Autism may present differently in people assigned as female at birth. A key feature is masking or camouflaging symptoms. This may result in a later diagnosis.

Research suggests females are more likely than males to mask symptoms to adapt to social situations

“Masking,” or “camouflaging,” involves adapting behaviors to suppress autism symptoms in social situations or developing living and communication skills that allow a person to live independently.

Some people may use the term “high functioning” to describe people who do not display stereotypical symptoms of autism, do not have an intellectual disability, and have an intelligence quotient (IQ) of around 70 or higher.

However, this term is problematic because intellectual abilities may not correlate to functional abilities, and this categorization may prevent certain people from getting the support they require.

Instead, it is important to recognize autism as a spectrum and identify subtypes of autism based on functional and cognitive abilities.

This article will look at key symptoms of autism in females. It will also outline what a person can do if they think they are autistic.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Was this helpful?
A high functioning autistic female sitting on a couch -1.Share on Pinterest
Getty Images

According to a 2021 case series, camouflaging is a key feature of autism in females.

This means they often mask social difficulties using techniques to try to “fit in” with peers who are not autistic, such as copying how others behave in social situations. Because of this, it may be challenging for others to recognize the signs and symptoms of autism in females.

Where they are apparent, key symptoms include the following:

Social difficulties

Autistic females may have difficulties making or maintaining social relationships, particularly friendships.

Although they may have the motivation to make friends, they may have difficulty carrying on long-term relationships and managing conflict.

Difficulty making eye contact

Autistic people may find it challenging to make and maintain eye contact. However, autistic females may force themselves to make eye contact to hide autistic traits.

Sensory sensitivity

Autistic people may have a heightened response to sensory stimulation, such as bright lights.

Autistic females may also experience increased sensitivity to strong smells, textured fabrics, or loud noises.

Executive function difficulties

Difficulties with executive function are common in autism. Executive function refers to a set of skills, including planning.

Those who are autistic may find it difficult to change their routines, have difficulty working toward a goal, or have difficulty with time management.

Obsessive interests

Females who are autistic may have an intense interest in certain areas.

Research suggests they may have increased interest in animals, fictional characters, or psychology. While the interest itself may not be unusual, the high level of intensity can be a trait of autism.

Sleep problems

Sleep problems may be more common in autistic people, particularly females.

Emotional regulation difficulties

Autistic people may have difficulty regulating their emotions.

Females who are autistic may have more difficulty with this than autistic males. This can include heightened reactions and states of discomfort or distress.

Repetitive behaviors

Autistic people may display repetitive behaviors, such as rocking or hand-flapping. These behaviors may also include repetition of words or phrases or resistance to change.

Anxiety and depression

Internalizing or socially camouflaging autistic traits can be mentally exhausting and negatively impact people’s mental health.

Research suggests these behaviors may increase the likelihood of:

According to a 2019 study, symptoms of autism may appear more subtle or less typical in females than males.

This may be related to the fact that research suggests autistic females are more likely to internalize difficulties and use camouflaging to mask symptoms to fit into social situations. Camouflaging strategies may also factor in the later diagnosis of female autism.

These factors may increase the risk of mental health issues in females with autism.

Mental health conditions more commonly co-occur in autistic people than people who are not autistic, including:

Trauma and autism may also have an association, and autism may increase the risk of exposure to traumatic events.

Post-traumatic stress disorder (PTSD) may intensify certain autism symptoms, while autism may alter how people perceive certain events. Both conditions can also share similar features, such as increased rumination.

A 2022 blog-based study notes that while all autistic individuals have a higher risk of mental health problems compared with people who are not autistic, autistic females have higher rates of mental health conditions compared with autistic males.

This might be a result of the increased likelihood of camouflaging their symptoms of autism, leading to psychological distress.

The authors also suggest that autistic females who are least likely to receive an autism diagnosis have the most significant risk of mental health problems.

Recognizing mental health conditions related to autism

Mental health conditions and autism symptoms may overlap, so it is best to contact a healthcare professional for a thorough diagnosis.

No set test for diagnosing mental health disorders exists. Instead, doctors will evaluate symptoms. They may use criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), to diagnose a mental health condition.

Autistic females usually receive a diagnosis later in life compared with males, especially among females with a level of intellectual ability that is average or higher than average.

Because symptoms in females may present differently or more subtly than in males, and females may be more likely to mask autism symptoms, it can be challenging for them to get a diagnosis.

If people think they may have symptoms of autism, they can talk with a doctor and ask for a referral for an autism evaluation. This referral may be to a psychologist, neuropsychologist, or psychiatrist, who may ask about:

  • communication or social interaction challenges
  • repetitive behaviors or restricted interests
  • sensory issues

A doctor may also ask family members about a person’s developmental years to help make a diagnosis.

Is there an online test?

Although there are online tests for autism, there do not appear to be any specifically for female adults.

Online tests may also vary in reliability and research. It is important to see a healthcare professional to diagnose autism correctly.

Signs of autism in a female child may include:

  • difficulties with communication and social skills
  • hyperfocus on specific topics
  • repetitive behaviors, although they may mask these
  • not participating in school to their full potential or abilities
  • significant language delays
  • lack of flexibility in routines

If parents or caregivers think a child may be autistic, it is important they take the child to all recommended screenings for developmental delays and ask about additional screening for autism.

Getting an evaluation and diagnosis as soon as possible can help people get support sooner.

Learn more about autism in girls.

Females with autism or their parents or caregivers may find the following resources helpful:

Autism can present differently in females than males, which may result in females getting an autism diagnosis later in life.

If people think they may have symptoms of autism, they can see a doctor and ask for a referral for an autism screening and evaluation. Getting a correct diagnosis can help people receive support.

Autism resources

Visit our dedicated hub for more research-backed information and in-depth resources on autism.

Was this helpful?