I’ve written quite broadly about autism, diagnosis, and self-identity, but today I’d like to get a bit more specific. Let’s look at a list of autistic traits and challenges that are often identified in childhood or adolescence, particularly for those who don’t have really obvious early-childhood differences:1
Difficulties with social communication, particularly with small talk and taking turns in conversations.
Difficulties with nonverbal communication, like interpreting others' facial expressions, under- or over-expressing their own facial expressions, and using more or less eye contact than peers.
Difficulties intuiting social expectations in different situations and developing and maintaining friendships if they don’t have other kids around with shared interests and communication styles.
Stereotyped repetitive motor movements or vocal sounds (‘stimming’) and other sensory-seeking behaviours may be seen when processing thoughts and emotions.
May insist on sameness and be inflexible about changes to routines
May have intense, narrowly focused interests (‘special interests’) or collections, and have specific items or toys that they are very attached to.
May be hyper-reactive to sensory input, such as experiencing some noises that others barely notice as uncomfortable or distracting, and other everyday sounds as highly pleasurable or soothing.
May have difficulties with interoception (recognising internal signals within the body like hunger or emotional states) and proprioception (knowing where one’s body is in space), which is seen in unusual gait and sitting positions.
May have advanced abilities in particular areas, most commonly (if present) factual memory, visual recall and imagination, musical or artistic aptitude, maths or language skills, and pattern recognition.
For a lot of people who are recognised as having these traits in childhood, their differences are less obvious to others by the time they’re adults. From this, in past it has sometimes been concluded that autism is something people grow out, of or can be “cured” from through behavioural therapies.
There are neuro-developmental changes that happen for all people as we move from childhood into adulthood, so to expect to see adults behaving in the same way they did as children is a bit ridiculous. However, the particular neurological differences that come with autism have been widely shown to remain throughout life. Learning new skills for getting by in the world, navigating social interactions, and managing emotions generally comes with development within a supportive environment in the transition from adolescence into young-adulthood, and this can make a big difference to some of the challenges autistic children face.
I also think it’s really interesting to reflect on how much more control most adults have over their environment than children do. If an adult is able to choose the social interactions they have and mostly limit it to people who have similar interests and communication styles, choose education and work that fits their interests and cognitive style, and curate an environment around them that suits their sensory needs and preferences for routine, many of those differences might become either irrelevant or even beneficial.
Then there’s ‘masking’. Masking is consciously performing social behaviours that mimic what comes naturally to neurotypical or allistic people,2 and this explains why some autistic people’s behaviour isn’t noticeably different to others in those interactions. It’s not something that every autistic person is actually capable of doing, and there are pretty obvious benefits that come with being able to mask autistic traits in some situations.3
People socialised as girls4 tend to be more capable and adept at masking, even as children. This might involve putting a lot of energy into monitoring the people around them and their own bodies, facial expressions, and behaviours to make sure they match. They’ll hide soothing sensory-seeking behaviour that might look weird to others. They tolerate a level of sensory discomfort that others don’t rather than drawing attention to themselves by “making a fuss”. And usually, like most autistic people who mask, these girls just assume that everyone else is doing the same. Constantly monitoring the reactions of others makes them especially sensitive to rejection, making social interactions even more fraught. While the meltdowns of overwhelmed or distressed autistic boys might draw attention from everyone around, high-masking autistic girls are more likely to withdraw and internalise their anguish.
Even for adults, masking is an energy drain. This is part of why most autistic people strongly identify as introverts - not because they don’t want fulfilling social interactions, but because so many interactions demand that they behave in a way that feels uncomfortable and exhausting. For people who have been masking throughout their lives, the load of feeling unseen and misunderstood can have a huge impact on self-esteem. Rejection sensitivity only adds to the struggles of initiating and sustaining relationships and can become a self-fulling fear.
However, autistic people who can mask some of those behavioural and social communication traits still can’t make their brain process information in a different way from how it is wired. While the connection patterns in an allistic brain seem to use prior conclusions for context and skip over information deemed irrelevant (called ‘top-down thinking’), the autistic brain takes in all the information presented and tries to make logical sense of it (‘bottom-up thinking’).5 This makes autistic people independent critical thinkers and lateral problem solvers. Natural autistic communication is usually direct, logical, and information-based. Autistic people tend to be intrinsically motivated by their interests and values rather than by external social or material rewards. And an innate sense of justice is a common characteristic of autistic people that comes with the logical dissonance between how they’re told people should be treated and what they observe.
All of these characteristics can (and should!) be celebrated as strengths. However, societal expectations of women tend to look different from this, and autistic women are instead unduly penalised. This graphic below rings true for too many undiagnosed autistic women.
Throughout adult life, external demands can change with new jobs or living situations, and a change in situation can highlight sensory, social, or cognitive processing differences that make masking harder than it might have been in past.
The result of all this is that autistic people are far more likely to suffer from mental health disorders than their allistic peers, and women are particularly vulnerable. Depression, anxiety, self-harm, and eating disorders are common. Autistic burnout from chronic life stress can be a recurrent pattern, and misdiagnosis can lead to treatment that doesn’t suit the needs of an autistic individual at all. When masking isn’t understood or recognised, the social struggles of autistic women are sometimes misdiagnosed as Borderline Personality Disorder, which may be cooccurring but also misses addressing all their needs.
Some women reach a mental health crisis point and are referred for an autism assessment. For others, this realisation comes from having a child with obvious autistic traits and realising that those are traits they’ve inherited from them. And some women just spend their lives wondering why life is so much harder for them than it seems like it should be.6
It’s my hope that getting this information out there draws attention to the hidden struggles in our midst, helps us all to rethink the assumptions and expectations we project onto others, and ensures that when a woman tells you she thinks she might be autistic, you’ll have a bit more understanding about what that might mean for her. Comments or questions below (or by DM if you know me personally), I’m always keen to engage!
This list has been adapted from the AutismNZ website because I think they’ve laid things out particularly clearly, so have a read through for more detail.
While ‘neurotypical’ describes brains that function “typically of most people”, it’s a bit of a vague term for this context. ‘Allistic’ just means ‘not autistic’, which isn’t a very commonly used term but for the sake of clarity it should be! But it is worth noting that sometimes other neurodivergent people like those with ADHD are easier for autistic people to interact with and relate to, because they may not fit typical social expectations particularly well themselves either.
If you want to read about masking from someone else (if you’re not inclined to take my word for all of this, by all means do your own research!), there’s a lot of really good info in this article at Healthline.
As in, it seems to be more related to growing up with all the social expectations put on girls rather than because of female genetics.
This piece on Medium gives a much clearer and more detailed explanation of bottom-up thinking than I’ve given you.
For more late-diagnosed autistic women’s experiences, the Squarepeg Podcast is fantastic. It’s a huge resource of autistic women and non-binary folk from different countries being interviewed about their life and experiences. Though the stories themselves are really diverse, the patterns I’ve written about are ones that come up pretty consistently throughout these interviews, along with the different ways they have each have found wellbeing and flourishing.
Thanks for distilling this info right here! Very helpful. I started Unmasking Autism recently and (because of course I had to know WHY autism is/works the way it does) I was interested in the bottom-up information gathering and processing style. Not sure I do that, but then again, the fact that I had to bottom-up process autism might be a telling sign 😂
Looking forward to more newsletters from you!