Why autism in women is often misdiagnosed

When you discuss your physical, emotional and mental concerns with a medical professional, you’re hoping (and assuming) that they will provide answers to your problems and help you improve them. Unfortunately, it’s not uncommon to visit a health care provider and still have your experiences be misunderstood and invalidated. It is very frustrating to continue to struggle to be seen, heard and taken seriously by providers, which makes it feel almost impossible to get appropriate care.

Accurate diagnosis is essential in every type of health care. It helps ensure that the person gets the support that they need. This support could mean different things for different people, who may need more or less types of support at different times in their life. That’s why appropriate resources, and a sense of community, can help autistic women feel seen and supported in their intersectional experiences and identities. Autistic women are often misdiagnosed and their concerns are often brushed off or minimized, leaving them to struggle with aspects of everyday life while still looking for answers to their differences or receiving years of treatment for conditions that may not even apply to them.

We’ll discuss the commonalities of autism in women, why they are often misdiagnosed, and what autism can “look” like in women.

How common is autism in women?

The truth is, we don’t know. Almost all data examines the prevalence rates of autistic children. The CDC’s Autism and Developmental Disabilities Monitoring Network showed 1 in 68 children were autistic in 2010. In 2020, that statistic increased to 1 in 36 children.

More boys are diagnosed autistic than girls. But it’s important to note that the skewed autistic ratio of males to females doesn’t mean that girls and women are less likely to be autistic. Girls and women likely have a lower prevalence rate of diagnosis because autistic characteristics in females tend to be overlooked or misinterpreted, which means they aren’t included in prevalence rates or considered in research. In fact, until recently almost everything we know about autism was based on researching boys.

Why autistic women tend to be misdiagnosed

Autistic traits and/or the related challenges autistic girls and women experience are often misdiagnosed as symptoms of a mental health disorder. For example, social differences and poor eye contact may be conceptualized as a symptom of social anxiety disorder. Misdiagnosis also frequently occurs when undiagnosed autism leads to depression, anxiety, or poor self-esteem and autism is missed as the underlying cause. 

Additionally, women are more likely to mask or camouflage autistic traits. Girls are socialized early on to smile and make eye contact. They learn to mimic social behaviors they see accepted in others and are typically more interested in social relationships than males. Masking is adaptive as a coping skill and survival strategy but results in missed diagnosis. 

Special interests may also be overlooked in females since they frequently share similarities with the interests of allistic girls. For example, not everyone would assume that a girl who has an interest in horses or flowers is autistic.

Autistic characteristics in women

Here are a few common characteristics of autism in women:

• Social struggles — Many social difficulties that are chalked up to being shy or having anxiety are commonly misdiagnosed autism signs in women. These difficulties can include differences in engagement with peers or having a hard time participating in social norms.

• Sensory sensitivity — Sensory sensitivities are frequently overwhelming and sometimes impairing, causing interference in social and occupational functioning. High-masking women still have sensory sensitivities but may force themselves to tolerate this intense discomfort to avoid being seen as a “bother” to neurotypicals. This can lead to burnout.  

• Anxiety and depression — Masking on a regular basis takes a significant toll on a woman's emotional and mental health, leading to anxiety, depression, and/or burnout. Physical health may also be affected.

NeuroSpark can help autistic women who have been misdiagnosed.

If you’re a woman, you may have been told that you’re shy, sensitive, or your differences are “all in your head.” We promise to never minimize or invalidate your story or your experiences. The good news is that our adult autism assessment process is thoughtfully conducted to identify lesser-known or more subtle characteristics of later-identified people who may also be high-masking. 

Our one-on-one coaching and accommodations consulting can help you find confidence and contentment in your life. 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.