When autism spectrum disorders (ASD) first entered the medical landscape, most research about the condition centered on men and boys. Until recent decades, a common assumption about autism was that it only affected males.
As of 2024, however, more and more women and girls are receiving autism diagnoses, many of them later in life. So, why the sudden increase?
More women, girls, and people assigned female at birth (AFAB) are diagnosed with autism spectrum disorders every year, partly because we’re still learning about ASD, and partly because no two people experience autism in the same way—especially if they are two people of different genders.
In this article, Ability Central explores some of the lesser-known symptoms of autism, including the ways the autism experience changes for women, girls, and people assigned female at birth (AFAB).
We answer your frequently asked questions about autism in women, including:
What role does gender identity play in the autism diagnosis process?
Why is so little known about women and autism spectrum disorders?
How are autism symptoms different for women, girls, and AFAB people?
Is it harder for women to get an autism diagnosis?
How does autism treatment for women differ from autism treatment for men?
Where can I get more information about autism spectrum disorders (ASD)?
What role does gender identity play in the autism diagnosis process?
Before we begin, let’s start with an important caveat. We at Ability Central recognize the complex definition of gender and honor our transgender, gender nonconforming, and nonbinary community members. However, it’s important to note that most research into autism spectrum disorders has been based on cisgender people (people whose gender identity matches their sex assigned at birth).
To simplify our findings, for the purposes of this article only, we use the words “women” and “girls” to describe people who are biologically female or assigned female at birth (AFAB). Similarly, we use the words “men” or “boys” in this article to describe people who are biologically male or assigned male at birth (AMAB).
Gender diversity in autism research is slowly improving, but for now, these are the terms most frequently used in the field.
Why is so little known about women and autism spectrum disorders (ASD)?
Historically, autism spectrum disorder (ASD) has been considered a “male” condition, one that primarily affects boys. In fact, the very first research study into autism, diagnosed by Leo Kanner in 1943, focused more on male patients than on girls. This set an unfortunate precedent in autism research that has continued to this day.
Until about 2014, studies into autism focused on men and boys with ASD, working under the incorrect impression that men were 4 to 5 times more likely to be born with ASD than women.
Part of the disparity here comes from symptoms: men and women show different ASD symptoms, in the same way that attention-deficit/hyperactivity disorder symptoms tend to vary between boys and girls.
Similarly, because of expected social roles, women with ASD may have historically had an easier time “masking” their symptoms than did men with ASD. For example, women with ASD may be more likely to recognize the need for social interactions, imitate others in order to fit in, or develop one or two close friendships, while men with ASD show the more anti-social tendencies most people associate with autism.
How are autism symptoms different for women and girls?
Both men and women with autism show traditional autism symptoms like antisocial behavior, special interests, and repetitive or compulsive behaviors. However, autism stereotypes and a lack of diversity in autism research have made doctors more likely to write off women’s autism symptoms as more “socially acceptable” or less unusual.
For example, according to a study from Harvard Medical School, boys with autism may show special interests in things like trains, dinosaurs, or space travel—subjects most doctors see as telltale signs of autism. Girls with ASD, on the other hand, may have more “socially aligned” interests, like music, animals, books, or celebrities.
Common symptoms of autism in both men and women include:
Finding it hard to understand other people's emotions
Anxiety about social situations
Difficulty making friends
Often being misunderstood and appearing to be blunt or even rude
Taking words and phrases too literally
Having intense anxiety over any changes in the daily routine
Avoiding eye contact
Repetitive tendencies and behavior
Stimming, self-soothing, or repetitive movements
In addition to these—or instead of them—women with autism may have more specific symptoms, including:
Overactive imagination
Perfectionism
Restrictive eating patterns or eating disorders
Showing different sides of your personality depending on the social situation (for example, with friends versus with family)
Having only one or two close friends
Disliking things that are feminine, popular, or fashionable
Texture sensitivities, often visible in clothing choices
Appearing innocent or naïve
Being prone to meltdowns, but only in comfortable environments (like at home or around a trusted person)
Social fatigue from working very hard to mask autism symptoms, possibly without noticing
Some of these symptoms may be misdiagnosed as other neurological or mental health conditions, like mood disorders or eating disorders.
Is it harder for women to get an autism diagnosis?
Because women and girls are more likely to mask their autism symptoms, it can be harder for them to get an official diagnosis. Many boys are diagnosed with ASD after they show behavioral problems or difficulties in school. For girls, these symptoms are subtler and may not be noticeable until adulthood.
Research suggests that girls and young women with autism are more motivated than boys to fit in socially. Girls may:
Learn acceptable social behavior from TV, movies, and people around them
Mimic facial expressions, speech patterns, and nonverbal communication tics, even if they don’t completely understand them
Work harder to maintain eye contact
Pay more attention to grooming and self-care
Have higher levels of social anxiety, stress, and mental exhaustion
Of girls and women diagnosed with autism:
Only 8% are diagnosed before age 6 (compared to 25% of boys with autism)
About 20% are diagnosed before age 11 (compared to 50% of boys with autism)
How does autism treatment for women differ from autism treatment for men?
Most autism treatments follow a system like applied behavior analysis (ABA), a form of therapy that focuses on building habits, learning life skills, and changing behaviors with positive or negative reinforcement.
Generally, autism treatments for women are pretty much the same as autism treatments for men. Women and girls with autism may need more help with:
Organization
Task management
Planning
Daily routines
Short-term memory
Impulse control
Mental flexibility (like coping with spontaneous events or unexpected change)
For more information about autism treatment for kids and adults, see What To Do First After an Autism Diagnosis.
If you believe you or a loved one may have symptoms of ASD, you can start by scheduling an appointment with your family doctor, primary care physician, or pediatrician. For more information on the autism diagnosis process, see How to Recognize Autism Symptoms in Children and Adults.
Where can I get more information about autism spectrum disorders?
To learn more about autism, see Ability Central’s ASD resources:
To find a doctor, autism support group, or local nonprofit offering programs for adults with autism, check out the Ability Central Service Locator tool, a searchable database of organizations all over the country offering support for people with communication disabilities.
Additional Information
The content provided in this article is for informational purposes only and is not intended as a substitute for legal, medical, or other professional advice. While we strive to provide accurate and up-to-date resources, some information may become outdated or incomplete. Always consult with your provider about personal medical concerns.
