Masking Autism: Undiagnosed Women and Girls

Autism is often thought of as a condition that mostly affects boys, but women and girls can be autistic too - it just isn’t always easy to spot. In fact, many females go undiagnosed for years or are misdiagnosed with conditions like anxiety or depression. Why? Because autism in girls often looks different from autism in boys. One big reason behind this is something called ‘masking,’ where girls consciously or unconsciously hide their autistic traits to fit in.

Why Are Autistic Women and Girls Often Undiagnosed?

The world has long seen autism as a male condition, with diagnostic criteria largely based on how boys show autistic behaviours.  When autism was first discovered around 50 years ago it was only boys who were part of the testing. Boys with autism might be more outwardly withdrawn, struggle with social cues, or have noticeable stimming behaviours, like hand-flapping or rocking. In contrast, girls often learn to mimic social behaviour, blending in by copying how others talk, act, or dress. This helps them avoid standing out but also makes it harder for parents, teachers, and even healthcare professionals to spot the signs of autism.

Girls are also more likely to internalise their challenges, leading to a quiet struggle that’s easily missed. They might be labelled as shy, anxious, or sensitive instead of being seen as autistic. According to the National Autistic Society, many women don't receive a diagnosis until adulthood - sometimes after years of confusion about why they feel different.

The Role of Masking Autism

Masking, or camouflaging, is a major reason why autism goes unnoticed in women and girls. Masking involves hiding or suppressing natural autistic behaviours to fit in with neurotypical people. A girl might push herself to make eye contact, memorise social scripts for conversations, or keep her feelings and behaviours hidden in public. 

Whilst masking can help her navigate social situations and avoid bullying, it’s incredibly exhausting. Over time, this constant effort to appear neurotypical can lead to burnout, anxiety, depression, and even identity issues. Some women describe feeling like they're living a double life - acting one way in public but struggling in private.

The problem is, masking also delays diagnosis. Girls can become so good at hiding their autistic traits that they aren’t flagged for autism assessments until later in life, if ever. This can lead to a lack of support during crucial years of schooling, social development, and even career building.  With later diagnosis it could be that a woman is of an age where they could be considered perimenopausal or menopausal. This can also disguise the need for an autism assessment.

The Impact of Late Autism Diagnosis

The effects of being undiagnosed or diagnosed late are significant. Many women who don’t understand why they feel different internalise their struggles, thinking something must be wrong with them. This can cause low self-esteem and mental health challenges. Without a proper diagnosis, they may miss out on support that could help them manage sensory sensitivities, social difficulties, or the challenges of school or work environments.

Getting a diagnosis, even in adulthood, can be life-changing. It offers a sense of relief and validation - it finally explains why certain things have been harder for them. It also opens up access to resources, like therapy, autism-friendly workplaces, or support networks that can make life much more manageable.

Why Awareness Matters

The more we understand how autism presents in women and girls, the sooner we can support them. This means recognising that autism doesn’t always look the same in everyone and that quiet struggles are just as real as more visible ones. We need to move away from the idea that autism is a male condition and start creating environments where autistic girls and women feel comfortable being themselves - without needing to mask or hide.

How We Can Help

Autism in women and girls has been overlooked for far too long. Many go undiagnosed because their autism doesn’t fit the stereotypical image, leading to challenges that could be avoided with proper support. At Grace our expert team of Neurodiversity Advisers provides advice and support on all areas of neurodiversity, from help with understanding conditions and managing symptoms, to accessing support, services and funding. If you, your organisation or anyone you are close to is looking for support, get in touch. 

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Grace Consulting are the UK’s founding providers of expert independent advice on elderly care advice, special needs advice and neurodiversity advice. 

Independence and client wellbeing are at the heart of everything we do. We listen, reassure and advise you on how to move forwards and find the best possible solutions for your unique life challenges.