Autism in Women: What Are the Signs and Why Is It Difficult to Diagnose?

Reviewed by: Dr Darren O’Reilly

Published date: February 12, 2026

• OVERVIEW
• SYMPTOMS
• ADULTS
• CHILDREN
• WOMEN
• DIAGNOSIS
• TREATMENT
• MEDICATION

Someone with autism is three times more likely to be male than female. Not because men are more predisposed to autism, but because the signs of autism in women are less detectable. The reason? The fewer, subtler, or less stereotypical symptoms of autism in women.  Every autistic female who remains undiagnosed means one woman unable to access the support they need to thrive. 

Drawing on our experience as a specialist-led autism and ADHD assessment and treatment clinic in the UK, we at AuDHD Psychiatry discuss the symptoms and true prevalence of autism in women and girls.

Key Takeaways

• There are more males diagnosed with autism than females.
• There may be as many women as men with autism, but autism in women is more difficult to diagnose.
• Women with autism tend to camouflage their symptoms or mimic socially acceptable behaviours to fit in.
• Women’s coping mechanisms can make them more susceptible to developing mental health issues. 
• Women, even those with the subtlest autistic traits, must be tested and assessed, as a proper diagnosis unlocks access to treatment and support.

The Prevalence of Autism in Women

The prevalence of autism in women is often underestimated. Loomes et. al. (2017) conducted a systematic review and meta-analysis of 54 studies on the prevalence of autism in children. Their findings revealed that the male-to-female odds ratio in children with autism is 3:1.

This does not mean there are more men with autism than women, just that there are more men than women diagnosed with autism. 

In truth, the actual male-to-female prevalence gap could be much narrower than the numbers show. Burrows, C. et. al. (2022) adjusted their measure for autism spectrum disorder (ASD) to account for the subtler presentation of autistic traits in women. Their findings? A high-concern group with a 1:1 male-to-female ratio.

In another study, McCrosin, R. (2022) analysed a dataset of 1,711 children below 18 years old to estimate the number of female autism cases missed. Their calculations yielded a male-to-female ratio of 3:4, and apparently, 80% of females remain undiagnosed at 18.

Why Is Autism Often Underdiagnosed in Women?

Why is autism often underdiagnosed in women? It’s because autism in women usually manifests differently than it does in men, and traditional measures may be unable to detect the subtle signs of autism in women.

Externally, an autistic girl or woman may appear fine and socially adjusted. As a result, even professionals may dismiss the remnants of autistic traits in women as mere shyness, anxiety or sensitivity, or they may attribute these characteristics to other conditions.

In other words, the way autism is represented in women can make it difficult to arrive at a definite autism diagnosis.

Symptoms of Autism in Women

Women with autism may:

• Find it challenging to understand facial expressions and social cues
• Have specific sensory hypersensitivities (e.g., bright lights, loud sounds, scratchy textures)
• Have an atypically deep engrossment in particular topics or activities 

However, amidst their difficulties, women with autism are often skilled in:

• Masking or camouflaging their symptoms
• Mimicking socially acceptable behaviours
• Appearing socially confident
• Developing socially acceptable interests

In other words, many women with autism may not have been diagnosed because they do not fit the ASD stereotype.

Aside: You know how there are various types of autism? This high-functioning autism in women and girls, if detected in an assessment, might have been classified under Asperger’s syndrome in the past.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer recognises Asperger’s syndrome. Instead, it now belongs to the ASD group, which accounts for autism and other similar conditions. ASD has three levels based on the presenting autism symptoms and the amount of support people in each level need:

• Level 1 autism (requires support)
• Level 2 autism (requires substantial support)
• Level 3 autism (requires very substantial support) 

How Does Autism Affect Women’s Self-Identity and Self-Esteem?

Autism affects women’s self-identity and self-esteem, especially since women tend to mask, mimic and force themselves to be sociable. 

On the one hand, such coping mechanisms allow women with autism to fit in better or avoid social stigma. On the other hand, these can lead to a loss of a sense of self and low self-esteem in the long run.

It gets worse. As women become skilled at hiding their adult autism, a diagnosis becomes even less likely. This is unfortunate, as an undiagnosed autistic female cannot:

• Get the right autism treatment, whether that be medication for autism, therapy, skills training, or a combination of these.
• Access the autism support they need.
• Take advantage of autism benefits, including the Access to Work autism grant or the autism PIP (personal independence payment).

In the end, the continuous masking and the lack of necessary support can lead to autistic burnout in women with autism.

Frequently Asked Questions

Women With Autism Need Support

The prevalence of autism in women is underestimated because women are good at masking and mimicking behaviours. This underdiagnosis is a problem, as continuous camouflaging can lead to identity confusion, low self-esteem, and mental health issues.

If you think you have autism, get an autism test. Better yet, book a private autism assessment and get clarity on whether or not you have autism.

Skip the wait.

Get support from experienced ADHD and autism specialists who understand real-life challenges & can help you access care sooner.

Talk to our qualified, compassionate team. Get a response in 24 business hours.

☎ Call us at 0131 516 1656

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References:

Author:

Dr Darren O’Reilly

DPsych, CPsychol, HCPC Registered, Consultant Psychologist

Darren is a mental health advocate and founder of ADHDdegree. He’s passionate about making ADHD support more accessible, affordable, and stigma-free for everyone navigating neurodiversity.

Know more about his qualifications.

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