Table of ContentsView AllTable of ContentsCommon SignsAutism in WomenCausesDiagnosisSupport and TreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Common Signs
Autism in Women
Causes
Diagnosis
Support and Treatment
Frequently Asked Questions
Autism spectrum disorder(ASD) is a developmental disability that is usually diagnosed at or before the age of 3. While people of any sex and gender can be autistic, it is common forpeople assigned female at birthto be diagnosed with ASD later in life. Many autistic women and nonbinary people are not diagnosed until they reach adulthood.
According to the Centers for Disease Control and Prevention (CDC), the prevalence of ASD in the United States in 2020 was 3.8 higher for boys than girls—or about 4% of boys and 1% of girls aged 8 years old.
Sex and Gender
Peopleassigned female at birthare not all girls/women. Women, nonbinary people, and trans men all face certain challenges in getting an autism diagnosis compared to cisgender men.
This article will go over how autism might be different along gender lines, and what some of the challenges are in diagnosing autism in girls and women.
Common Traits of Autism
People of all sexes,genders, races, ethnicities, and backgrounds can be autistic. Just like autism is a spectrum, autistic people are a varied group. The mix of traits that each autistic person displays, how they experience and interact with the world, as well as how much support they need, will vary.
There is also evidence that the traits of autism can look different in women than it does in men, which may partly explain why there is a gap in early diagnosis for autistic girls.
The most common signs of autism include:
The criteria for diagnosing autism have changed over time. In 2013, several categories of autism—including Asperger syndrome and pervasive developmental disorder not otherwise specified—were removed from the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” (DSM-5).
To make a formal diagnosis of autism according to the DSM-5, the traits must have been present before the age of 3—even if the diagnosis is not made until much later in a person’s life.
First-Person LanguageMany people diagnosed with autism spectrum disorder prefer using identity-first language rather than person-first language. For example, they may prefer saying “an autistic person" rather than “a person who has autism.”
First-Person Language
Many people diagnosed with autism spectrum disorder prefer using identity-first language rather than person-first language. For example, they may prefer saying “an autistic person" rather than “a person who has autism.”
Communication Differences
To be diagnosed with autism, a person will have differences concerning communication. There is some evidence that autistic girls and women might be better at “studying” their peers to learn about neurotypical socializing and can imitate these behaviors, or mask, to try to fit in.
Some of the most commonspeech-related differencesautistic people have include:
Autistic Speech Patterns
In addition to differences with speech and body language, autistic people have challenges with social communication:
Communications Challenges for Autistic People
Behavioral Differences
Autistic behaviors are not always easy to spot, depending on their frequency and intensity. There is also evidence that autistic girls may have more socially acceptable behaviors or are better at hiding these behaviors than boys, which makes diagnosis harder.
Common autistic behaviors can include:
Sensory Differences
When the criteria for autism changed in 2013, the DSM-5 added a new set of traits to the list that considered sensory differences. The update included an autistic person’s increased sensitivity to or interest in sensory factors in their environment like pain, temperature, sounds, textures, light, and movement.
Most autistic people have sensory sensitivities—though what they are and how severe they are will vary. Autistic people may find some sounds incredibly overstimulating—even painful. Other people seek out certain textures that they find soothing and enjoyable.
For example, an autistic person might:
Some autistic people also experience understimulation, a feeling of boredom, discomfort, and stagnancy that can grow until it becomes painful. Dancing, listening to loud music, watching an interesting video, or playing a game can all help with understimulation.
Autistic people may seek out sensory stimulation and comfort through food or drink. Some autistic people have a specific (and often short) list of foods that they are always comfortable eating. These foods are referred to as “safe foods.” Depending on how restrictive their eating requirements are, it can be difficult for autistic people to get all their necessary nutrients and calories.
Eating disorders such asavoidant-restrictive food intake disorder(ARFID) are conditions that often co-occur with being autistic. While ARFID is not about weight and body image, it can lead to weight loss. On the surface, it can easily look like more well-known eating disorders like anorexia or bulimia nervosa.
Sometimes, autistic girls and women are mistakenly diagnosed with anorexia nervosa (AN) because of their restrictive eating patterns. However, it’s also possible for autistic people to have eating disorders other than ARFID, including AN.
Autism and Self-CareAutistic people often have difficulty withmotor skillsand planning actions (executive function), which can make self-care tasks challenging.While it’s true that some autistic girls and women are not interested in nor understand the gendered social expectations attached to activities like putting on makeup and shaving body hair, other autistic people may want to partake but struggle because of the complex planning and motor skills needed to do them. Autistic people of all genders may also find it difficult to brush and shower daily. When you add sensory sensitivities to the mix, an autistic person may have a very hard time doing something as “simple” as washing their hair in the shower.Autistic people who menstruate may also find managing their periods extremely difficult, since there are many changes involved that can be overstimulating (e.g., painful cramps, new smells, the sight of blood, the discomfort of wearing a pad, tampon, or cup), including having to change their routines (e.g., needing to change pads/tampons, having to avoid certain activities or certain safe foods).
Autism and Self-Care
Autistic people often have difficulty withmotor skillsand planning actions (executive function), which can make self-care tasks challenging.While it’s true that some autistic girls and women are not interested in nor understand the gendered social expectations attached to activities like putting on makeup and shaving body hair, other autistic people may want to partake but struggle because of the complex planning and motor skills needed to do them. Autistic people of all genders may also find it difficult to brush and shower daily. When you add sensory sensitivities to the mix, an autistic person may have a very hard time doing something as “simple” as washing their hair in the shower.Autistic people who menstruate may also find managing their periods extremely difficult, since there are many changes involved that can be overstimulating (e.g., painful cramps, new smells, the sight of blood, the discomfort of wearing a pad, tampon, or cup), including having to change their routines (e.g., needing to change pads/tampons, having to avoid certain activities or certain safe foods).
Autistic people often have difficulty withmotor skillsand planning actions (executive function), which can make self-care tasks challenging.
While it’s true that some autistic girls and women are not interested in nor understand the gendered social expectations attached to activities like putting on makeup and shaving body hair, other autistic people may want to partake but struggle because of the complex planning and motor skills needed to do them. Autistic people of all genders may also find it difficult to brush and shower daily. When you add sensory sensitivities to the mix, an autistic person may have a very hard time doing something as “simple” as washing their hair in the shower.
Autistic people who menstruate may also find managing their periods extremely difficult, since there are many changes involved that can be overstimulating (e.g., painful cramps, new smells, the sight of blood, the discomfort of wearing a pad, tampon, or cup), including having to change their routines (e.g., needing to change pads/tampons, having to avoid certain activities or certain safe foods).
Sensory Overload in Autism
Understanding Autism in Women
Many autistic people are over-empathetic to people, animals, and non-living objects, especially autistic women and nonbinary people who are socialized as such. Autistic people often just do not express, feel, or display empathy in ways that allistic (non-autistic) people are used to recognizing.
In recent years, it has become clear that autism is underdiagnosed in people who aren’t cisgender men.The possible reasons for the disparity include:
Researchers are still trying to understand how autism is different for girls and women. However, the lack of gender diversity in diagnosed autistic people is a hindrance for scientists, as is the widespread delegitimization of thoughtful self-diagnosis.
Autistic women, nonbinary people, and all people of color are less likely to have professional diagnoses due to discrimination, being underinsured, or not possessing the hundreds to thousands of dollars a professional diagnosis costs. Until things change, there will continue to be a lack of gender diversity in studies on, and knowledge about, autistic people.
Unraveling the Complex Causes of Autism, According to Experts
Masking/Camouflaging
Some research has suggested that autistic girls might be more likely than boys to intentionally or unintentionally hide or cover up their traits. This is called camouflaging or, more commonly, masking.
For example, autistic girls might be better at:
While girls on the spectrum might be better than boys at masking, doing so takes considerable effort to maintain, and autistic girls often have trouble forming and maintaining peer relationships with allistic (non-autistic) people. Finding community with other autistic and neurodivergent people can be a homecoming experience for many people.
It is very important that everyone, especially marginalized people, have people around them who they can relate with and who understand them. Many adults coming into their autistic identity are discovering such community online and in person.
Suicide Prevention HotlineIf you or someone you know are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. For more mental health resources, see ourNational Helpline Database.
Suicide Prevention Hotline
If you or someone you know are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. For more mental health resources, see ourNational Helpline Database.
Co-occuring Conditions
Co-occuring conditions are diagnoses that are commonly given in addition to a main diagnosis. Research suggests that co-occurring conditions are more common with autistic girls than boys.Co-occurring conditions are also more likely when a person is diagnosed with autism at a later age, as they most likely have not received the care, understanding, and support they’ve needed their whole lives.
Some common co-occurring conditions in autistic girls and women include:
There is no provencause of autism, though being autistic tends to run in families. Thankfully, it is not necessary to discover why people are autistic. As autistic self-advocacy has become more prominent, autistic advocates have begun pushing back against the idea that autism is a disease or syndrome that needs a cure or research done concerning its origin.
Autistic advocates point to the ongoing field of eugenics that shows that when marginalized traits have their causes known, they are systematically eradicated via infanticide or genetic selection. We see this phenomenon happening today with the population of people with Down Syndrome being nearly zero due to medical intervention in multiple European countries.
Finding the origin of autism will not better the lives of autistic people and actually endangers them. The search for the “cause” of autism is inextricably linked to the search for a cure, and both manifest in deadly ways for autistic people, as seen with the many parents who have fed their autistic children bleach in order to cure them.
It is more important for loved ones of autistic people to seek to learn about autistic people and to learn from autistic adults, advocates, and communities about what is best for them.For people wanting to support autistic populations at large, housing instability and homelessness, economic insecurity, and lack of access to medical, dental, and mental health care are some of the prevailing issues autistic people face that need more focus. Research and funding needs to be directed at these disparities as well as organizations and systems aiming to rectify them.
It is more important for loved ones of autistic people to seek to learn about autistic people and to learn from autistic adults, advocates, and communities about what is best for them.
For people wanting to support autistic populations at large, housing instability and homelessness, economic insecurity, and lack of access to medical, dental, and mental health care are some of the prevailing issues autistic people face that need more focus. Research and funding needs to be directed at these disparities as well as organizations and systems aiming to rectify them.
There is no single medical test for autism spectrum disorder. The diagnosis is based on observations and specific screening tools.
A child’s caregivers will usually fill out avariety of questionnairesabout their child’s infancy and toddlerhood and respond to questions about their child’s development, behavior, and skills. Healthcare professionals may ask this of adults seeking diagnoses as well. Providers can also use hands-on and observational tools to see if a person meets the criteria for autism and whether they have any co-occurring conditions.
According to the Centers for Disease Control and Prevention (CDC), about 1 in 54 American children are autistic—and only about 1 in 4autistic children are girls.While the 1-to-4 ratio is considered accurate, researchers have found that the ratio might actually be closer to 1-to-3.
Self-DiagnosisGetting professionally diagnosed with autism as an adult can be a time-consuming and costly process. For marginalized communities, including women, self-diagnosis is the only option when placed against the cost of a professional diagnosis. Due to growing awareness of this disparity, self-diagnosis is becoming more accepted within the autistic community.
Self-Diagnosis
Getting professionally diagnosed with autism as an adult can be a time-consuming and costly process. For marginalized communities, including women, self-diagnosis is the only option when placed against the cost of a professional diagnosis. Due to growing awareness of this disparity, self-diagnosis is becoming more accepted within the autistic community.
Autism Diagnosis in Children: Traits and Testing
There is no “best” treatment for autism. Some possible treatments for autism include:
People who are diagnosed with autism as adults often have low support needs (what used to be called “high functioning”) but that does not mean they would not benefit from having support. These people are also likely to have been masking for years or decades and might need more support when they stop masking or reach burnout.
Autistic adults often seek support on their own, like talk therapy. Some people find social skills coaching,sensory integration therapy, and support groups with other autistic adults helpful.
Summary
Autism in women and girls is underdiagnosed and/or diagnosed at a later age. There are some possible reasons for the disparity.
The basis for diagnosing autism is often skewed toward behaviors that are more common in boys. Some evidence suggests that girls might be better at masking, hiding autistic behaviors, or are more likely to have “socially acceptable" special interests.
It’s not uncommon for women to only find out they are autistic as adults; however, the process of getting a formal diagnosis as an adult can be timely and costly. Autistic women are also more likely to have other mental health conditions including anxiety, an eating disorder, and obsessive-compulsive disorder.
Getting support can make a positive difference at any age for autistic people, though earlier intervention is ideal.
Frequently Asked QuestionsThe primary traits of autism include difficulties with speech and social communication, sensory sensitivities, and repetitive behaviors. Autistic people may also have trouble expressing their ideas and emotions, and struggle with understanding others' points of view.Because it is a spectrum disorder, autism can look different in every individual, and traits can range in presentation and intensity.Learn MoreAutistic TraitsAccording to the official diagnostic criteria, signs of autism must appear before the age of 3. However, when someone is very good at masking or hiding their autistic traits, autism may not be diagnosed until later.Learn MoreDevelopmental Milestones in Autistic ChildrenAutism is not a degenerative disease. In general, people with autism build skills as they get older. In some cases, however, co-occurring issues such as anxiety or autistic burnout can get in the way of progress and even cause skill regression. In addition, some issues such as social communication differences can become more of a problem as a child grows up.Learn MoreTherapies for Autistic Adults
The primary traits of autism include difficulties with speech and social communication, sensory sensitivities, and repetitive behaviors. Autistic people may also have trouble expressing their ideas and emotions, and struggle with understanding others' points of view.Because it is a spectrum disorder, autism can look different in every individual, and traits can range in presentation and intensity.Learn MoreAutistic Traits
The primary traits of autism include difficulties with speech and social communication, sensory sensitivities, and repetitive behaviors. Autistic people may also have trouble expressing their ideas and emotions, and struggle with understanding others' points of view.Because it is a spectrum disorder, autism can look different in every individual, and traits can range in presentation and intensity.
The primary traits of autism include difficulties with speech and social communication, sensory sensitivities, and repetitive behaviors. Autistic people may also have trouble expressing their ideas and emotions, and struggle with understanding others' points of view.
Because it is a spectrum disorder, autism can look different in every individual, and traits can range in presentation and intensity.
Learn MoreAutistic Traits
According to the official diagnostic criteria, signs of autism must appear before the age of 3. However, when someone is very good at masking or hiding their autistic traits, autism may not be diagnosed until later.Learn MoreDevelopmental Milestones in Autistic Children
According to the official diagnostic criteria, signs of autism must appear before the age of 3. However, when someone is very good at masking or hiding their autistic traits, autism may not be diagnosed until later.
Learn MoreDevelopmental Milestones in Autistic Children
Autism is not a degenerative disease. In general, people with autism build skills as they get older. In some cases, however, co-occurring issues such as anxiety or autistic burnout can get in the way of progress and even cause skill regression. In addition, some issues such as social communication differences can become more of a problem as a child grows up.Learn MoreTherapies for Autistic Adults
Autism is not a degenerative disease. In general, people with autism build skills as they get older. In some cases, however, co-occurring issues such as anxiety or autistic burnout can get in the way of progress and even cause skill regression. In addition, some issues such as social communication differences can become more of a problem as a child grows up.
Learn MoreTherapies for Autistic Adults
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Maenner MJ, Warren Z, Ashley Robinson Williams, et al.Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. 2023;72(2):1-14. doi:10.15585/mmwr.ss7202a1
Hull L, Petrides KV, Mandy W.The female autism phenotype and camouflaging: a narrative review.Rev J Autism Dev Disord. 2020;7(4):306-317. doi:10.1007/s40489-020-00197-9
American Psychiatric Association.Diagnostic and statistical manual of mental disorders(5th ed., text rev.). doi:10.1176/appi.books.9780890425787
Autism Self Advocacy Network.Identity-first language.
Children’s Hospital of Philadelphia.Diagnostic criteria for autism spectrum disorder in the DSM-5.
ARFID Awareness UK.ARFID & autism.
Autism Research Institute.Executive function & autism.
National Autistic Society.Autistic people and periods.
Baron-Cohen S.The extreme male brain theory of autism.Trends Cogn Sci. 2002;6(6):248-254. doi:10.1016/s1364-6613(02)01904-6
Rødgaard EM, Jensen K, Miskowiak KW, Mottron L.Autism comorbidities show elevated female-to-male odds ratios and are associated with the age of first autism diagnosis.Acta Psychiatr Scand. 2021;144(5):475-486. doi:10.1111/acps.13345
Zhang S.The last children of down syndrome.The Atlantic.
Zadrozny B.Parents are poisoning their children with bleach to ‘cure’ autism. These moms are trying to stop it.NBC News.
U.S. Centers for Disease Control and Prevention.Clinical testing and diagnosis for autism spectrum disorder.
Maenner MJ, Shaw KA, Baio J, et al.Prevalence of autism spectrum disorder among children aged 8 years - autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2016.MMWR Surveill Summ. 2020;69(4):1-12. doi:10.15585/mmwr.ss6904a1
Milner V, McIntosh H, Colvert E, Happé F.A qualitative exploration of the female experience of autism spectrum disorder (ASD).J Autism Dev Disord. 2019;49(6):2389-2402. doi:10.1007/s10803-019-03906-4
Centers for Disease Control and Prevention.Treatment and intervention for autism spectrum disorder.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
