. Others spoke of withdrawing from society for extended periods, a condition in Japan known as hikikomori.
The implications of this study extend beyond the experiences of the seven participants.
It raises broader questions about how cultural values shape the understanding and treatment of neurodivergence.
In Japan, the tendency to avoid standing out can make it especially difficult for autistic people to advocate for their needs or express themselves authentically.
Unlike in some Western countries, where the neurodiversity movement has gained visibility, many Japanese autistic individuals face cultural and institutional barriers to acceptance.
This research suggests a need for greater awareness and education about autism in Japan—not only among the public but also among healthcare professionals and employers.
Interviewees expressed a desire for more inclusive spaces and support systems, where they could feel understood without needing to mask their identities. Some also voiced interest in becoming advocates themselves, using their experiences to help others.
Although the sample size was small, and all participants were diagnosed in adulthood, the findings offer valuable insight into how cultural context shapes autistic experiences.
The interviews took place in 2016, and societal attitudes may have evolved since then, especially with growing awareness of neurodiversity. Nonetheless, the study highlights enduring challenges that merit attention from policymakers, clinicians, and the wider public.
In a society where fitting in is often prioritized over self-expression, the voices of autistic adults in Japan reveal a pressing need for compassion, understanding, and systemic change.
As the neurodiversity movement continues to grow globally, studies like this offer a crucial reminder: true inclusion requires listening to autistic people in all their diversity, across all cultures.
Citation
Harada, N., Pellicano, E., Kumagaya, S., Ayaya, S., Asada, K., & Senju, A. ‘I don’t think they understand the reality of autism’: The lived experiences of autistic adults in Japan. Autism. https://doi.org/10.1177_13623613251355303
