Brain-based identities, especially around autism, have received much attention in recent literature on biopolitics through concepts such as brainhood, cerebral selfhood, and neurochemical selves. This article complicates conversations about self and brain by presenting ethnographic data about Italian autistic youth. It demonstrates the complexities of the ways in which youth draw on brain discourses and autism identity discourses. While youth and their parents did sometimes talk about autism as related to selfhood, and autism as related to brains, and even brainhood as related to selfhood, they rarely spoke of all three concepts together. Youth’s use of autism identity discourses proved sporadic, and instrumental. Italian youth did not mobilize biopolitical modes of engagement the same way as scholars have described in other settings, suggesting important cross-cultural variation in how people relate to notions of self and brain linked to broader differences in Western biomedicines. This study provides a rich description of identity discourses employed by autistic Italian youth, demonstrating how they can use autism as a tentative basis for seeking collective identity and social interaction while negotiating skepticism about its meaning for individual identity. Throughout, the brain plays a minimal role, resisting neuro-essentialist or neuro-hegemonic conceptualizations of autism.