Why Are Autistic Girls Frequently Misdiagnosed with Other Conditions?

PostedNovember 13, 2025

UpdatedNovember 13, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

It’s surprisingly common for autism misdiagnosis in girls to happen, with many receiving labels like anxiety, borderline personality disorder, or ADHD instead. This is largely due to how autism presents differently in females often more internalised, subtle, and socially masked. These nuanced behaviours don’t always align with traditional diagnostic models, leading to missed or incorrect diagnoses.

One of the major contributing factors is the gender bias embedded in early autism research, which focused heavily on boys. As a result, the criteria used in assessments often overlook female autism traits such as social mimicry, perfectionism, and emotionally intense interests that seem age appropriate. Many girls excel at imitating others and can blend in socially, hiding their underlying challenges. This tendency to camouflage can cause underdiagnosis or entirely misdirected diagnoses.

Key Misunderstood Patterns

Here are traits that commonly contribute to diagnostic confusion:

Social Masking

Girls may learn to copy peers or suppress natural behaviours to appear socially competent, concealing difficulties with reciprocity or interpretation.

Emotion-led Presentations

Instead of obvious behavioural signs, girls often show distress through anxiety, mood issues, or obsessive behaviours prompting mental health rather than neurodevelopmental diagnoses.

Special Interests Hidden in Plain Sight

Their intense focus may centre on socially acceptable topics (like animals or fashion), making it harder to recognise the fixated, repetitive nature typical of autism.

These patterns call for more inclusive tools and informed evaluation.

Visit providers like Autism Detect for personal consultations that consider the full context of gender and development.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to misdiagnosis and differential diagnosis.

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.