"autism isn't real" is the sort of thing you get mad about when you don't realize psychiatry/psychology are infant fields and that most diagnoses are just ways of labelling people with what kind of therapy/drugs the doctor suspects the person needs

"hmmmmm it looks like mental health diagnoses are things that people get to get special attention and treatment" yes what did you think they were exactly. does a person have to prove to you that they have the exact imbalance of humours you care about

it goes without saying that any diagnoses that entitle people to special institutional treatment will be taken advantage of by people who could probably go without, but that's a problem when our institutions are deeply unequal, not a deep problem with psychiatry

this is one reason we get confusing things like people saying that people with autism don't pick up social cues, while others say they actually have an enhanced sense of them but don't act on them the right way. this is actually a matter of debate in psych https://www.pnas.org/content/116/39/19245

The problem is that, when a condition becomes diagnosable and is treated, the nature of the people who have it changes (through treatment). maybe autistic people pick up social cues better but only after years of treatment where clinicians give them special training at it

But the fact is that most of us have known children where there's clearly something "off", where they need some kind of help that regular social and educational circles are not prepared to provide them. diagnoses are how we sort those people so clinicians can make sense of them

These range from labels that say "this kid can probably go to school but will much better off extra training/therapy/medication" (autism/adhd/depression) to "this person will be a danger to themselves and drugs/therapy are imperative" (bipolar disorder/paranoid schizophrenia)

Anyone with the smallest shred of empathy for others realizes this intersects with factors of race, gender, and class in disgusting ways. Black kids get locked up before they get to someone who marks them as needing help; white boys get adderall after their first B in school

But this is a fact of inequalities within our system, not of the basic institutions of clinical psychiatry and psychology, which just acknowledge that some people need therapy, and some people need drugs. It's the inequalities that need to be changed, not Psychiatry