Why Autism in Girls and Women Is Chronically Underdiagnosed

The original diagnostic criteria for autism were built on studies of mostly white, mostly male children. The tools we still use today reflect that origin.

Girls and women who are autistic often present differently. They mask more extensively, having learned earlier that social performance is expected of them. They develop sophisticated scripts and social camouflage. They are described as "shy," "quirky," "anxious," or "overly sensitive" — but not autistic.

The result: women are diagnosed, on average, years later than men. Many are first diagnosed with anxiety, depression, or borderline personality disorder. The masking that helped them survive costs them their mental health.

Late diagnosis carries a specific kind of grief — for the girl who struggled without language for what was happening, for the years of trying to fix herself rather than understand herself.

The autism community has been working to correct this for decades. Researchers like Sarah Hendrickx, Lorna Wing, and more recently Devon Price have built a substantial body of work on female autism presentation. But the average clinician has not caught up.

If you are a woman who suspects you are autistic — or a parent raising a daughter who doesn't fit the profile the school describes — trust the instinct. Seek an evaluator who has experience with women and masked presentations. You are not wrong for wondering.