For decades, research and diagnostic criteria for autism has been predominantly built around the male profile. This has resulted in women and girls being misdiagnosed, misrepresented or left to understand their symptoms on their own. In reality, autism can present differently in girls and women. Girls and women also tend to have developed ways of hiding their symptoms.
What masking looks like
Masking is often an automatic social camouflaging response. It can develop over years of observing others and learning the potential negative effects of certain behaviours. For many autistic women and girls, masking becomes a necessary survival strategy used to navigate a neurotypical world.
It can include:
- Mirroring: Copying the mannerisms, accents, or body language of those around you to blend in.
- Scripting: Mentally rehearsing conversations, planning topics in advance, or practicing facial expressions before social interactions.
- People-pleasing: Going along with social situations that feel overwhelming to avoid standing out, often at the expense of your own boundaries.
- Suppressing natural urges: Forcing uncomfortable eye contact or actively hiding self-soothing behaviors (stimming), such as fidgeting or hand-flapping, while in public.
- Performing emotion: Displaying the socially expected emotional response even when it doesn’t feel natural.
Continuous masking can become incredibly exhausting. Over time, this leads to autistic burnout, and many autistic women describe feeling a deep sense of not knowing who they really are when they no longer have to mask.
Why young girls tend to go undiagnosed
From a young age, girls are socialised to observe, imitate, and adapt to those around them. For autistic girls, this can develop into masking their symptoms, where they consciously or unconsciously mimic the social behaviour of others in order to fit in. They may study how role models interact, dress similarly to peers, and suppress traits that might draw attention.
Due to their symptoms being less visible, autistic girls tend to be overlooked by teachers, parents, and clinicians. Because standard diagnostic tools were historically based on male presentations of autism, girls are frequently misdiagnosed with co-occurring conditions like anxiety, depression, or eating disorders before their autism is ever recognised.
Instead of receiving a timely autism assessment, they may simply be told they are:
- Shy or introverted
- Mature for their age
- Anxious or oversensitive
This is why our Child Autism Assessments strictly follow NICE guidelines and are specifically tailored to recognise how autism presents differently in girls, ensuring that no vital developmental history is missed.
Impact of a late or missed diagnosis
When autism goes undiagnosed, girls and women are often left without an explanation for experiences that have shaped their entire lives.
Late diagnosis can provide relief for people who find themselves with more answers for their lifelong experiences. It can support less self-blame and greater self-compassion. Diagnosis also allows individuals to access support within their workplace or education. If you are an adult seeking answers, learn more about our Adult Autism Diagnostic Assessments.
Supporting autistic girls and women
- Challenge assumptions and biases about how autism is ‘meant’ to look
- Take self-reporting seriously, women and girls with autism often have significant insight into their own experience
- Ensure that safe spaces are created where there is no expectation to mask
