Autism spectrum disorder in females: late diagnosis

*Source has requested anonymity

Key Points:

• There is a much higher prevalence of autism spectrum disorder in males compared to females, according to a 2023 report from the Australian Institute of Health and Welfare
• Autism spectrum disorder is expressed differently in every individual
• Although some people appear to respond appropriately in social situations, it can be uncomfortable and confusing

The whoosh of the air conditioner circles around the room, creating a whirlwind of sound around the office to which most of the workers are oblivious or at least seem to be.

Unfortunately for Amy*, this is a sound that prevents her from focusing on her job and greatly impacts her concentration. To reduce the stress, Amy rubs her hands together in an action known as ‘stimming.’ Stimming, also known as ‘self-stimulation,’ is done to help a person regulate their emotions and self-regulate.

Amy has autism spectrum disorder but was only recently diagnosed as an adult at the age of 24, whereas many boys are diagnosed in childhood. 

As Amy has anxiety, she assumed that her problems with change were something that anyone might experience. However, after a discussion with her psychologist, she was told that driving the same route to work, despite there being faster options, was slightly unusual.

On one particular day, there were extensive roadworks, which prevented her from maintaining her routine and caused a meltdown. 

“I panicked and had what I now know to be a melt-down: shaking, inability to talk, crying and inability to think.”

Melt-downs may appear similar to tantrums but they can be experienced by people of any age and often occur when one feels utterly overwhelmed and can’t self-regulate.

After reflecting more on her life and how her anxiety differed significantly from her friends she realised that she’d eat pasta with a bland sauce for weeks on end and found it distressing when something stopped her from this.

As a teenager, Amy ate chicken nuggets almost exclusively for five months. At the time, she had no idea why. Now she understands how having autism spectrum disorder played a significant role in her rigid diet and thinking patterns.  

However, as with many other disorders, there are crossovers between autism and other conditions that appear to share similar traits. When Amy was seeing a psychologist to help her manage her depressive symptoms, borderline personality disorder was brought into the discussion by the health professional.

Autism spectrum disorder wasn’t even mentioned until she saw a different psychologist later. This possible diagnosis had been missed as Amy demonstrated eye contact and relatively appropriate social interactions. However, unknown to others, Amy finds eye contact and conversations with unfamiliar people to be extremely uncomfortable. 

Perhaps this form of ‘masking’ contributes to the reduced prevalence of females who are officially diagnosed with autism spectrum disorder, in addition to most of the research having been conducted on males, according to Boston University in 2024. Masking includes behaviours used by a person to hide their autistic traits, e.g. social difficulties, such as mirroring others’ facial expressions

According to current statistics from the Australian Institute of Health and Welfare, published in 2023, the prevalence of autism spectrum disorder is four times higher in males than in females. As previously explored through Amy’s recollections, females may present differently and may be more apt at masking to comply with typical social conventions. 

Since receiving her diagnosis, Amy now utilises numerous strategies to assist in maintaining a job, relationship and social life. Some of her strategies include using fidget toys, music and mindfulness. However, there is one most useful thing:

“Dried apricots! When I’m feeling overstimulated and stressed, I place a small one on my tongue. Feeling the different grooves of the fruit and eventually getting to that tart taste helps bring me back to the present,” she said.

There are also companies such as Coles supermarkets that understand the overstimulation that some environments provide and have made efforts to improve shopping experiences for those affected with a quiet hour.

If you think you might have autism, reach out to your local doctor to have a conversation about the next step.

Have you recently been diagnosed with autism? What helps you self-regulate? 

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