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Diagnosing autism in females

How Autism Presents Differently in Females

Autism spectrum disorder (ASD) is a complex developmental condition that affects communication, social skills, behavior, and sensory processing. Historically, autism has been viewed as a predominately male diagnosis.

However, research now shows that many females are also on the spectrum – they just tend to present differently than males.

Why Autism is Underdiagnosed in Females

There are several reasons why autism often gets missed in females:

Diagnostic criteria is based on male presentation – The early diagnostic criteria for autism was developed based on male subjects exclusively. As a result, the criteria is skewed towards how autism presents in males. Core traits like intense focus, poor eye contact, and stimming behaviors may look different or be less apparent in females.

Females are better at masking symptoms – From an early age, females are socialized to blend in, follow social rules, and mask their authentic selves. Many autistic girls intuitively learn to camouflage their symptoms in social settings, leading to less overt symptoms.

Special interests align with gender norms – While autistic males may have obscure or narrow special interests like train schedules or license plates, autistic females often have interests that fit within societal gender roles like animals, art, or reading. This can cause their intense focus to be overlooked.

Sensory issues are less disruptive – Females on the spectrum tend to have more subtle sensory sensitivities like sensitivity to textures or fabrics. In contrast, males are more prone to overt meltdowns. As a result, sensory issues in females may be dismissed or overlooked.

Key Signs of Autism in Females

While autism cannot be diagnosed based on gendered traits, there are some common characteristics of how females may present:

More socially engaged but struggles with subtleties – Many autistic girls have an eager interest in friendships and social connections. However, they may struggle to pick up on social cues, body language, vocal tones, and subtleties in conversations.

Hard time maintaining friendships – Autistic females often have difficulties sustaining long-term friendships. They may lose friends when social rules become more complex in the tween and teen years. Or they may be taken advantage of due to social naivety.

Excessively rule-oriented – Girls on the spectrum tend to strictly adhere to rules, orders, and structures. They usually have a strong sense of right and wrong and a rigid code of ethics. This rule-bound nature can lead to anxiety when things don’t go according to plan.

Camouflaging causes exhaustion – Many females exert enormous energy camouflaging their autism during social interactions, leading to burnout. Autistic women report feeling utterly exhausted after social events where they masked their true selves.

Sensory sensitivities – Tactile sensitivities to clothing textures and tags are common in autistic females. Food textures may also be an issue. Some girls avoid social situations because they involve loud music, bright lights, crowds, or other overstimulation.

Special interests – Autistic girls commonly have intense interests in topics like animals, fiction, pop culture, art, or music. Hyper-focusing on interests at the exclusion of other activities is a red flag.

The Impact of Late Diagnosis in Females

When autism goes undetected in females, it can have severe consequences, including:

  • Social isolation, anxiety, and depression
  • Exhaustion and burnout from constant masking
  • Lack of access to supportive therapies and services
  • Increased vulnerability to bullying, abuse, and exploitation
  • Poor self-image and diminished self-worth

Additionally, many autistic women are misdiagnosed with conditions like bipolar disorder, OCD, or borderline personality disorder. The right diagnosis is key to getting the proper support.

Benefits of Diagnosis

Getting an accurate ASD diagnosis can be life-changing for females. Some of the benefits include:

  • Community and connections with fellow autistic females
  • Access to supportive therapies and services
  • Education, accommodations, and disability services in school
  • Job accommodations and protections in the workplace
  • Explanation for lifelong social and sensory challenges
  • Self-acceptance and removing stigma or shame

Significant Strides in Recognizing Autism in Females

While autism in females is still under-recognized, significant progress has been made in understanding how it may present differently than in males. The gap between diagnosis rates in boys and girls is starting to close.

It is now clear that autism is not just a “male condition”. Females have unique manifestations that must be considered for accurate identification and support. We still have a long way to go, but increased awareness of autism in all its diversity is helping females get recognized and validated. This allows them to get the tools they need to thrive as themselves.


Females with autism have unique presentation and challenges that have been overlooked for too long. Diagnosing autism in girls often happens much later than in boys, if at all. This delay results in years of unmet needs and diminished self-esteem.

However, as awareness grows, more females are receiving life-changing diagnoses and supports. While autism presents differently across all individuals, understanding its manifestation in females marks an important step forward in inclusion and support.

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