Thousands of women are living with undiagnosed autism, not because it isn't there, but because they've spent a lifetime hiding it. The real story behind masking, misdiagnosis, and why the system keeps getting it wrong.
Autism in women has long remained under-recognised, with many cases going undiagnosed until adulthood. While autism spectrum disorder (ASD) has traditionally been associated with males, growing research suggests that this gender gap is not due to actual prevalence, but rather how differently the condition presents in women and how easily it is overlooked.
Experts now say that one of the biggest reasons autism is frequently missed in women is a phenomenon known as “masking.” This refers to the conscious or unconscious effort to hide traits associated with autism in order to fit into social expectations. Women, in particular, tend to develop these coping strategies early in life, making their symptoms far less visible to others.
Masking can take many forms. It may involve forcing eye contact, mimicking facial expressions, rehearsing conversations, or suppressing behaviours like stimming. Over time, these efforts help individuals appear socially “typical,” but they also make it significantly harder for doctors, teachers, and even family members to recognise underlying autism.
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Historically, diagnostic criteria for autism have been developed based largely on studies involving boys. As a result, the traits most commonly associated with autism, such as overt social withdrawal or repetitive behaviours, are often more noticeable in males. Women, however, may display subtler signs that do not fit these traditional patterns.
For example, girls with autism may still form friendships, but often struggle internally with maintaining them. Their interests may appear socially acceptable, such as books, animals, or art, rather than the more stereotypical “restricted interests” seen in boys. These differences can lead professionals to overlook autism entirely.
Because of this mismatch, many women are either diagnosed much later in life or misdiagnosed with other conditions, such as anxiety, depression, or personality disorders.
While masking may help women navigate social environments, it often comes at a high psychological cost. Constantly monitoring behaviour and trying to meet societal expectations can be mentally exhausting. Over time, this can lead to burnout, identity confusion, and increased vulnerability to mental health issues such as anxiety and depression.
Many women report feeling as though they are “performing” in everyday situations, unsure of which behaviours are genuinely their own. This long-term strain can delay self-understanding and prevent individuals from seeking appropriate support.
One of the major consequences of underdiagnosis is the lack of timely support. Without a clear diagnosis, many women do not receive the resources, accommodations, or understanding they need, whether in school, work, or personal life.
In some cases, women only discover they are autistic later in adulthood, often after their children are diagnosed or after years of struggling with unexplained challenges. By this stage, they may have already faced years of misinterpretation and unmet needs.
Studies also indicate that while boys are typically diagnosed earlier, the number of diagnosed women increases significantly during adolescence and adulthood, further highlighting the delay in recognition.
There is now a growing push within the medical and research community to better understand how autism presents in women. Experts are calling for more inclusive diagnostic tools, increased awareness among healthcare professionals, and a shift away from outdated stereotypes that portray autism as a predominantly male condition.
Improving recognition is not just about diagnosis; it is about ensuring that women receive the support and validation they deserve. When autism is correctly identified, it can help individuals better understand themselves, access appropriate care, and build a stronger sense of identity.
As awareness continues to grow, there is hope that future generations of women will not face the same challenges in being recognised and understood. Addressing the gaps in diagnosis and acknowledging the role of masking are key steps toward a more inclusive and accurate understanding of autism.
Ultimately, recognising autism in women is not just a medical issue; it is a matter of equity, ensuring that no one is overlooked simply because their experience does not fit traditional expectations.
Source: Gulf News
