Autism in Women: Recognising the Signs and Understanding the Differences

Autism Spectrum Disorder

We’ve all heard of the term “on the spectrum” but what is meant by this? Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects communication, social interaction, and patterns of behaviour. Due to the differing levels of presentations and severity, it is known to be a spectrum with milder to more severe polarities. While public awareness of autism has grown, much of the research and diagnostic criteria have historically been based on boys and men. This has left many women and girls overlooked, misdiagnosed, or only receiving a diagnosis later in life.

At Clarity Mind Therapy in Abergavenny, I often hear from women who suspected something was different about their experience of the world for years, only to discover in adulthood that autism was underlying all of their challenges. Understanding and identifying the signs and symptoms of autism in women is a vital step toward support, self-compassion and distress management.

Signs and Symptoms of Autism in Women

Autism can present differently in women and girls compared to men, often in more subtle or less stereotypical ways. Common signs may include:

• Social communication differences

  • Difficulty understanding social rules, unspoken cues, or “small talk.” Some clients of mine sometimes describe not knowing how to make small talk.

  • A tendency to script conversations or rehearse interactions in advance to overcompensate.

  • Strong preference for deep, meaningful conversations rather than casual chat and an avoidance of the latter.

• Masking or camouflaging

  • Many women consciously or unconsciously may mimic others in order to “fit in.”

  • Suppressing stimming behaviours (like hand movements, rocking, or fidgeting) in public to appear socially typical.

  • Changing their presentation (similar to seeming like different people) in different settings, which can be exhausting over time.

• Intense interests

  • Special interests may be similar to their friends (e.g., books, animals, fashion) but communicated with more intensity or focus.

  • These interests may often give comfort, predictability, and joy. These can be misunderstood to others as “just a hobby.”

• Sensory sensitivities

  • Increased sensitivity to sounds, textures, lights, or smells.

  • Difficulty coping in crowded, noisy, or overstimulating environments. Feeling overwhelmed in these spaces and often avoiding them.

• Emotional and mental health struggles

  • Increased symptoms of anxiety, depression, and possible eating difficulties, often linked to feeling “different” to others for most of the lifespan.

  • Burnout from constantly masking autistic traits in order to appear “neurotypical” in public and social contexts.

Why Diagnosing Autism in Girls is Difficult

Girls with autism are often missed during childhood. There are several reasons for this:

• Camouflaging – Girls may hide their autistic traits by imitating their friends, teachers and parents to overlook challenges.

• Stereotypes – Autism has been framed around “male” presentations, such as overt social withdrawal or obvious repetitive behaviours. Sometimes this even includes the emotional “melt-down” or what most people interpret as a “tantrum.” This is not always a typical presentation of autism especially with people outside of their immediate family.

• Misdiagnosis – Symptoms may be mistaken for social anxiety, personality difficulties, ADHD, mood disorders or even disobedience or “troublesome/ bad behaviour” which often causes significant problems especially during schooling. We need to identify Autism and manage this rather than just disciplining “naughty” children.

• Expectations of gender – Social pressures on girls to be polite, caring, and accommodating can mask underlying struggles. This can force them into further camouflaging or masking behaviour to fit these gender norms.

This means many women are diagnosed much later in life, often after years of difficulties with relationships, work or mental health. Receiving a diagnosis in adulthood can bring a sense of relief and self-understanding, but also grief for the support that wasn’t available earlier.

Emotions when receiving a Diagnosis in Adulthood

Many of my clients have conflicting emotions when they are first diagnosed with Autism. They are firstly relieved to know that they are not “broken” and feel understood. Yet, there is a fear that they have a chronic condition that they believe is untreatable. This is a myth in that we can treat Autism in terms of understanding the symptoms and managing them. This is an area of passion for me at Clarity Mind Therapy. Secondly, this condition has been with the person for their whole life- this is the moment it should start getting easier. The diagnosis does not mean life get’s harder. No, it means that the difficult symptoms are finally understood and better managed to lead a more fulfilling and balanced life. While these feelings are completely understandable and valid, they are not based on the reality of receiving a diagnosis of Autism.

Differences Between Men and Women in Autism

While autism affects each individual uniquely, research and clinical observations highlight some broad differences:

• Social coping – Women are more likely to camouflage, whereas men may display more outwardly obvious social difficulties. This makes it harder to diagnose women with Autism.

• Special interests – Men may develop niche or technical interests, while women’s intense interests may appear more socially acceptable (e.g., celebrities, literature, or animals). This appears as normal behaviour at times instead of a indication of Autism.

• Diagnosis age – Boys are often identified in childhood, while women may not receive a diagnosis until adolescence or adulthood. By this time they have created habits of compensation behaviours that hide the important symptoms for diagnosis.

• Emotional impact – Women often internalise struggles, leading to anxiety or depression, whereas men may externalise difficulties more visibly. This often leads to females with Autism being treated for anxiety or depression instead of the main root cause.

Moving Forward

Recognising autism in women requires sensitivity and awareness of these different presentations. At Clarity Mind Therapy, we work to provide a safe and understanding space where women can explore these experiences, whether they are seeking assessment, therapy, or simply a better understanding of themselves.

If you or someone you care about may be on the autism spectrum and would like to explore support options, you’re welcome to reach out. Therapy can help with self-acceptance, reducing the stress of masking, and developing strategies to thrive in everyday life.

Clarity Mind Therapy is led by Clinical Psychologist Brandon Kayat, offering private therapy in Abergavenny, South Wales, as well as online sessions across the UK.

Helpful UK Resources for Autism Support

If you are seeking information, assessment, or support around autism in the UK and Wales, the following organisations may help:

• National Autistic Society (NAS) – www.autism.org.uk
  Offers information, helplines, and resources for autistic individuals and families.

• Autistica – www.autistica.org.uk
  A UK research and support charity focusing on autism, mental health, and long-term wellbeing.

• Welsh Autism Helpline (run by NAS Cymru) – 0808 800 4104
  Provides confidential advice and support to autistic people and families in Wales.

• Children in Wales – ASD Support – www.childreninwales.org.uk
  Resources for parents, carers, and professionals supporting autistic children.