IN BRIEF
- Clinicians say masking behaviours have contributed to generations of autistic women being undiagnosed.
- A late diagnosis can help explain years of challenges, but may trigger a complex grief process.
New research is challenging long-held assumptions about autism, with experts suggesting women may have been underdiagnosed for decades.
For most of her life, Naomi (last name withheld) felt different.
She struggled socially, battled burnout, and spent years trying to understand why everyday interactions seemed harder for her than for others.
At 47, Naomi saw a psychologist who told her she may be neurodivergent.
"It was actually such a massive shock to me," she said.
News that makes sense
Your trusted source for staying up-to-date with the world around you. Get free daily news updates and analysis, straight to your inbox.
"I had a very limited and stereotyped understanding of what autism and ADHD were, and I just didn't think that that could be me."
Now 51, Naomi said receiving an autism diagnosis helped explain experiences that had followed her since childhood.
"You get a lot of criticism and negative feedback," she said.
"When you're growing up being told these things about you, these negative things, they're things that you really can't help. They're just part of who you are."
Her story reflects a growing trend as more women seek autism assessments later in life.
Researchers and clinicians say decades of autism research centred largely on boys and men may have left many women undiagnosed, with emerging evidence suggesting autism is far more common among females than previously thought.
Challenging the traditional autism ratio
For years, autism has been understood to affect boys at significantly higher rates than girls, with estimates often placing the ratio at around four males for every female diagnosed.
But recent research suggests the gap may be much narrower.
Clinical psychologist Dr Tamara May said some studies now estimate the ratio could be closer to two males for every female.
The changing figures are prompting experts to rethink long-held assumptions about how autism presents across genders.
"For a long time autism has been so commonly associated with boys and men," May said.
"Girls were often diagnosed with other conditions like depression, social anxiety or personality disorders because clinicians, teachers and parents didn't realise autism could commonly occur in girls."
Historically, diagnostic criteria were largely developed using studies of boys, meaning traits more commonly seen in girls were often overlooked.
Why women are often diagnosed later
May said autistic girls can present differently from autistic boys, making them harder to identify under traditional diagnostic frameworks.
"Girls tended to have more superficial social skills," she says.
"They might typically have one friend and become very attached to that one friend.
"From the outside, it would look like they have friends, whereas boys might have more obvious difficulties making friends."
Many girls also learn to "mask" or camouflage their autistic traits by copying social behaviours around them.
While this can help them fit in, it can also mean their struggles go unnoticed for years.
As awareness grows, increasing numbers of women are seeking assessments in adulthood, particularly during major life transitions such as relationship breakdowns, career burnout, parenthood or menopause.
The grief that can come with a diagnosis
While receiving a diagnosis can bring relief and self-understanding, it can also trigger a sense of loss.
May said many women experience grief as they reflect on years spent without answers.
"There can be a really significant grief process following a diagnosis," she said.
"People can become angry and upset that this wasn't picked up earlier in their life by parents, teachers or health professionals."
Many wonder how their lives might have been different if they had received support sooner.
"They've done a whole lot of therapy that doesn't really work for them or tried medications that aren't helpful for what they're going through," May said.
"It's very common to grieve for your younger self and what you've had to experience."
A better understanding of neurodiversity
Today, Naomi works as a neuroaffirming counsellor for the Autism Connect Helpline operated by Amaze, supporting others navigating their own diagnoses.
She said understanding her neurodivergence has transformed the way she sees herself.
"One of the things people often experience, as a neurodivergent person diagnosed later in life, is that sense that you are an outsider," she said.
"But when you're with others with the same brain style as you, things flow."
As research continues to evolve, experts hope greater awareness will help break down stereotypes that have historically prevented women and girls from achieving a diagnosis.
For Naomi, the diagnosis has brought clarity rather than regret.
"We're all really unique," she said.
"And this kind of diversity makes society a richer, more wonderful place."
For the latest from SBS News, download our app and subscribe to our newsletter.
