Autism in women and girls

Autism often presents differently in males and females, and understanding these differences is important to providing the best support.

Until recently, autism was thought to overwhelmingly affect boys. The current ratio of males to females with autism is often put at 4:1 (four boys to every girl). However, recent research suggests the actual figure could be as low as 2:1 as we increase our understanding of autism and how it can present differently in each gender.

Parents with daughters on the spectrum will often share frustrating tales of how difficult it was to get a proper diagnosis for their daughters, while many autistic women did not receive diagnoses until adulthood.

Why does autism seem more common in males?

There is a growing body of work that indicates that autism presents differently in girls and, therefore, often goes unrecognised, especially in verbally fluent girls with normal intelligence. 

With the diagnostic criteria for autism based largely on how autism presents in males, girls can often ‘slip under the radar’ or get misdiagnosed. Girls with autism seem to have less restricted and repetitive behaviours than boys. Still, it’s also possible that some of these behaviours go unrecognised — for example, an obsessive interest in collecting dolls may be misinterpreted as pretend play.

Many girls with autism also appear to be better at ‘camouflaging’ or ‘masking’ to try and fit in. They are generally better at imitating their peers, which can hide their autistic traits. This is also one of the reasons why girls with autism often receive a diagnosis at an older age than their autistic male peers. 

What does autism look like in girls?

Although every person with autism is different, here are some common characteristics in women and girls with autism:

• Restricted and repetitive behaviours that are more focused on movement, people or animals, such as hair twirling, music, fashion, TV shows and horses
• A strong imagination (might escape into the worlds of nature or fiction)
• A desire to arrange and organise objects
• Not wanting to play cooperatively with female peers (for example, wanting to dictate the rules of play or preferring to play alone to maintain control)
• Being intense and possessive about friends
• A tendency to ‘mimic’ others in social situations in order to blend in
• An ability to hold their emotions in check at school or work, but be prone to meltdowns or explosive behaviour at home
• Strong sensory sensitivities, especially to sounds and touch (for example; clothing tags, socks or even deodorant).
• While boys with autism are more likely to have outwardly challenging behaviours, girls with autism are more vulnerable to internalising problems

For autistic girls to thrive, it’s important they have access to a timely and accurate diagnosis, and the informed supports that come with it. A delayed or missed diagnosis can impede their education and development, as well as their social and community participation. As our understanding of how autism affects females is still emerging, it’s important that parents and professionals stay updated on the best ways to support girls and women, ensuring they receive a diagnosis as early as possible and have access to evidence-based therapies and support to help them thrive. 

Helpful resources

• 'Are Girls With Autism Hiding In Plain Sight?' - A discussion of gender differences in autism and the barriers autistic girls and their families face to accessing diagnosis and quality support.
• 'Autism - It's Different In Girls' - A discussion of how autism can present in girls and the prevalence of misdiagnosis and inadequate support for autistic girls.
• 'Autistic Girls and Women' - A discussion around autism in girls and women at different life stages and the prevalence and impact of masking/camouflaging.
• 'Going to the GP about my mental health - A guide for Autistic women' - A step-by-step guide for autistic women around seeing a GP for mental health support, with advice for what to do before, during and after an appointment.
• 'Interventions for Girls and Women on the Autism Spectrum' - A discussion of how autism can present in girls and women, which support options are the most effective and how they can be tailored to meet an autistic girl or woman's individual needs.