Autism in Women and Girls: Why It’s Often Missed and What “Masking” Looks Like

Autism in girls and women is frequently overlooked because it doesn’t always fit the classic male-based model of autism. At Glow Pediatrics, our physical office in Oklahoma provides comprehensive autism evaluations with specific attention to how autism presents in girls, teens, and young women.

Why Autism Is Often Missed in Girls and Women

1. Diagnostic Bias Toward Male Patterns

Historically, autism research and diagnostic tools were developed based on studies of boys, leading to a male-centric view of autism. Girls often present traits differently, meaning traditional assessments may not flag their differences.

2. Girls May Be Diagnosed Much Later

Research shows that girls with autism are more likely to be diagnosed later in life compared with boys, simply because their symptoms are less obvious or more socially masked.

Delayed diagnoses mean many girls grow up without early support, often struggling with mental health challenges long before anyone understands why.

What Is Masking?

Masking is when someone hides or camouflages their natural autistic traits in order to appear more “typical” in social settings. It’s a survival strategy rather than a choice—something girls and women often adopt early in life.

Masking might look like:

• Rehearsing conversations before they happen

• Forcing eye contact even when it feels uncomfortable

• Imitating peers’ gestures, tone, or expressions

• Suppressing stimming or sensory responses

• Memorizing social rules rather than intuitively using them

These behaviors can hide underlying struggles, making girls seem socially skilled on the surface while masking internal challenges.

Signs Masking May Be Happening

Even though masking helps someone “fit in,” it often comes at a cost. Some common signs include:

• Feeling exhausted after social interactions, even if they appeared to go well.

• Replaying conversations later and worrying about how they sounded.

• Intense social anxiety, despite appearing calm or friendly.

• Interests that are deep but socially acceptable (e.g., animals, books, art).

• Perfectionism or rigid routines that help manage uncertainty.

These signs may not raise red flags in a quick clinical screening, but they do reflect consistent experiences many girls live with daily.

Why Missed Diagnosis Matters

Girls who mask for years may avoid early diagnosis—and with it, crucial support. Studies show that later diagnosis is associated with lower quality of life scores, particularly when masking is involved.

Without proper support:

• Anxiety, depression, or exhaustion may be treated without addressing the root cause.

• Some girls may be misdiagnosed with conditions like ADHD or anxiety instead of autism.

Recognizing the true picture of autism in girls and women helps families get the right support sooner, changing developmental pathways and wellbeing.

Autism in girls and women often looks different. Masking may hide struggles, but it does not eliminate them. Recognizing these differences allows for accurate diagnosis and meaningful support.

Glow Pediatrics provides in-person autism evaluations at our Oklahoma office, serving families in Oklahoma City, Moore, Norman, Edmond, and surrounding areas. Our practice specializes in autism, co-occurring ADHD, and sensory and emotional regulation challenges.

Glow Pediatrics offers evidence-based autism evaluations led by a Board-Certified Integrative Pediatrician | Holistic/Integrative Autism & ADHD care doctor in Oklahoma, focused on clarity, validation, and comprehensive care.

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