Evidence Standards and Source Library

Every clinical claim on this site is sourced. This page explains what counts as evidence here, what doesn't, and where to find the primary literature behind each topic area. It's organized by subject cluster, not by post — so if you're looking for the research behind a specific claim, you can find it here without having to hunt through individual articles.

This is a living document. It's updated when new posts are published and when the literature in a given area shifts meaningfully.

Not all sources are equal, and I don't treat them as if they are. Here's the hierarchy I use, in descending order of weight:

Peer-reviewed empirical research — studies published in indexed journals, subject to peer review, with transparent methodology. Systematic reviews and meta-analyses sit at the top of this tier when they exist. Individual studies are cited with their limitations noted where those limitations are material to the claim being made.

Clinical consensus documents — guidelines from professional bodies (WPATH, APA, AASECT, NASW, AAMFT) that synthesize the available research and represent the current standard of care. These carry significant weight because they reflect collective expert judgment, but they're not infallible and I note when a consensus position is contested or when the underlying evidence base is thinner than the confidence of the document suggests.

Theoretical frameworks with empirical support — models like Interpersonal Theory of Suicide, Terror Management Theory, or Polyvagal Theory that have generated testable predictions and accumulated supporting evidence, even where the full model remains debated. I use these as interpretive lenses, not as settled fact.

Expert clinical writing — books, essays, and clinical commentary from practitioners with documented expertise in a given area. Cited as perspective, not as evidence for empirical claims.

What I don't use as evidence: anecdote alone, social media consensus, ideologically motivated sources without empirical grounding, or studies I haven't read in full. If a claim appears on this site without a citation, it's either a clinical observation I'm flagging as such, or an error — and I want to know about the latter.

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17. https://doi.org/10.1023/A:1005653411471

Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/10.1007/s10803-018-03830-2

Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). "Putting on my best normal": Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5

Lai, M.-C., Lombardo, M. V., & Baron-Cohen, S. (2014). Autism. The Lancet, 383(9920), 896–910. https://doi.org/10.1016/S0140-6736(13)61539-1

Lai, M.-C., Lombardo, M. V., Ruigrok, A. N. V., Chakrabarti, B., Auyeung, B., Szatmari, P., Happé, F., & Baron-Cohen, S. (2017). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702. https://doi.org/10.1177/1362361316671012

Milton, D. E. M. (2012). On the ontological status of autism: The 'double empathy problem.' Disability & Society, 27(6), 883–887. https://doi.org/10.1080/09687599.2012.710008

→ Used in: Not Narcissism, Forty Years Late, AuDHD Mood Cycling vs. Bipolar

Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.

Faraone, S. V., Asherson, P., Banaschewski, T., Biederman, J., Buitelaar, J. K., Ramos-Quiroga, J. A., Rohde, L. A., Sonuga-Barke, E. J. S., Tannock, R., & Franke, B. (2015). Attention-deficit/hyperactivity disorder. Nature Reviews Disease Primers, 1, 15020. https://doi.org/10.1038/nrdp.2015.20

Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik, K., Spencer, T., Ustun, T. B., Walters, E. E., & Zaslavsky, A. M. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry, 163(4), 716–723. https://doi.org/10.1176/ajp.2006.163.4.716

Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966

→ Used in: AuDHD Mood Cycling vs. Bipolar, Rejection Sensitive Dysphoria, RSD vs. Anxious Attachment

Kinnaird, E., Stewart, C., & Tchanturia, K. (2019). Investigating alexithymia in autism: A systematic review and meta-analysis. European Psychiatry, 55, 80–89. https://doi.org/10.1016/j.eurpsy.2018.10.008

Luminet, O., Nielson, K. A., & Ridout, N. (2021). Alexithymia and memory: A comprehensive review of behavioral and neuroimaging studies. Body, Movement and Dance in Psychotherapy, 16(1), 4–31. https://doi.org/10.1080/17432979.2020.1862928

→ Used in: Alexithymia Quick Read, AuDHD Mood Cycling vs. Bipolar

Raymaker, D. M., Teo, A. R., Steckler, N. A., Lentz, B., Scharer, M., Delos Santos, A., Kapp, S. K., Hunter, M., Joyce, A., & Nicolaidis, C. (2020). "Having all of your internal resources exhausted beyond measure and being left with no clean-up crew": Defining autistic burnout. Autism in Adulthood, 2(2), 132–143. https://doi.org/10.1089/aut.2019.0079

→ Used in: Autistic Burnout Quick Read, AuDHD Mood Cycling vs. Bipolar

Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., Ettner, R., Fraser, L., Goodman, M., Green, J., Hancock, A. B., Johnson, T. W., Karasic, D. H., Knudson, G. A., Leibowitz, S. F., Meyer-Bahlburg, H. F. L., Monstrey, S. J., Motmans, J., Nahata, L., … Arcelus, J. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(S1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644

Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., Rosenthal, S. M., Safer, J. D., Tangpricha, V., & T'Sjoen, G. G. (2017). Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 102(11), 3869–3903. https://doi.org/10.1210/jc.2017-01658

Murad, M. H., Elamin, M. B., Garcia, M. Z., Mullan, R. J., Murad, A., Erwin, P. J., & Montori, V. M. (2010). Hormonal therapy and sex reassignment: A systematic review and meta-analysis of quality of life and psychosocial outcomes. Clinical Endocrinology, 72(2), 214–231. https://doi.org/10.1111/j.1365-2265.2009.03625.x

White Hughto, J. M., & Reisner, S. L. (2016). A systematic review of the effects of hormone therapy on psychological functioning and quality of life in transgender individuals. Transgender Health, 1(1), 21–31. https://doi.org/10.1089/trgh.2015.0008

→ Used in: WPATH SOC8 Quick Read, Transmasculine HRT Guide, Transfeminine HRT Guide, Gender-Affirming Surgery Field Guide

Herman, J. L. (1992). Trauma and recovery: The aftermath of violence — from domestic abuse to political terror. Basic Books.

Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.

Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton.

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389–399. https://doi.org/10.1002/jts.20047

→ Used in: What the Body Already Knew, Body Keeps the Closet, Religious Trauma and LGBTQ+ Somatization

Joiner, T. E. (2005). Why people die by suicide. Harvard University Press.

Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological Review, 117(2), 575–600. https://doi.org/10.1037/a0018697

→ Used in: Interpersonal Theory of Suicide Quick Read, The Vice Grip

Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018). Risk markers for suicidality in autistic adults. Molecular Autism, 9, 42. https://doi.org/10.1186/s13229-018-0226-4

Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P., & Bölte, S. (2016). Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 208(3), 232–238. https://doi.org/10.1192/bjp.bp.114.160192

Kirby, A. V., Bakian, A. V., Zhang, Y., Bilder, D. A., Keeshin, B. R., & Coon, H. (2019). A 20-year study of suicide death in a statewide autism population. Autism Research, 12(4), 658–666. https://doi.org/10.1002/aur.2076

→ Used in: Neurodivergence and Suicide Quick Read, Neurodivergence and Suicide: Autism and ADHD Mechanisms

Durkheim, É. (1897/1951). Suicide: A study in sociology (J. A. Spaulding & G. Simpson, Trans.). Free Press.

→ Used in: Durkheim: Sociology of Suicide Quick Read

Posner, K., Brown, G. K., Stanley, B., Brent, D. A., Yershova, K. V., Oquendo, M. A., Currier, G. W., Melvin, G. A., Greenhill, L., Shen, S., & Mann, J. J. (2011). The Columbia–Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266–1277. https://doi.org/10.1176/appi.ajp.2011.10111704

→ Used in: Suicide Screening Tool Limitations for Neurodivergent Clients, Safety Planning for Neurodivergent Clients

Johnson, M. P. (2008). A typology of domestic violence: Intimate terrorism, violent resistance, and situational couple violence. Northeastern University Press.

Stark, E. (2007). Coercive control: How men entrap women in personal life. Oxford University Press.

Walker, L. E. (1979). The battered woman. Harper & Row.

→ Used in: Power and Control Wheel, Reactive Abuse, Flying Monkeys and Smear Campaigns

Bowen, M. (1978). Family therapy in clinical practice. Jason Aronson.

Minuchin, S. (1974). Families and family therapy. Harvard University Press.

→ Used in: The Family Sin-Eater, The Dishwasher

Conley, T. D., Ziegler, A., Moors, A. C., Matsick, J. L., & Valentine, B. (2013). A critical examination of popular assumptions about the benefits and outcomes of monogamous relationships. Personality and Social Psychology Review, 17(2), 124–141. https://doi.org/10.1177/1088868312467087

Rubel, A. N., & Bogaert, A. F. (2015). Consensual nonmonogamy: Psychological well-being and relationship quality correlates. Journal of Sex Research, 52(9), 961–982. https://doi.org/10.1080/00224499.2014.942722

→ Used in: Ethical Non-Monogamy: What Therapists Get Wrong, Polyamory: Structure, Communication, Clinical Lens

Connolly, P. H. (2006). Psychological functioning of bondage/domination/sado-masochism (BDSM) practitioners. Journal of Psychology & Human Sexuality, 18(1), 79–120. https://doi.org/10.1300/J056v18n01_05

Richters, J., de Visser, R. O., Rissel, C. E., Grulich, A. E., & Smith, A. M. A. (2008). Demographic and psychosocial features of participants in bondage and discipline, "sadomasochism" or dominance and submission (BDSM): Data from a national survey. Journal of Sexual Medicine, 5(7), 1660–1668. https://doi.org/10.1111/j.1743-6109.2008.00795.x

→ Used in: BDSM vs. Abuse: How to Tell the Difference, Kink/BDSM Consent: A Clinical Framework, Is This Assault?

Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674

Pachankis, J. E., Goldfried, M. R., & Ramrattan, M. E. (2008). Extension of the rejection sensitivity model to the interpersonal functioning of gay men. Journal of Consulting and Clinical Psychology, 76(2), 306–317. https://doi.org/10.1037/0022-006X.76.2.306

Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annual Review of Clinical Psychology, 12, 465–487. https://doi.org/10.1146/annurev-clinpsy-021815-093153

→ Used in: Religious Trauma and LGBTQ+ Somatization, Body Keeps the Closet, Being Non-Monosexual, Hair Is Not Gender

Nhat Hanh, T. (1998). The heart of the Buddha's teaching: Transforming suffering into peace, joy, and liberation. Broadway Books.

Nhat Hanh, T. (2009). Happiness: Essential mindfulness practices. Parallax Press.

Siegel, R. D., Germer, C. K., & Olendzki, A. (2009). Mindfulness: What is it? Where did it come from? In F. Didonna (Ed.), Clinical handbook of mindfulness (pp. 17–35). Springer.

→ Used in: No Reference Point, No Happiness, Meet People Where They're At

Greenberg, J., Pyszczynski, T., & Solomon, S. (1986). The causes and consequences of a need for self-esteem: A terror management theory. In R. F. Baumeister (Ed.), Public self and private self (pp. 189–212). Springer.

Pyszczynski, T., Greenberg, J., & Solomon, S. (1999). A dual-process model of defense against conscious and unconscious death-related thoughts: An extension of terror management theory. Psychological Review, 106(4), 835–845. https://doi.org/10.1037/0033-295X.106.4.835

→ Used in: Terror Management Theory: Neurodivergent Mortality Quick Read

This site is written by a licensed therapist, not a researcher. I read primary literature carefully and cite it accurately, but I am not a systematic reviewer and I don't claim to have surveyed every relevant study in any given area. Where the evidence base is thin, contested, or rapidly evolving, I say so in the relevant post.

If you find a citation error, a claim that isn't supported by the source cited, or a significant omission in a topic area, I want to know. Email [email protected].