What Is the Female Autism Phenotype?

Why do so many autistic girls and women fall through the diagnostic cracks?

Many autistic females are going undiagnosed until their 30s, 40s, 50s, or even later. Autistic females have some of the highest rates of suicide due to the mass failure of healthcare professionals to recognize the different ways that autism presents in girls, women, and those assigned female at birth (afab). More awareness about the female autism phenotype — or how autism presents in girls and women — is needed to protect the mental and physical health of individuals on the autism spectrum. | Photo by Bruce Christianson on Unsplash

Many autistic girls and women are not being properly diagnosed — some do not receive an autism diagnosis until their 30s, 40s, 50s, or even older.

Born with autism, a genetic neurodevelopmental condition associated with various social, neurological, and sensory difficulties, these girls and women are able to hide the signs and characteristics of autism from themselves and others, even evading the concern of the most highly-trained healthcare professionals.

More commonly and devastatingly, they are misdiagnosed with conditions like borderline personality disorder, obsessive-compulsive disorder, social anxiety, bipolar disorder, and so on.

These conditions — including eating disorders like anorexia — can be highly comorbid (often appearing alongside autism), but without that key autism diagnosis, a girl or woman’s understanding of herself will be limited — sometimes with devastating consequences. She will unlikely get the support and help that she needs.

But why are so many autistic girls and women never diagnosed or not diagnosed until late in life?