What I Want You to Know about Autistic Women and Girls

By Tracy Smith

CW: serious mental illness, eating disorders.

When you are asked to imagine an autistic person, who do you think of? Someone male? This wouldn’t be surprising, as studies indicate that up to five times as many autistic men and boys are diagnosed in comparison to women (National Autistic Society). Indeed, the National Autistic Society put the ratio of men to women who access their adult services at 3:1. Although, through conversations with the autistic community, it appears that women more generally are under-diagnosed. Many choosing not to seek diagnosis for a myriad of reasons. Concerned over stigma “I want to adopt in the future and worry it might be viewed negatively”, worried they may not be believed “people are always incredulous when I raise it” or facing barriers to healthcare access “they don’t believe I have chronic fatigue so why would they help me with this”.

To compound the issues around under-diagnosis, when autistic women (any person female at birth) do reach out for support, they are likely to exhibit a subtle presentation which often differs from the more externally obvious traits. The characteristics of autistic females may be overlooked, their interests in books, animals, or teenage bands thought to be typical interests for their age.

As a young child, I read obsessively. I could read confidently at the age of three. This continued into my childhood, spending so much time immersed in books that I had to hide under the table, in my wardrobe, in the bathroom, anywhere to make sure my books weren’t taken away. ‘Socialisation’ you see.

I lived a magical world in my stories and fact books, I loved how you could choose what adventure to dive into, what information you wanted to learn, and how to temporarily sate an endless curiosity. For a time, before I went to sleep, I picked a word from the dictionary to memorise and use in conversation the next day. But these quirks were viewed as academic excellence, a desire to succeed and in a way, yes, they were. I struggle with perfectionism to this day. The intense drive to make sure everything looks and sounds ‘just right’, can easily lead to burn out. It’s an exhausting and unhelpful frame of mind to be in. With this post, I forced myself to commit only a couple of pomodoro cycles to it and will press send without being fully satisfied. But for me, that’s growth.

Autistic women and girls may appear more social, driven by a greater desire to fit in and feel accepted. They can develop highly compensatory masking techniques from an early age to do this. They may appear quieter and want to please, prioritising other people’s needs above their own. Used to being told they are wrong or have done something incorrectly, they begin to question their own thoughts, feelings, and desires, turning their frustrations inward. This could explain why autistic females are more likely to experience depression and anxiety, attempt suicide a rate of eight times higher than non-autistic women (BBC) and have a greater tendency to develop an eating disorder (NAS).

Friendships can often be challenging for autistic people. More so for autistic women and girls who can find it harder to navigate changing expectations and trends, particularly around the time of puberty. Girls friendships can be termed ‘fickle friends’ with fallings out and disagreements frequent. These friendship features can hide social difficulties that an autistic girl may experience in their teenage years. I remember as a teenager, not understanding why everyone wanted a tiny sports rucksack, why it would be desired. To me, these bags didn’t have enough space to carry all your books, so you had to have another carrier bag which was cumbersome to transport. But, wanting to fit in, I bought one anyway, secretly hating myself for giving in, but knowing I had to or risk ridicule. I took this mimicking to its peak when my best friend at the time changed their style completely. I went out and bought the exact same outfit I had seen her in, thinking it would be a compliment. No reader, as you can probably guess, it wasn’t. Knowing the boundaries of what is acceptable, and what is not, is hard for me to work out. It’s probably why I find human behaviour so fascinating, choosing to study this for my masters. I guess its easier for me to approach this from an academic standpoint rather than a personal one. Safer that way, less hurt.

While I now feel secure in my own interests and tastes, as a teen living through school days which felt a lot like the hunger games, it was a difficult time. As part of my work, I support autistic students at university through specialist autism mentoring. I help them get the most from their university experience, giving them the tools and strategies I wished I had when I was studying at undergraduate.

It’s a huge privilege to enter their world, hear their vulnerabilities, and be with them on their journey at such a crucial time in their lives. Knowing that they have someone who thinks and perceives similarly to them can be transformational, with much of my work supporting them to develop and maintain a positive autistic identity.

So, what do I want you to know about autistic women and girls? We are out there, sometimes invisible, but doing our best in a world which doesn’t always work for us. Please be accepting of difference, be inclusive in your approach, and strive to understand the qualities that make us all unique.

Author’s Note: Tracy Smith is the founder of InclusiveApproaches Ltd, an organisation providing specialist mentoring to neurodivergent adults in work and higher education. Tracy, her husband, and two teenagers are all neurodivergent in multiple ways, creating inimitable family dynamics!

Alongside her mentoring she has a strong interest in neurodiversity in work, writing and presenting on this subject in various areas, most notably being published in a poetry anthology called “Neurodi-VERSE”. Her expertise has helped inform disability strategies at senior levels within organisations, working towards a world which is increasingly accessible for her teenagers, and for future generations.

You can find Tracy at www.linkedin.com/in/tracyasmith or at www.linktr.ee/inclusiveapproaches