why is autism often missed in women & girls?

Authors: Madeleine Noller, Jess Snyder, & Liv Mace

​During this week’s lab meeting, the B-RAD lab discussed the TED Talk, “Why Autism is Often Missed in Women and Girls” by Kate Kahlem, which draws on her personal experiences with autism. This conversation focused on how gender biases in research and society influence the way autism is recognized and diagnosed. More specifically, our discussion highlighted three key themes: the late diagnosis of autism in women, the role of masking, and the broader implications for research and clinical practice.   

A key takeaway from both the TED Talk and our discussion was that autism is often diagnosed later in girls due to differences in how it presents. Historically, autism research has focused primarily on boys, which has contributed to a significant gap in recognizing how autistic traits present in girls. Kahle emphasizes that many autistic girls do not display the “classic” behaviors typically associated with autism, which can delay diagnosis.

We mentioned that some of these behaviors can include perfectionism or hyper-fixation in one's interests. As a result, many girls go undiagnosed during critical developmental periods which can impact their access to support. The lack of diagnosis is connected to the concept of masking, which helps to explain why these traits often go unnoticed. 

Masking was one of the most important concepts explored in both the TED Talk and our lab discussion. Kahle describes masking as the process of copying social behaviors to fit into neurotypical expectations. While masking can help individuals navigate social situations, it often comes at a significant cost. Masking requires constant effort and can contribute to anxiety, depression, and a loss of personal identity over time. Our group expanded on this by discussing how prolonged masking, specifically during adolescence, can create additional barriers to self-understanding and mental well-being. These challenges highlight the need to better recognize and address masking in both research and clinical settings. 

We also discussed how societal expectations play a role in missed diagnoses. Kahle explains that girls are often socialized to be more emotionally aware and compliant, which can make autistic traits less noticeable. Because girls are expected to “fit in,” they tend to develop stronger masking behaviors than boys, leading clinicians to overlook or misinterpret their symptoms. This reinforces the idea that misdiagnoses are not only biological but are also shaped by cultural norms and biases. Additionally, the underrepresentation of women in autism research contributes to systemic gaps in diagnosis and care. Addressing these gaps requires a shift away from male-centered models toward a more inclusive understanding of neurodiversity. 

Another takeaway from Kahle’s talk is the impact of diagnosis on self-understanding. Kahle shares that receiving her diagnosis as a teenager helped her make sense of her experiences and provided a new path for accessing appropriate support. Rather than viewing autism as something that needs to be “fixed,” she reframes it as a different way the brain can function. This perspective aligns with our group’s discussion of shifting towards neurodiversity-focused approaches that emphasize accommodations and strengths rather than focusing on the deficits. 

This connects directly to the broader implications for neuroscience research and clinical practice. The continued underrepresentation of women in autism research contributes to systemic gaps in diagnosis and care. Addressing these disparities requires not only earlier recognition of symptoms in girls, but a difference in how autism is conceptualized. Expanding research to reflect a wider range of experiences is essential for building a more accurate and inclusive understanding of neurodiversity. 
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Overall, our discussion reinforced the importance of inclusion in neuroscience. By recognizing biases in both research and society, we can move toward more accurate diagnoses, better support systems, and a more inclusive understanding of how different brains function.