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Autistic women and girls

More women and girls than ever before are discovering that they are autistic. Many had been missed or misdiagnosed due to outdated stereotypes about autism. But that is slowly changing.

In the past, it was assumed that autistic people were overwhelmingly men and boys, and only very rarely women and girls. This is wrong. There are many women, girls and non-binary people on the autism spectrum.

Although we now know much more about the experiences of autistic women and girls, society's understanding of autism has been limited by outdated stereotypes and incorrect assumptions. Although autism research and professional practice are slowly catching up to the realities of life for autistic women and girls, many barriers to diagnosis and support remain. 

Does autism present differently in women and girls?

It is important that autistic women and girls receive a diagnosis (or recognise that they are autistic) so they can understand themselves and access support. However, because of stereotyped ideas about what autism looks like and who can be autistic, many autistic women and girls struggle to get a diagnosis, receive a diagnosis late in life or are misdiagnosed with conditions other than autism. 

Autistic characteristics in women and girls may differ from those of other autistic people. They might seem to have fewer social difficulties than autistic men and boys, but this could be because they are more likely to 'mask' their autistic traits (though the stress of doing so can result in anxiety and overwhelm). At school, autistic girls may be more likely to be part of a friendship group and this could be a reason that teachers don't notice their differences. They may also be missed if their academic achievement masks difficulties they are facing in other areas. 

Some of the core characteristics of autism are having ‘repetitive behaviours’ and highly-focused interests. Stereotyped examples of these include rocking backwards and forwards, and a fascination with trains. However, in autistic women and girls these behaviours and interests may be similar to those of non-autistic women and girls, such as twirling hair and reading books, and as such may go unnoticed despite the greater intensity or focus typical for autistic people.  

Doctors and other healthcare professionals can lack knowledge about how autism may present differently in women and girls. This means women and girls may be misdiagnosed with mental health issues or their autistic traits may be missed amid the symptoms of co-occurring conditions. Some tools used to diagnose autism are designed to identify autistic characteristics that may be more common in autistic men and boys. This means the process may not be as sensitive to characteristics more commonly found in autistic women and girls. 

In November 2022, NAS launched ‘Now I Know’, a campaign highlighting the experiences of late-diagnosed autistic women and non-binary people from across the country.

The campaign was photographed by autistic photographer Alex Heron, who works at Rankin Studio. You can watch short films or read longer interviews with the six people featured in the campaign. A series of additional interviews will be published at regular intervals sharing the stories of autistic women and non-binary people who responded to the #NowIKnow campaign on social media. 

Find out more

Stories from the Spectrum: autistic women

Many of the autistic women we’ve spoken to have talked about getting a late diagnosis, or have had difficulty getting the support they need.

As part of our Stories from the Spectrum series, we interviewed several women and girls, who shared their experiences with us.

"I feel autistic women are more likely to be described as ‘anxious’ and an autism diagnosis overlooked, since it can challenge gender stereotypes."
Dr Camilla Pang

Sara Gibbs, autistic comedy writer, told us: "I think there is a lack of understanding of how autism can present in girls, who are often socialised differently."

Charl Davies, autistic tattoo artist, said: "I find that being a female I am expected to behave a certain way to fit in socially which is why I have spent so much time masking."

Dr Camilla Pang, autistic scientist and author, explained: "I feel autistic women are more likely to be described as ‘anxious’ and an autism diagnosis overlooked, since it can challenge gender stereotypes."

Dr Kate Fox, autistic poet and comedian, said: "I don’t think there’s an inherent difference between autistic men and women. What there is a difference in, is how society treats and socialises males and females."
 

Read more stories

Are men more likely to be diagnosed as autistic than women?

 

Studies and statistics 

  • Various studies suggest that the ratio of autistic males to females ranges from 2:1 to 16:1. The most-up-to-date estimate is 3:1.
  • In Leo Kanner's 1943 study of a small group of autistic children, there were four times as many boys as girls.
  • Lorna Wing (renowned psychiatrist and co-founder of our charity's first diagnosis centre)  found in her 1981 paper on autism and sex ratios in early childhood, that among people with a diagnosis of Asperger syndrome (as it was called at the time) there were 15 times more men and boys than women and girls, while in autistic people with learning difficulties, the ratio of men and boys to women and girls was closer to 2:1.
  • In a much larger 1993 study of Asperger syndrome in mainstream schools in Sweden, Ehlers and Gillberg found a boy to girl ratio of 4:1.
  • Brugha's 2009 survey of adults living in households throughout England found that 1.8% of men and boys surveyed had a diagnosis of autism, compared to 0.2% of women and girls.
  • In 2015, the ratio of men to women supported by the National Autistic Society’s adult services was approximately 3:1, and the ratio of boys to girls in our charity’s schools was approximately 5:1.
  • In a 2017 study, Loomes and other researchers analysed existing prevalence studies and found that the male-to-female ratio was nearer 3:1.

Why are more men diagnosed as autistic?

We don’t know exactly why more men and boys are diagnosed as autistic than women and girls. It is clear that many autistic women and girls are missed or misdiagnosed. It was previously thought that there were many more autistic men than women, but estimates of the ratio have gotten closer and closer over time. 

Many theories to explain the diagnosis gap have been put forward, but none have been conclusively proven. Some of the theories are:

Please note:

Research and knowledge about autism changes constantly. Some of these theories may not reflect how we think about autism today.

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  • a potential 'female autism phenotype' – in other words, autistic women and girls have characteristics that don’t fit with the traditional profile of autism 
  • autism assessments are less sensitive to autistic traits more commonly found in women and girls
  • women and girls are more likely to ‘mask’ or camouflage their differences
  • autistic traits in girls are under-reported by teachers 
  • a range of biological and environmental factors may mean men and boys have a higher prevalence of autism
  • the 'extreme male brain' theory of autism, which focuses on the effects of foetal testosterone on brain development

Critiques of the 'extreme male brain' theory

A Critique of the Extreme-Male-Brain Theory of autism

By Rachel Cohen-Rottenberg

Sexing the Autistic brain: Extreme Male?

By Dr Daniel Voyer

Books by autistic women and girls 

The following books were suggested by NAS staff. Inclusion on this list should not be considered an endorsement by NAS as these books have not been reviewed through the same rigorous process as our advice and guidance content sources. 

Non-fiction 

  • Autism and masking: how and why people do it, and the impact it can have, Helen Ellis, with Dr Felicity Sedgewick and Dr Laura Hull 
  • Safeguarding autistic girls: strategies for professionals, Dr Carly Jones MBE 
  • Spectrum women, Barb Cook and Dr Michelle Garnett (editors) 
  • Supporting spectacular girls: a practical guide to developing autistic girls' wellbeing and self-esteem, Helen Clarke 
  • Taking off the mask: practical exercises to help understand and minimise the effects of autistic camouflaging, Hannah Belcher 
  • The independent woman's handbook for super safe living on the autistic spectrum; The autism-friendly guide to periods; The autism-friendly guide to self-employment, Robyn Steward 
  • Women and girls with autism spectrum disorder, Sarah Hendrickx 

Autobiography 

  • Drama queen: one autistic woman and a life of unhelpful labels, Sara Gibbs 
  • Odd girl out: an autistic woman in a neurotypical world, Laura James 
  • Travelling by train: the journey of an autistic mother, Laurie Morgan 

Fiction 

  • A Kind of Spark, Elle McNicoll 
  • Can You See Me?, Libby Scott and Rebecca Westcott 

Links, resources and article sources

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The Spectrum magazine

Explore one of the UK's largest collections of autistic art, poetry, and prose. The Spectrum magazine is created by and for autistic people, and is available both online and in print.

Read the Spectrum
Autistic student and member of the LGBTQ+ community

Autism and gender identity

We look at the connection between autism and gender identity, and hear stories from non-binary and transgender autistic people.

Find out more


Related training 

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Understanding women and girls

Gain a comprehensive understanding of autism in women and girls, exploring how characteristics may differ at different stages of life.

Read more

Women and girls on the autism spectrum

This E-learning module aims to support professionals to identify autistic women and girls.

Find out more


Related professional practice

Autistic women, pregnancy and motherhood

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Lana Grant gives insight into her experience of pregnancy and motherhood

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Right Click for Women and Girls

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Online support for autistic women and girls

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Autism and menstruation

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Autistic people's experiences of menstruation

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