Autism used to be thought of as a “boy’s” condition. But today, we know it can affect people of all genders.
In girls, autism often gets overlooked. This is because girls typically don’t exhibit stereotypical autistic behaviors. They tend to be better at masking, and their symptoms can be harder to detect.
If you think your child might have autism, don’t hesitate to seek an evaluation and diagnosis. Look for a provider who understands the unique ways that autism can manifest in girls.
For a long time, autism spectrum disorder (ASD) was believed to mainly affect boys and men. This was, in part, because much of the autism research historically excluded girls and women. Unfortunately, this has led to many girls with autism being misdiagnosed or not receiving a diagnosis at all.
Today, we have a growing body of research on autism and gender. And we now know that it can affect anyone. For girls and women, however, it can present differently. Their symptoms might not fit the stereotype of “typical” autistic behavior. But that doesn’t mean they don’t experience challenges. Learning more about how autism manifests in girls can help you know when a young person in your life might need support.
A note on gendered language: At Rula, we believe that all people, regardless of gender, deserve research-backed information to support their mental health. One of the challenges in discussing autism spectrum disorder (ASD) and women is that most of the research focuses on people assigned female at birth (AFAB individuals).
It’s clear that gender and socialization play a role in autism identification and diagnosis. But we don’t yet have reliable data to demonstrate how this experience might diverge for gender diverse individuals. This is because, unfortunately, the scientific community has largely focused on autism as it presents in cisgender boys and men. As new, more inclusive research is published, we’re committed to updating our content to reflect these changes.
Signs of autism in girls and teenagers
According to the Centers for Disease Control and Prevention (CDC), autism is about three times more common in boys than in girls. To explain this disparity, some experts point to the genetic and brain differences between boys and girls. But girls are also less likely to exhibit some of the more obvious behavioral signs of autism, like hand flapping or other forms of stimming. So their symptoms might get misinterpreted or overlooked.
As you review the following signs of autism in girls, remember that the condition exists on a spectrum. It’s not that girls always exhibit fewer or less severe symptoms than boys. The main difference tends to lie in how they’re expressed.
Signs and symptoms of autism in girls may include:
Having an intense interest in a few specific things (even those typically associated with their gender, like dolls or horses)
Being prone to sensory overwhelm, or having aversions to certain textures, foods, smells, loud sounds, and more
Having trouble with social communication or interacting with peers
Difficulty maintaining eye contact
Being overly shy or reserved
Engaging in repetitive behaviors such as stacking toys or arranging objects in a specific way (this might look like staying organized)
Having a strong preference for consistent routines and becoming upset if there’s a deviation (this can be mistaken for having good time management)
Trouble with physical communication (waving, pointing)
Experiencing heightened anxiety — especially during the teen years — often due to attempts to hide their symptoms or fit in
If you’re a parent or guardian, you might be wondering how to tell the difference between an autistic trait and a personality “quirk” in your child. One thing to consider is the impact on daily functioning.
For example, are the behaviors consistently preventing your child from learning, communicating, or playing with friends? Do their differences make it hard to regulate their emotions or navigate change? If so, don’t hesitate to ask for help. A medical or mental health professional, like a psychologist, psychiatrist, pediatrician, or neurologist, can provide an autism evaluation and help you determine next steps.
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What’s known about the cause of autism in girls
We don’t yet fully understand all the causes of autism in girls. But here’s what we know about some of the risk factors:
Genetics: A girl may be more likely to develop autism if a close relative (like a twin or sibling) also has it. However, genetic vulnerability may differ slightly between boys and girls.
Brain differences: Researchers have observed differences in the structure and functionality of the brains of people with autism. However, these differences aren't identical among boys and girls with autism.
Parents: There’s some evidence to suggest that parental age may have a role in autism. Parents who are older are more likely to have a child with autism.
Environment: Prenatal exposure to air pollution or certain chemicals may be a contributor to autism but not a standalone cause. In addition, there’s no verifiable link between vaccines and autism.
Barriers to autism diagnosis for young girls
Many young girls with autism age into adulthood without ever receiving a diagnosis. Throughout childhood, they may struggle to manage symptoms without access to support.
This is often due to barriers, including:
Outdated perceptions: The stereotype of autism being a “boy” condition might make adults less likely to view a girl's behavior as a sign of autism.
Masking: Girls may be more skilled in masking or concealing their symptoms due to the way they’re socialized. This means that their symptoms might be harder to detect. For example, they might be better able to pick up social cues and “blend in.” But this often can eventually lead to burnout.
Less obvious symptoms: Boys with autism are more likely to exhibit aggression, repetitive behaviors, and other observable behaviors. Girls’ symptoms tend to be subtler, like staring or eating problems, and harder to detect.
Misdiagnosis: Given that many girls don’t fit the typical “model” of autism, they’re frequently misdiagnosed. They may develop low self-esteem, depression, or anxiety because they’re struggling with undiagnosed autism. But without addressing the underlying issue, they may not find relief.
Getting an autism assessment and next steps
If you think your child might be showing signs of autism, talk to their pediatrician. They can discuss your concerns with you and provide an assessment. In some cases, they may refer you to another specialist for further testing.
There isn’t a single test that can identify autism. Your child’s provider will use a combination of observations and assessments. They’ll also want to know what you’re observing at home, how things are going at school, with peers, and other day-to-day activities.
Once your child is diagnosed with autism, their provider may recommend various therapies, depending on their needs. As you expand your child’s care team, look for providers with experience working with girls with autism.
When autism goes undiagnosed in girls, it often leads to anxiety, depression, or low self-esteem. Many feel different but don’t know why. Constant masking can also cause burnout. But with the right support, these same challenges can turn into strengths, and girls can grow with confidence and thrive.
Brandy Chalmers, LPC
Clinical reviewer
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People of all genders can be diagnosed with autism. But boys and girls can have very different symptoms, and girls may not exhibit the typical signs or learn how to mask from an early age. Because of this, girls aren’t diagnosed with autism at the same rate as boys.
If you’re concerned about your child, don’t hesitate to ask for help. Talk to their pediatrician, psychiatrist, or other provider, and let them know that you’d like to pursue an autism evaluation. With the right support, your child can learn new skills, strengthen their self-esteem, and embrace their neurodiversity.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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