5 Commonly Overlooked Signs of Autism in Women

Signs of autism are often overlooked or brushed off if they aren’t extremely prevalent or severe. Many autistic people are undiagnosed or misdiagnosed as children. But it surprises many people how much lower the diagnosis rate is for women versus men. In fact, autism has a male-to-female ratio of 4:1.

That ratio is alarming. While many may look at that statistic and just assume that autism is four times more common in men than women, that’s not the case. There are many signs of autism in women that go undiagnosed by professionals. It can prevent them from getting the proper resources and tools that they need.

Read on to learn about the differences in autism diagnoses between men and women, as well as commonly overlooked signs of autism in women to be aware of.

How autism diagnoses differ for men and women

We’ve already established that men have a much higher likelihood of being diagnosed with autism than women. But why?

There have been a few theories explored in the past. For example, in 1997, there was a theory proposed that was called extreme male brain (EMB) theory. It centered on the idea that men exhibit systemizing behavior by recognizing patterns in the world, while women show socializing behavior with their ability to pick up social cues. The systemizing behavior can align with the signs of autism, while women’s increased empathy also leads to increased masking in women from an early age. Additionally, females typically internalize distress more than males who typically externalize distress, so their autism can present differently.

Another theory has been about the connection between autism and exposure to prenatal testosterone, which can cause “male-typical” behavior.

It's also important to note that many of the autism research subjects have been white males. There simply is a skewed gender imbalance in autism studies that has not included enough girls and women (and people of color). Since autism research has historically focused on boys, providers haven’t aren't informed enough to understand or detect how autism presents differently in females.

There are many reasons why autistic women are disproportionately undiagnosed or underdiagnosed with autism. Autistic women often have a much more subtle presentation of the signs. They are more likely to mask or camouflage their signs, which can lead to burnout and exhaustion. For example, they might be able to make eye contact with others, but internally, this causes them stress and discomfort.

It’s also common for autistic signs in women to be overshadowed by stereotypes. For example, people may believe that a girl having an excessive female-typical interest, such as horses, isn’t a sign of autism.

5 overlooked signs of autism in women

Many signs of autism stem from difficulty with social interaction or a decreased desire for social situations. But for women, these signs are often brushed off as anxiety or general shyness. By being aware of these commonly overlooked signs of autism in women, we can help reduce the disproportionality of misdiagnosis and ensure that they get the support and tools they need.

Anxiety or depression — Symptoms of anxiety or depression often overlap with signs of autism, such as disinterest in social situations and trouble with concentration. This behavior can not only lead to a lack of diagnosis for autism, but it can also result in a misdiagnosis of anxiety or depression. This means that a person can be prescribed medication that they don’t need, which may do more harm than good.

Control of body or facial expressions — Some autistic people may struggle with nonverbal communication such as facial expressions or gestures during situations and conversations. If a woman is trying to conform to those around her, she may deliberately control her body movements and facial expressions to mask, or she may hyperfixate on the nonverbal communication of herself and others around her.

Shyness — Being introverted and bashful around others is often just seen as shyness in women. In fact, shyness often goes hand in hand with politeness, which is commonly accepted, and even expected, of women. But shyness is often a sign of an autistic woman trying to determine her place in a social situation, feeling unsure about how to engage with others, or feeling overwhelmed by the pressure of social expectations.

Social struggles — Differences in social communication between autistic and neurotypical people are one of the major diagnostic categories of autism. Having trouble making and maintaining friendships, struggling to engage in conversations outside of their interests, difficulties picking up or participating in social norms, or needing time to decompress after a social event can all be traits of autism in women. These social struggles may not always be apparent in high-masking women, but they could be causing a lot of stress.

Rigid adherence to routine — Prioritization of responsibilities, such as work or school, over social gatherings can go deeper than just wanting to meet a deadline. Autistic people tend to ensure that they stick to a rigid schedule to avoid unexpected changes in routine or unwanted social interactions with others.

NeuroSpark understands how autism presents in women

At NeuroSpark, we are women-led and neurodivergent-led. We help women make sense of their experiences and understand their unique brain style. We love helping women navigate through their journey of self-discovery.

If you’re a woman who is self-diagnosed, formally diagnosed, or simply exploring their neurodivergent identity, our one-on-one coaching and accommodations consulting can help you find confidence and contentment. We are also offering therapy in select states and are taking great care to consciously expand our network of neurodiversity-affirming therapy to include more states.

Contact our team today for more information or to schedule a consultation.