Women’s health issues are taken less serious than men’s and sadly this is the case with autism in women. It’s a brutal fact that health outcomes for women are often worse due to the simple fact of being women. It’s not widely enough known that, for example, the symptoms of a heart attack are different in women than in men; or that symptoms of ovarian cysts are often assumed merely to be normal cyclical pain. Much of what we are told about various health issues is drawn from how these conditions affect men, and while their needs are of course important, it’s worrying that it often means conditions are misunderstood or misdiagnosed when they affect women.
This is certainly the case as it pertains to women with autism. Women find it more difficult to get diagnosed: partly because societally they are expected to behave a certain way which leads to “masking” of their autistic traits. It is also the case that much autism research has been based on male-dominated cases. As a result, it usually is the case that where women are eventually diagnosed, it’s often well into adulthood and after years of being treated for misdiagnosed depression or anxiety. So it is important to look seriously at how autism may affect women, and how to proceed when seeking help dealing with it.
Autism is a complex condition, and it is always worth remembering that rarely will you find two people in whom it presents identically. In women, this can be even more pronounced because the way the condition presents is different from in men. Many women adapt to societal expectations to fit in – often going as far as to rehearse conversations and closely observing peers for cues on how to act; this masking allows autistic women to appear neurotypical, but often at a cost.
By blending in, diagnosis can be delayed as teachers, doctors and even loved ones – who will usually be the first to notice signs – may not recognize the struggles a woman with autism faces. Suppressing the heightened sensitivity, anxiety and emotional processing issues can be exhausting and, even where traits show, they may be simply waved away as shyness or introversion. On the one hand this is no bad thing; people with autism are just people. On another, though, it means that assistance available to men with autism often doesn’t reach women in the same situation.
One of the biggest challenges faced by any woman with autism is the journey to diagnosis. Many spend years or even decades being told that they have anxiety, depression or even a personality disorder before they receive the truth. This can be particularly frustrating, because many of their challenges stem not from a mental illness but from a society that struggles to accommodate neurodivergence, and often simply doesn’t recognize it in women.
Living undiagnosed, and often not even being aware that they may have a condition at all, women may often wonder why trying to maintain a social life feels draining, or why they run up against sensory overload in seemingly benign situations. Feeling that they simply have a personality that is over-sensitive, they are likely to be more prone to low self-esteem, and the coping mechanisms they have developed are exhausting and unsustainable at the expense of personal well-being.
Social connections can be especially testing for women with autism. Whether a friendship, romantic relationship, or workplace dynamic, the cues can be difficult to unpick. Many women with autism thrive one-on-one where they can form a deeper connection, but in groups or more surface-level situations will struggle, and this can lead to burnout from overcompensating.
The nuances of autism and relationships can also present difficulties in romantic relationships, with partners assuming they lack interest due to differences in how emotions are expressed. A diagnosis can really help in these situations, as autistic women are in a place to explain their challenges, needs and boundaries, and partners are usually in a more receptive mood to understand. It is often harder to start relationships but, when in a partnership, the deep connection fostered can last longer and be more rewarding than a comparable relationship for a non-autistic person.
Masking social expectations often leads women with autism to feel they have to conform to traditional gender roles; they feel it is expected for them to be the emotional caretaker in a relationship, for example. It is important for anyone in a relationship to be able to be open about their needs and concerns, and a lifetime of masking can make some feel that they need to persist in a situation that isn’t working for them.
The challenges faced by women with autism aren’t due to autism. Instead, they are caused by society’s expectation that women simply won’t be autistic. Indeed, some of the traits of autism show in the form of incredible strengths and gifts, from an ability to think outside of the box and to focus deeply. While the perception is often that people with autism lack empathy, the reverse is often true; they may be highly empathetic but express it differently from a neurotypical person. Many autistic women display a strong affinity for the arts and activism.
In addition, throwing off the mask and embracing neurodiversity can lead to a sense of self-acceptance. It is empowering to know that your brain isn’t working worse than other people’s, just differently. By leaning into that difference and with awareness and support, it can be a chance to carve out a career that works for you, find a relationship that sustains you rather than depleting you, and live a life that gives you what you need.
The world is only beginning to recognize the realities of autism in women; more work is certainly needed to ensure that women are diagnosed earlier, receive the support that will help them, and have spaces where they don’t need to mask. Autism in women is not a new thing – it’s always been here, and now it is time for the world to pay attention.
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