Understanding late autism diagnosis in women

Many women exploring autism later in life are not looking for answers out of nowhere. It’s the result of years of adapting, observing and holding things together. Autism has long been defined through a male lens, which has left generations of women, girls and nonbinary people assigned female at birth unseen.  

Research suggests that up to 80% of autistic girls are undiagnosed by 18, because they’re more likely to mask their traits from a young age, learning to copy social behaviour, suppress differences and appear to cope. This ability to mask is often mistaken for resilience, when in reality it hides support needs and delays recognition.  

Realising autism may be part of the picture can feel deeply validating but also emotional. With growing awareness, more women are reclaiming their stories and exploring whether a late diagnosis could bring clarity, self-understanding and a kinder explanation for their experiences. If this resonates, that curiosity is valid and shared by many others. 

Why autism in women is often overlooked

Autism cannot develop in later life, so a late diagnosis simply means early signs were missed. Unlike some conditions, there’s no single blood test or scan to detect autism. Diagnosis is based on developmental history, everyday behaviour and lived experiences. 

Many women begin questioning whether they might be autistic after navigating an assessment for their child, during periods of burnout or mental health struggles, or when they come across relatable content about autism online. 

Here are the key reasons women are commonly underdiagnosed:

• Assessment tools were designed with boys in mind – Traditional diagnostic criteria were built on studies of boys. This means they can miss female traits such as masking, socially acceptable special interests and strong verbal skills. 
• Masking hides autistic traits – Masking is when someone consciously or subconsciously imitates others or suppresses behaviours to appear socially typical. Women often become very skilled at this from a young age and while masking can help someone cope in the moment it can make autism harder to recognise.  
• Misdiagnosis is common – Many autistic women are first diagnosed with anxiety or depression. Others are misdiagnosed with personality disorders. Research suggests nearly 80% of autistic women are misdiagnosed before receiving the correct diagnosis. 

A gentle self-reflection checklist

This checklist is not diagnostic, but it can help you explore your experiences: 

• You feel tired or overwhelmed after socialising because you work hard to appear natural 
• Your interests feel grounding or absorbing and you return to them for comfort 
• You communicate well yet find social rules confusing or draining 
• You avoid certain places or situations because of sensory overwhelm

Feel familiar? You may want to explore an assessment. Seeking a diagnosis is a very personal journey so it’s worth understanding the benefits and considerations of an autism diagnosis. 

Consequences of a late diagnosis 

Without a diagnosis, many women spend years feeling out of step. This can lead to: 

• Burnout from long-term masking 
• Anxiety or depression linked to unmet support needs 
• Misdiagnosis and treatment that does not fit 
• Barriers to education and work 
• Reduced quality of life 

Women diagnosed later in life often face significant mental health challenges. Research shows that around 70% experience anxiety and 60% experience depression, far higher than those diagnosed earlier. These struggles often stem from years of misunderstanding their own needs and living without appropriate support. 

Masking, hiding autistic traits to fit in socially, is common among women and can lead to autistic burnout, a state of severe physical and emotional exhaustion. Studies link prolonged masking to increased anxiety, depression and even suicidal thoughts, making the emotional toll of late recognition profound. 

Before receiving an autism diagnosis, many women are misdiagnosed with conditions like anxiety, OCD or borderline personality disorder. One study found 15% of patients at a BPD clinic actually met criteria for autism, highlighting how often autistic traits are misunderstood. Misdiagnosis delays access to tailored support and appropriate treatment, leaving women without the help they need. 

Without a diagnosis, women often miss out on accommodations that could help them succeed in school or work. Sensory sensitivities and executive functioning challenges can make environments overwhelming, leading to career instability and strained relationships over time. 

The emotional load of “trying to cope” without understanding why can be heavy but a diagnosis can open the door to clarity and support. 

Is a late diagnosis still worth pursuing for women? 

A formal autism diagnosis in adulthood can be life changing for many, offering practical benefits as well as bringing a sense of relief. It can help you to: 

• Understand yourself more kindly: Reframing past experiences through an autistic lens can reduce self-blame. 
• Access workplace adjustments and support: Although not legally required, you may feel more confident requesting accommodations with a formal diagnosis. 
• Reduce burnout by honouring your needs: Knowing you’re autistic can make it easier to set boundaries. 
• Build confidence through self-knowledge: Understanding your strengths and challenges can guide personal growth. 
• Connect with autistic community spaces: Some support groups and services are diagnosis-based. 

If you’re curious to learn more about the process, check out our blog that explores what you will be asked during an autism assessment. 

However, a clinical diagnosis isn’t the only valid path. For some women, self-identification is enough to bring clarity and relief. Self-diagnosis can be empowering when: 

• Access or cost is a barrier: Some wait more than a year to be assessed by the NHS and self-funded private assessments aren’t accessible to everyone. 
• You already feel certain after research and reflection: Many women recognise themselves in autistic traits and find peace without formal confirmation. 

For example, some women join online autistic communities after self-identifying and find the validation and support they need without pursuing a formal assessment. Others use self-knowledge to adjust their environment, advocate for sensory needs or explain their experiences to loved ones. 

Ultimately, whether you choose a formal diagnosis or self-identification, your experience is valid. The most important thing is finding the understanding and support that helps you thrive.