Why Are So Many Autistic Girls and Women Still Missing Out on Early Identification?

Despite growing awareness of autism, many girls and women continue to be overlooked when it comes to early diagnosis. This oversight can delay crucial support and understanding during formative years.

Incorrect Stereotypes

For decades, autism was widely perceived as a “male condition.” This gendered assumption led to biased research methodologies:

• Male-centric studies: Most autism research included significantly more boys than girls, skewing diagnostic criteria.
• Underrepresentation of girls: As a result, many traits that autistic girls exhibit were not well documented or recognized.
• Ongoing research gaps: Scientists are still working to recruit more girls into autism research to build a more accurate understanding of how autism presents across genders.

Incomplete Research

Gender bias has historically shaped both autism research and its clinical application:

• Skewed symptom profiles: Research often highlighted behaviors more typical of boys, such as playing alone or externalizing behavior.
• False assumptions: Being female was often thought to lower the likelihood of an autism diagnosis, leading to misdiagnosis or missed diagnosis altogether.

Compensatory Behaviors

Autistic girls are often better at masking their symptoms, which makes early diagnosis more difficult:

• Masking and adaptation: Girls may mimic peers, focus on socially acceptable interests (like books or music), or hide their difficulties.
• Camouflaging at early ages: This ability to “pass” as neurotypical can obscure signs of autism, especially during the critical early years when diagnosis is most effective.

Limited Diagnosis

Clinicians may unintentionally delay diagnosis for girls by adopting a “wait and see” approach:

• Delayed intervention: Without obvious signs, clinicians may hesitate to refer girls for assessment.
• Comorbid conditions as diagnostic clues: Girls are more likely to be diagnosed if they exhibit co-occurring conditions such as:
  • Seizures
  • Hyperactivity
  • ADHD
  • OCD
  • Intellectual disability
  • Eating, sleep, and temperament challenges
  • Depression or other mood disorders

This highlights a major gap—girls often only get diagnosed when other significant issues arise.