Autism is a diverse condition that affects individuals of all genders; the overall prevalence estimate of autism in the U.S. is one in 36 children. According to the Centers for Disease Control and Prevention (CDC), as of March 2023 about 4% of boys and 1% of girls age 8 years have autism.

Although an autism diagnosis occurs more often in men than women, recent research suggests that autism in women may be underdiagnosed or misdiagnosed. Recognizing and understanding how autism presents in women is crucial to an accurate diagnosis, appropriate support, and targeted interventions. The evolving understanding of gender differences in autism is dismantling the notion that autism is more or less a "male condition.”

Autistic women are more likely to develop compensatory strategies to mask their challenges. For example, women often have stronger social imitation skills and the ability to mimic social behavior compared to men. Due to their social foundation, girls may develop one or two close friendships, helping them absorb social rules and norms. Their strong social interest may lead them to "camouflage" or compensate for social understanding and communication challenges, making these vulnerabilities difficult to detect in everyday interactions or larger classroom or employment settings. As a result of these differences, women are often more likely to be diagnosed later in life, if at all.

The ability to camouflage and mask their challenges can lead to misinterpretation of the degree to which autistic women actually struggle, as they may appear more socially competent than they feel or understand. While non-autistic people of both genders and autistic men may also engage in masking, autistic women tend to do so to a greater degree. The burden of masking can be exhausting, and may contribute to feelings of isolation and mental health issues.

Restricted interests and repetitive behaviors occur in autistic men and women; however, the nature of these behaviors can differ. Traditionally, clinicians have been trained to recognize stereotypical male-associated restricted interests, such as transportation, dinosaurs, or space. In contrast, autistic women may develop restricted interests that are more closely aligned with societal norms, such as animals, art, celebrities, or literature.

This divergence can contribute to the misperception that women with these interests are simply showing enthusiasm for “normal” hobbies rather than autistic traits. Repetitive patterns of behavior in women can manifest as classic autistic behaviors like rocking or hand/finger movements, but may also appear as behaviors not necessarily associated with autism, such as perfectionistic tendencies or restrictive patterns of eating/eating disorders.

Since some symptoms of autism may present differently in women, they may receive other diagnoses first, such as anxiety and mood disorders, learning disorders, and/or eating disorders. This phenomenon is called diagnostic overshadowing, which occurs when a person’s symptoms are attributed to a psychiatric problem versus an underlying medical issue or developmental delay such as autism. Such overshadowing can complicate the diagnostic process, as the focus may be on managing these secondary conditions rather than recognizing the underlying autistic traits.

Some women recognize autistic traits in themselves when a family member, partner, or friend is diagnosed with autism. An accurate diagnosis enables them to receive the appropriate therapeutic treatments, supports, and accommodations, as well as access to services and connection to available resources.

Most research about gender identity seems to focus on cisgender individuals, or those who have a gender identity matching their sex assigned at birth. When meeting with a provider, it is important to ask about their experience with women on the spectrum and how they tailor assessment methods and support for woman patients/clients. Women often benefit from woman-specific supports and resources.

Many individuals, including autistic persons, embody a range of gender identities, including but not limited to nonbinary and transgender. Recent research shows an increase in gender diversity within the autistic community compared to the population at large. Therefore, there has been a recent shift toward embracing gender diversity beyond the cisgender paradigm in research. Embracing an expanded understanding of what it means to be autistic will lead to a more inclusive perspective that ensures all individuals, regardless of gender, receive the recognition and support they deserve.

The Autistic Women and Nonbinary Network provides useful information and resources for gender-diverse autistic individuals.

For diagnostic information, see our article about seeking an ASD diagnosis as an adult.

Recommended Reading and Viewing

For women:

• Camouflage: The Hidden Lives of Autistic Women by Dr. Sarah Bargiela

• 22 Things a Woman with Asperger’s Syndrome Wants Her Partner to Know by Rudy Simone

• The Autistic Brain: Exploring the Strengths of a Different Kind of Mind by Temple Grandin

• Odd Girl Out: An Autistic Woman in a Neurotypical World by Laura James

• From the American Autism Association: 5 TedX Talks from Women with Autism

For caregivers:

• A Guide to Mental Health Issues in Girls and Young Women on the Autism Spectrum: Diagnosis, Intervention and Family Support by Dr. Judy Eaton

• Girls Growing Up on the Autism Spectrum: What Parents and Professionals Should Know About the Pre-Teen and Teenage Years by Shana Nichols with Gina Marie Moravcik and Samara Pulver Tetenbaum

For partners of autistic adults:

• The Other Half of Asperger Syndrome: A Guide to Living in an Intimate Relationship with a Partner Who is on the Autism Spectrum by Maxine Aston