It is not uncommon for females to get a diagnosis of autism much later than males because unfortunately many are not clued up to the differences autism displays in girls and women in comparison to men.
Typically, we see that females are more likely to get a misdiagnosis or multiple diagnoses of things not directly hitting what the key issue is, such as a diagnosis of generalised anxiety disorder, eating disorders, depression before they get the autism diagnosis which often helps to explain all of these issues. Sadly, we see more self-harm in teenage females undiagnosed as they struggle to understand themselves and challenges they face in comparison to others.
Why does it take so long and why are females getting missed?
Autism in females presents differently to males and does not follow the stereotype of autism that both the trained and untrained eye are able to pick up early. Females tend to be less disruptive in school and therefore teaching staff do not see the need for intervention or support. Females tend to appear more social in school; have friendship groups but it is not until those are carefully examined that you see more behaviours like controlling, imitating, intense interest etc. All of this leads to females being particularly good at masking their challenges; in that they manage to cope/ hide well in public places (school and work) by ‘fitting in’ and when they get home to their comfort they need time to express, regulate, hide, re-fuel all the energies and effort it took to ‘fit in’.
The assessment and the label
Some females due to their level of self-awareness and desire to fit in do not want a label/ diagnosis and so when taken to an assessment actually mask extremely well during the assessment as they ‘know what the assessor’ was looking for/ testing – which then means that their diagnosis is either inconclusive, borderline or shows as non-autistic which actually means they do not get the diagnosis. This is a challenge because it means they will continue to mask (using up a lot energy) instead of owning their autism eventually leading to burnout, continue with self-awareness challenges that could lead to or maintain eating disorders, depression, self-harm etc. But generally, will mean that they won’t get access to the support that they need whether that be in school learning support during lessons, exams etc. or in work reasonable adjustments.
Tips on what to do if you suspect your daughter is autistic
1. The core differences of autism remain the same whether male or female – write down a list of how they present for your daughter to share with the professional who is referring or assessing.
2. Observe her in interactions to see if the social interaction is typically developing or if she is over compensating in some way or form (typical compensations are being controlling/ bossy in play, taking over, copying/ imitating, playing the same thing, or withdrawal).
3. Speak to her about how everyone’s brain is different to help her understand her own differences and come to terms with the idea of being neurodivergent as a lead into finding a diagnosis as a positive thing.
4. Talk about the doors that could open once a diagnosis is achieved, but also explain that it doesn’t change everything and isn’t magic!
5. Look for positive examples and role models of autistic females to discuss.
If you would like to discuss working with me please contact elisa@thinkautism.co.uk to arrange a time to talk.