Clinical psychologist Simon Baron-Cohen’s “extreme male brain” theory suggests that people with autism process the world through a ‘male’ lens – this skewed perception perpetuates a profound misunderstanding of how autism presents across genders. Due to harmful misconceptions that dwell on the patriarchy, health professionals often disregard autism as a viable diagnosis for cisgender women and gender diverse people. This all too common error has left autistic women and gender nonconforming people wondering; Would things be different if I were a boy? Could I have been diagnosed earlier? Would I have received support sooner?
In the face of negligence, autistic women and gender nonconforming people continue to thrive with a determination to be seen. Emily Katy, author of Girl Unmasked: How Uncovering My Autism Saved My Life, recalls experiencing blatant instances of misogyny from professionals, while dealing with the ramifications of missed diagnosis. “I was admitted to an inpatient ward because I was a very distressed autistic person, and this wasn’t recognised at the time. My mental health notes describe me as having ‘hysterical attacks’ when I didn’t get my own way. The word hysterical is such a sexist term,” she explains. “Because I was an autistic girl who had friends, and I could communicate verbally, that really got in the way of me being diagnosed – I didn’t fit into this preconceived stereotype of an autistic person, of an autistic male,” a saddeningly familiar experience for many autistic people of marginalised genders.
Research shows that those assigned male at birth are three times more likely to be diagnosed with autism than those assigned female at birth and that women have a higher average age of diagnosis, making them considerably more likely to receive a diagnosis in adulthood.
Emily explains that The Social Communication Questionnaire (SCQ) is based on cisgender males: “I scored low on the questionnaire, so I didn’t qualify for an autism assessment. Had they gone off the current screening process, I wouldn’t have received a diagnosis at all.” Such dismissal is often aided by misogynistic rhetoric. “During the diagnostic process, I was told that I was overly emotional, melodramatic, hormonal – it’s these buzzwords that are used by professionals to dismiss women with autism,” recalls Emily.
“Growing up, not knowing that I was autistic made me feel broken,” says Emily. Community is central in dismantling this feeling, she affirms. “Everything I know about autism, I learned from the autistic community and from other autistic people. It was never something I was taught by professionals. I found out what I know about my autism, pretty much on Twitter and Instagram.” Social media has been a lifeline for autistic people of marginalised genders, explains Emily: “When I realised that there were other autistic people online that had similar experiences to me, it was mind blowing. You feel like you’re the only one in the world who thinks in this way. When I connected with that community online, I just felt much less alone. Community is one of the most important things that comes with finding out that you are autistic.”
Everything I know about autism, I learned from the autistic community and from other autistic people. It was never something I was taught by professionals. I found out what I know about my autism, pretty much on Twitter and Instagram.
Emily uses her blog Authentically Emily to harness this notion and nurture the online community that she gained when she was first recognised as autistic. This led to the publication of her book, Girl Unmasked, which has been hailed as essential reading. She also supports her community through her work as a mental health nurse, where she works with young neurodivergent people.
With similar experiences, Poppy McDonald – an autistic artist, content creator, and founder of the group Autism and Women – is advocating for herself and her community through her work. “I first got assessed for autism when I was four, but because I was masking during the assessment, which is so common in girls, I wasn’t officially diagnosed,” Poppy explains.
In his book Aspergers and Girls, Tony Attwood explains that: “Girls are more able to follow social actions by delayed imitation because they observe others and copy them, masking the symptoms of autism.”
In high school, everyone just knew me as the girl that would cry all of the time – but they didn’t understand what was going on in my head as an autistic woman. The kids didn’t, the teachers didn’t, and they didn’t try to.
Recalling her experience in education, Poppy says, “I really struggled maintaining friends, I just felt so isolated. I think that’s a very common experience among neurodivergent women. In high school, everyone just knew me as the girl that would cry all of the time – but they didn’t understand what was going on in my head as an autistic woman. The kids didn’t, the teachers didn’t, and they didn’t try to.”
The Child and Adolescent Mental Health Services (CAMHS) described Poppy as a “school refuser,” a harmful label that isolated her further. “I was seen as a refuser, naughty, disruptive, my notes actually said ‘school refuser’ on them. When actually, I was just an autistic girl without proper support.”
It might sound a bit abstract, but the bows can be interpreted as a presentation of women, particularly neurodivergent women, with them coming in different colours, shapes, and sizes. I’d love for people to see a bow and think, yeah – that’s me.
After receiving her diagnosis at the age of 14, despite having been assessed 10 years prior, Poppy continued to suffer due to the neglect that she had faced as an autistic woman. This is when she turned to sharing her artwork online. After building a supportive community of like-minded individuals, Poppy began talking openly about her autism. Her most recent painting series, a coquettish display of juvenile bows against profound black backdrops, has racked up millions of views on the platform. “It might sound a bit abstract, but the bows can be interpreted as a presentation of women, particularly neurodivergent women, with them coming in different colours, shapes, and sizes. I’d love for people to see a bow and think, yeah – that’s me.”
Similarly to Emily, Poppy explains that “Community, for autistic people, autistic women, it’s a lifeline. It makes you realise that actually you’re not alone – there’s nothing wrong with you, there’s everything wrong with the system.”
This feeling led to the creation of Poppy’s support group, which aims to nurture a community of female-identifying people with autism, named simply, “Autism and Women” – two words that have historically been separated. “We have an incredibly supportive group of women, who are connected through our group chat. If somebody is struggling, they turn to the group chat, people are really able to lean on each other for support. We also host events and meetups to really harness that in person community which is integral,” she explains.
Negligence in regards to neurodivergence also stands true for gender nonconforming people. Rachelle Cox is a gender nonconforming writer, activist, and content creator. After recently discovering that they are autistic, Rachelle has “a new lease of life” and affirms that “awareness is freedom.”
Research shows that gender nonconforming people are between three to six times more likely to be neurodivergent when compared to cisgender people. Despite this, just as there is a lack of catered care for autistic women, there is no specific support for autistic people who are also gender nonconforming. “You know what’s wild? Once you get diagnosed with autism, there’s no support,” explains Rachelle. “It’s a very scary time for marginalised genders anyway, and then you’re not receiving support for the way that your brain operates.”
Rachelle reflects on the intertwined sense of shame that she feels as both a neurodivergent and gender nonconforming person. “There’s so much shame for gender nonconforming people. Realistically, being both gender nonconforming and autistic, you deal with isolation, bullying, discrimination, hate crimes, and on top of all that, not receiving guidance or diagnosis is so hard.”
Speaking on the sense of thwarted belongingness that is prevalent among autistic people – and amplified by being gender nonconforming – they say, “I’ve realised that everyone just wants to be loved. When you are being excluded from society in multiple different ways, it’s so difficult to feel worthiness.”
Like many autistic women and gender nonconforming people, Rachelle has fallen victim to harmful stereotypes that continue to dominate conversations regarding neurodivergence. “I’ve experienced a lot of people telling me that I’m not autistic because I’m sociable, I love fashion, all of these things,” she reveals. “It made me doubt my neurodivergence, saying that if you have friends, you can’t be autistic, it’s detrimental.”
Despite these women and gender nonconforming people receiving diagnosis eventually – it’s clear that autistic people of marginalised genders are in the midst of a mental health crisis. With a lack of catered care, we can only expect this to worsen. The absence of official support available amplifies the importance of alternative help, such as community and charity.
Rachelle affirms the central importance of community for neurodivergent people of marginalised genders. “Community is so important, it allows you to learn and understand yourself more. You feel finally accepted. These people will hold you.”
Autistic Girls Network campaigns for better recognition and diagnosis of autistic girls and non-binary young people, and supports them in finding their identity and feeling understood. You can support them here.
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