How does autism present differently in girls and women?
- Dr Harry Woodward
- Dec 25, 2025
- 3 min read
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Autism doesn’t come with a single instruction manual. If it did, many parents of autistic girls (and many autistic women themselves) might have had answers much earlier.
For a long time, autism was described — and diagnosed — mainly through research on boys. That has left generations of girls quietly flying under the radar, often doing remarkably well at coping… right up until they don’t.
Let’s talk about why autism can look different in girls and women, what signs are often missed, and what this means for families seeking clarity and support.
Why autism in girls is often missed
Girls are not less autistic than boys — but they are often less obvious to the outside world.
Many autistic girls:
Are socially interested (even if socialising feels exhausting)
Work very hard to “fit in”
Internalise difficulties rather than acting them out
As a result, they may not raise the same red flags in school or at home, especially in early childhood. This contributes to later diagnosis — or no diagnosis at all.
The NHS acknowledges that autism may present differently in girls and women, and that this can delay identification.
Masking: the great disappearing act
What is masking?
Masking (sometimes called camouflaging) is when an autistic person consciously or unconsciously hides their autistic traits to blend in socially.
This might include:
Copying peers’ speech, gestures, or interests
Forcing eye contact
Rehearsing conversations in advance
Suppressing stimming behaviours
Many girls become expert maskers from a very young age.
The cost of masking
Masking can look like “coping well” — but it often comes at a significant emotional cost, including:
Anxiety
Exhaustion
Low self-esteem
Burnout in adolescence or adulthood
The National Autistic Society highlights masking as a key reason autistic girls are often overlooked
Social differences that can be misunderstood
Autistic girls may appear socially capable, but that doesn’t mean social interaction feels easy.
Common experiences include:
One-to-one friendships feeling easier than group situations
Intense anxiety about friendships
Being highly sensitive to rejection or criticism
“Playing a role” rather than feeling authentic
From the outside, this can be misread as shyness, sensitivity, or perfectionism — rather than neurodevelopmental difference.
Interests that don’t raise alarms
We often expect autistic interests to look unusual or highly technical. In girls, interests may be:
Age-appropriate but unusually intense
Focused on people, animals, books, or fictional worlds
Deeply immersive rather than outwardly disruptive
Because these interests don’t stand out as “odd,” they are less likely to prompt referral.
NICE guidance reminds clinicians to consider autism even when presentations don’t match stereotypes.
Emotional wellbeing and late diagnosis
Many autistic women are first identified only after years of:
Anxiety
Depression
Eating difficulties
Chronic overwhelm
Often, autism is the missing piece that explains why life has felt so hard despite best efforts.
The CDC notes that increasing awareness is helping more girls and women receive appropriate recognition, though disparities remain.
What this means for parents
If you’re parenting a girl who:
Is constantly exhausted by school
Appears socially “fine” but falls apart at home
Is highly anxious, perfectionistic, or emotionally overwhelmed
Struggles quietly rather than loudly
it may be worth thinking about autism — even if no one has mentioned it before.
A thoughtful, neurodevelopmental assessment looks beyond surface behaviours and considers how a child experiences the world internally.
A gentle takeaway
Autistic girls and women are not missing autism — autism has been missing them.
When we broaden our understanding, we create space for earlier recognition, better support, and kinder self-understanding — for children now, and adults looking back.
And that’s always a good thing.
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