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What factors contribute to the underdiagnosis of autism in girls? 

Posted
Updated
ByMy Patient Advice
Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

The underdiagnosis of autism in females remains a significant challenge in healthcare. Many children who meet the criteria are overlooked because their traits do not match the patterns traditionally associated with the condition. This gap has serious implications for access to support, mental health, and educational opportunities. 

One major reason is that girls often adapt their behaviour to fit in socially, a process sometimes referred to as masking. They may rehearse conversations, copy the mannerisms of friends, or redirect their focus toward interests considered socially typical. Because these behaviours can reduce visible signs of difficulty, teachers and clinicians may underestimate the need for assessment. 

Try an online Autism test

Common Patterns in Female Presentation 

Awareness of subtle signs can help reduce the underdiagnosis gap: 

Social camouflage 

Skillful imitation of peers can hide communication challenges from adults and professionals. 

Acceptable interests 

Highly focused passions, such as animals or literature, are often mistaken for ordinary hobbies rather than indicators of neurodivergence. 

Internalised struggles 

Anxiety, perfectionism, or quiet withdrawal may replace the outward behaviours more common in boys, making them harder to identify. 

A delayed diagnosis means fewer opportunities for early intervention, leaving many without crucial guidance during formative years. Addressing this requires gender-aware assessment tools, training for professionals, and greater public education on how presentation differs between individuals.  

For tailored advice and support, visit providers like Autism Detect for personal consultations.  

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to cultural and gender barriers in diagnosis.

Try an online Autism test
Beatrice Holloway, MSc
Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS
Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy. 

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