In Person Calgary & Virtual Alberta
.png)
TEXT THIS NUMBER 403.800.5578
Autism in Women and Girls:
Autism can be present even when someone appears socially capable, successful, caring, or highly verbal.
For many years, autism research and diagnostic practice were shaped largely by studies of boys and men. As a result, the picture many people still have of autism—social withdrawal, obvious repetitive behaviour, limited interest in relationships, or highly unusual interests—does not always capture how autism may present in girls and women.
​
Research is increasingly showing that some autistic girls and women may be highly socially motivated, closely observe other people, rehearse social interactions, copy expected behaviour, and work extremely hard to appear as though social situations come naturally.
​
From the outside, they may seem to be coping.
Behind the scenes, however, the effort required to maintain that appearance can be enormous.
​
Recent reviews have also highlighted how historically male-dominated autism research has been. In one review discussed in New Scientist, fewer than 10% of more than 4,000 autistic participants in social-brain studies were female, while many studies either included only males or did not meaningfully examine sex differences.
The “Female Autism Phenotype”
The term female autism phenotype is sometimes used to describe patterns of autistic characteristics that appear to be more common among girls and women and may be less obvious on traditional autism measures.
​
It is important to emphasize that there is no single way for an autistic woman or girl to present. These patterns can also occur in boys, men, and gender-diverse people.
Research including Lai et al. (2015), Bargiela et al. (2016), and Hull et al. (2020) suggests that some autistic females may show:
-
Stronger motivation to make friends or belong socially
-
An intense desire to understand social rules
-
Greater use of imitation and observation
-
Carefully prepared conversation topics or scripts
-
Forced or learned eye contact
-
Copying the expressions, gestures, interests, or clothing of peers
-
Intense interests that appear socially typical
-
Strong imaginative abilities
-
A small number of close relationships rather than obvious social isolation
-
Significant anxiety about making social mistakes
-
A tendency to analyse conversations afterwards
-
​
-
Sensory difficulties that are hidden or endured rather than expressed openly
Emerging neuroscience research has also challenged the older assumption that autistic people necessarily have reduced social motivation. Some studies have found greater activity or connectivity within social-reward networks in autistic girls than would be predicted by traditional male-based models of autism.
Masking and Camouflaging
“Nobody knew how hard I was working to look normal.”
“Nobody knew how hard I was working to look normal.”
One of the most important concepts in understanding autism in women is camouflaging, often called masking.
​
Camouflaging involves consciously or unconsciously modifying behaviour to fit social expectations.
​
A woman may learn to:
Prepare before social situations
Perform during the interaction
Recover afterwards
Masking Can Hide Distress
A woman can appear:
Friendly. Articulate. Successful. Empathetic. Professional. Socially engaged.
​
And still be autistic.
This is one reason autism may remain unidentified until adulthood.
​
Camouflaging may help someone navigate school, university, work, relationships, or professional environments, but research has associated sustained masking with anxiety, exhaustion, stress, depression, and suicidal thoughts.
Assessment therefore needs to explore not only:
​
“Can you do this?”
but also:
“How do you do it, how much effort does it require, and what happens afterwards?”
Why Autism May Be Missed in Girls
A girl does not have to be socially withdrawn to be autistic.
She may desperately want friendships but struggle to understand how relationships work.
​
She may have one close friend and depend heavily on that friendship.
​
She may watch other girls closely and copy them.
She may behave very differently at school than she does at home.
She may appear quiet, compliant, mature, shy, perfectionistic, or anxious rather than disruptive.
​
She may hold herself together throughout the school day and experience emotional meltdowns once she reaches the safety of home.
​
Girls may therefore come to professional attention for anxiety, perfectionism, selective mutism, depression, eating difficulties, ADHD, or emotional dysregulation long before autism is considered.
​
Research has also raised concerns that traditional diagnostic models were developed disproportionately from male samples. The New Scientist review notes evidence of male bias within some commonly used assessment approaches and describes the substantial number of autistic girls who may reach adulthood without recognition.
Autism and Social Motivation
One persistent stereotype is that autistic people simply do not want relationships.
That does not describe many autistic women.
A woman may strongly desire:
-
Friendship
-
Romantic relationships
-
Marriage
-
Family
-
Acceptance
-
Community
-
Professional belonging
Her difficulty may lie not in wanting connection, but in intuitively navigating the complex and rapidly changing rules required to maintain it.
Some emerging research suggests that autistic girls may show stronger social-reward responses and greater sensitivity to social rejection than older models of autism predicted.
For these women, social difficulties may be accompanied by an unusually strong drive to work out what they are doing “wrong.”
Autism, Anxiety and Selective Mutism
Autism in girls can sometimes be hidden underneath significant anxiety.
Duvekot et al. (2017) examined overlap between autism and selective mutism and highlighted the importance of considering broader neurodevelopmental differences when girls present with severe social anxiety or difficulty speaking in particular situations.
A girl who becomes silent in school or unfamiliar environments may not simply be “shy.”
It can be useful to explore:
-
Sensory overload
-
Social-processing demands
-
Fear of getting the interaction wrong
-
Difficulty responding quickly enough
-
Need for predictability
-
Shutdown responses
-
Autism-related communication differences
Autism and Eating Difficulties
Food difficulties in autistic girls and women do not always centre on weight or body image.
Restriction may sometimes be associated with:
-
Food texture
-
Smell
-
Temperature
-
Appearance
-
Food touching other foods
-
Predictability
-
Fear of unfamiliar foods
-
Gastrointestinal sensations
-
Difficulty recognizing hunger
-
Strong routines surrounding eating
Research has identified important overlap between autism and restrictive eating difficulties.
Recent brain-imaging research described in New Scientist also found similarities between changes observed in children with avoidant/restrictive food intake disorder (ARFID) and patterns previously reported in autism. The researchers noted that sensory sensitivities are common to both conditions, although they cautioned against overinterpreting these early findings.
ARFID differs from anorexia in that restriction is not necessarily driven by body-image concerns. It may instead involve sensory sensitivities, low interest in food, or fears such as choking or vomiting.
This distinction can be particularly important when assessing autistic individuals.
Autism, Pregnancy and Motherhood
Autistic women may encounter additional challenges during pregnancy, childbirth, and parenting.
Potential areas of difficulty include:
-
Heightened sensory sensitivity during pregnancy
-
Difficulty tolerating medical examinations or procedures
-
Communication difficulties when overwhelmed
-
Anxiety around unpredictable medical environments
-
Sleep deprivation
-
Sensory overload from crying or constant touch
-
Loss of routines
-
The executive-function demands of parenting
-
Feeling scrutinized by healthcare professionals
-
Difficulty asking for help
At the same time, autistic women may bring significant strengths to parenting, including intense commitment to their children, attention to detail, loyalty, advocacy, creativity, and an ability to deeply understand a neurodivergent child.
Support should focus on what an individual mother needs, rather than assuming autism predicts a particular parenting style.
Autism May Become More Visible During Major Life Transitions
Some women cope successfully for years because they have constructed an environment that works for them.
Autistic characteristics may become more noticeable when demands exceed their ability to compensate.
This may happen during:
-
Starting high school
-
Beginning university
-
Leaving home
-
Starting a demanding career
-
Entering a serious relationship
-
Becoming a parent
-
Raising neurodivergent children
-
Divorce
-
Workplace promotion
-
Perimenopause or menopause
-
Caring for aging parents
-
Significant illness or prolonged stress
At these points, strategies that previously worked may no longer be enough.
The result can look like anxiety, depression or burnout when the deeper issue is that the person has been compensating for neurodevelopmental differences for many years.
What Should an Autism Assessment in Women Explore?
A thoughtful autism assessment should look beyond whether someone appears socially capable during an appointment.
It should explore the process behind the behaviour.
​
Important questions include:
Before social interaction
How much preparation is required?
Do you rehearse conversations?
Do you research what to say?
During social interaction
Are you consciously monitoring eye contact, facial expressions, tone of voice or body language?
Are you copying someone else?
​
After social interaction
How much recovery time do you need?
Do you experience exhaustion, shutdown, irritability or sensory overload?
Across your lifetime
Were these patterns present in childhood, even if they looked different?
​
Across environments
Do other people see the same person at work, at home and socially?
Understanding autism in women often requires examining what happens behind the scenes, not simply what is visible during a clinical interview.
Could Autism Explain Experiences That ADHD or Anxiety Do Not Fully Explain?
ABOUT US
ADHD, autism, anxiety and other conditions frequently overlap.
​
A previous ADHD diagnosis does not rule out autism.
​
Similarly, having anxiety does not necessarily explain:
-
lifelong sensory differences,
-
difficulty intuitively understanding social relationships,
-
intense need for predictability,
-
repetitive or regulating behaviours,
-
highly focused interests,
-
extensive social scripting,
-
or persistent camouflaging.
-
​
Sometimes an existing diagnosis is accurate—but incomplete.
A comprehensive assessment should consider the whole developmental picture rather than attempting to force someone's experiences into a single diagnosis.
When Might an Adult Autism Assessment Be Worth Considering?
ABOUT US
You may want to explore an autism assessment if you frequently think:
​
-
“Socializing looks easy for everyone else. Why do I have to work so hard at it?”
-
“People think I am confident, but they don't see how much preparation goes into it.”
-
“I copy people without even realizing I am doing it.”
-
“I can socialize, but afterwards I am completely exhausted.”
-
“I have always felt different, but I cannot explain why.”
-
“I have been treated for anxiety for years, but it doesn't explain everything.”
-
“My ADHD diagnosis explains part of my experience, but not all of it.”
-
“After my child was diagnosed with autism, I began recognizing many of the same characteristics in myself.”
-
​
An assessment is not about proving that you are autistic.
​
It is about developing a clearer understanding of how your brain works, what takes effort, what supports you need, and whether autism helps explain the pattern of experiences across your lifetime.
A Different Question
Instead of asking:
​
“Do I look autistic?”
​
A more useful question may be:
“How much effort does it take for me to look as though I am coping?”
For many late-diagnosed autistic women, that distinction changes everything.
If you have spent years wondering why relationships, sensory environments, change, work, parenting or everyday social expectations seem to require more effort for you than they do for other people, an autism assessment may help you understand the bigger picture.
New Discovery Psychological Services provides adult autism and neurodevelopmental assessments in Calgary and Alberta.
​
Book a Consultation
Talk with us about your experiences, questions, and whether an autism assessment may be appropriate for you.
​
References
Hull, L., et al. (2020). Research examining gender differences in autistic camouflaging.
Lai, M. C., et al. (2015). Research examining sex/gender differences in autism.
Duvekot, J., et al. (2017). Research examining autism, selective mutism and gender differences.
Loomis/Loomes, R., et al. (2017). Systematic review and meta-analysis examining gender and autism diagnosis. I would verify the spelling and exact citation before publishing this reference.
Bargiela, S., et al. (2016). Research examining the experiences of women diagnosed with autism in adulthood.
Saccenti, E., et al. (2021). Systematic review examining autism and eating disorders in females.
Pohl, A., et al. (2018/2020). Research examining healthcare access and experiences of autistic women and mothers.
Rippon, G. (2025). A revolutionary new understanding of autism in girls. New Scientist. The article summarizes growing evidence that autism research has historically underrepresented girls and women and that female presentations may not fit traditional male-derived models.
Wade, G. (2025). Brain changes with eating disorders similar to those in OCD and autism. New Scientist.