The National Autistic Society says that getting autism diagnoses is important because it helps autistic people understand themselves better and seek appropriate care. 

But they add that “because of stereotyped ideas about what autism looks like and who can be autistic, many autistic women and girls struggle to get a diagnosis, receive a diagnosis late in life or are misdiagnosed with conditions other than autism.” 

That’s partly because the signs of autism many of us grew up learning about can apply more often to boys and men than women and girls, they say.

We spoke to Dr Mikki Lee Elembaby Psy.D, a Manhattan-based psychologist from Clarity Therapy NYC who specialises in autism assessment and diagnosis, about why so “many autistic women fly under the radar.”

How does autism present differently in women?

Dr Elembaby told HuffPost UK: “For years, autism has been primarily studied and diagnosed based on how it appears in men.”

But autistic women are “often masking their struggles so well that they get misdiagnosed with anxiety, depression, or even personality disorders,” she said. 

According to the psychologist, some of the main signs of undiagnosed autism in adult women are:

1) Social ‘masking’ and exhaustion

“Many autistic women copy social behaviours to blend in—mimicking facial expressions, scripting conversations, or forcing eye contact,” Dr Elembaby said.

“But this takes a toll, often leading to deep fatigue and burnout.” 

2) Overanalysing social situations

According to the expert, autism in women can lead to, “Replaying conversations on loop, stressing over what they said ‘wrong,’ or feeling socially drained after even small interactions.” 

3) Sensory sensitivities that affect daily life

“Loud noises, bright lights, certain clothing textures, or strong smells can be overwhelming” to women with autism, the expert commented. 

“Some women are labelled ‘picky eaters’ due to sensory-based food aversions.”

4) Intense special interests (that fly under the radar)

Per Dr Elembaby: “While autistic men might fixate on numbers, trains, or mechanics, autistic women often develop deep fascinations with literature, psychology, nature, or fictional characters.” 

These fixations might not point people towards an autistic diagnosis as easily as those which some autistic men and boys prefer, she suggests.

5) Frequent misdiagnoses

”Many autistic women are first diagnosed with anxiety, depression, OCD, or borderline personality disorder before autism is even considered,” the assessor told us.

6) Struggles with boundaries and burnout

”Autistic women may be seen as ‘too sensitive,’ struggle with saying no, or push themselves to meet social expectations — until they hit a breaking point,” the psychologist said. 

What if I think I’m autistic?

“For many women, the realisation [that they’re autistic] only comes in adulthood— often when their child is diagnosed, prompting them to see the same traits in themselves,” Dr Elembaby told us. 

The NHS says that you should try to get an autism assessment if you think you’re autistic. Adults and children can both apply, though the health service warns waitlists may be long. 

The National Autistic Society has a page dedicated to helping adults who suspect they have autism decide whether to seek a diagnosis.

They outline the benefits of diagnosis, offer some pre-diagnosis questionnaires, and share which supports do or do not need an official diagnosis and in which cases.