Understanding Autism in Women: 3 Support Strategies Beyond Medication

For years, she thought she was simply “too sensitive.” Crowded stores felt exhausting. Bright lights were distracting. Conversations in groups felt overwhelming, and she often replayed them in her mind afterward, wondering if she had said the wrong thing. Many women spend years believing they are shy, anxious, or “too much,” only to discover later in life that Autism Spectrum Disorder (ASD) may help explain experiences they have had since childhood.

Autism in women is often diagnosed at a much later age because the signs are either missed or diagnosed under different ailments (1). But when a woman does receive a diagnosis of ASD, there is promising research for treatments that do not rely as heavily on medication.

What Is Autism Spectrum Disorder?

ASD is a developmental, neurodivergent condition that involves significant challenges in communication and social interaction, as well as limitations in behavior patterns. This includes repetitive, highly limited or restricted interests, and inflexibility, among others. The DSM-5 diagnostic criteria were updated by the American Psychiatric Association in 2022.

If you think you or a loved one may have ASD but have yet to be diagnosed, we recommend seeing a licensed therapist in one of our offices to discuss your concerns.

Why Autism in Women Gets Missed

There are several reasons a girl may be categorized as “normal” or as having a shy personality or possibly diagnosed with anxiety instead of autism when she’s growing up.

One reason is that anyone — female or male — who is naturally less expressive will not exhibit the expressive signs of another more overt personality who is struggling with social interaction. Another reason is that some of the research used to set the gold standard of autism measures was set using boys as the model, and girls present differently (1).

A girl may play by lining up the dolls and mimicking the same pretend story over and over. The reason the girl did not get assessed in the first place is that her play traits are more characteristic of her gender than the boy’s, and they are less noticeable.

Autism in women also gets missed because they learn to cope by masking their neurodivergent patterns of behavior and mimicking the behaviors they see of normalized social cues. This can be exhausting, and it often leads to burnout (2). For many women, masking becomes so automatic that they do not realize how much energy it requires until they begin experiencing chronic exhaustion or burnout. Many women do not seek treatment until they recognize the signs of burnout and wonder what could be causing their extreme responses to what appear to be everyday social interactions.

What Might Autism in Women Look Like?

Women with autism have similar interests to any woman, but some of the neurodivergences can include:

● Preferring one-on-one discussions instead of group discussions
● Sensory avoidance and sensitivity to light or sound
● Internalizing shutdowns so they appear to be zoning out, but in actuality, they are overwhelmed by external stimuli
● Practicing scripts to mimic the social norms that are expected
● Adopting personas to become like what they think they should be, e.g., an organized student or a helpful co-worker
● Stemming behaviors that aren’t as overt, such as hair twirling, cuticle picking, or quiet humming
● Misunderstanding conflicts, particularly in relationships or friendships
● Inability to maintain long-term friendships due to frustration, inflexibility, or limited interests

While every person is different, autism in women can also appear differently because there are levels of autism. These are some of the characteristics that might help you or someone you love find something relatable and a reason to reach out.

Treatments for Autism in Women Beyond Medicine

While medicines can provide relief to specific symptoms, this article maintains that a licensed counselor will work with a woman to determine those. It is important not to self-diagnose. Some women will have other conditions alongside ASD, and it is essential to understand their entire mental health portfolio to manage all conditions together.

Recent research suggests that a promising discovery could be beneficial, particularly for women (3) who struggle with sensory challenges related to autism. Using VR technology, one small study noted that women were better able to self-regulate when they were overstimulated. The technology allowed them to choose their own room filled with silence, and it did not matter what their physical location was.

This game-changer could be pivotal in helping anyone with autism, particularly in areas where moving locations is not an option, such as traveling through airports or in shopping malls. The research and prototype are still in their early stages, but the findings are promising.

Other treatments include resource-based support, such as guiding adolescents into adulthood by helping them with life skills and communication. An Applied Behavior Analysis (ABA) support can help adolescents transition through coaching that’s targeted to their specific needs.

The ABA might include breaking down large skill sets into smaller chunks for practical problem-solving. Practical examples are using ABA to ensure you are getting on the right bus at the end of your shift, or how to answer questions appropriately in a job interview.

Self-assessment and reflection tools also help autistic adults as they learn how to identify their own skill gaps. Then, they can recognize what guidance could be helpful as they seek treatment from a therapist. Reflecting on how they feel in relationships, friendships, or the workplace may help reveal a particular challenge with interpersonal communication.

On the other hand, a guided tool geared toward women with autism may ask about self-care habits, such as sleep, hobbies, and routines. These questions can provide clues related to a need for more attention to broadening interests or expanding routines.

Vocation and social support are also shown to be effective. Especially for autism in women, you or your loved one may have wondered why a specific line of work has been so challenging, and the diagnosis may shed some light on it.

With vocational support and the Americans with Disabilities Act, several companies are designing inclusive workspaces, programs, and workplace roles that enable a person diagnosed with ASD to thrive. Social support may include one-on-one peer feedback or group therapy, both guided by licensed therapists.

Research on Autism in Women

While the research on autism in women is still emerging, the future of support, treatment, and vitality is strong. Several universities have developed programs of study for adult learners with autism, recognizing the need for further advancement.

One recent study showed that clinicians need to keep autism on their radar when women seek treatment for other conditions, such as eating disorders, anxiety, burnout, and ADHD. Some women may have comorbidities or have been misdiagnosed at the time they initially sought treatment.

Next Steps

If you suspect that you or another adult woman you know has autism, there are a few ways you can help. Depending on the nature of your relationship, you can consider the following:

· When was the most recent appointment with her primary care physician?
· What other challenges are present?
· What are some of the past obstacles socially, academically, and interpersonally?

After that, or if you are the person you suspect may be autistic, you can contact a licensed psychologist or psychiatrist who specializes in ASD. Our offices are staffed with therapists who have the appropriate training and experience to help you on your journey to thriving and well-being.

One thing to keep in mind is that there is not one test or assessment that clinicians use to decide if you have autism. Instead, the diagnosis will be based on a variety of questionnaires, your medical and health history, and you will likely need multiple appointments. But the important part is that you will have access to support once you are diagnosed — whether you have autism or not.

Take the first step and reach out for an initial evaluation. In the meantime, you can read articles about autism spectrum disorder and watch videos of other adults who were diagnosed later in life. It may encourage you to hear about their stories, so you will be informed, educated, and motivated for the path ahead.

Autism in women is often more complex to assess than in men, especially during childhood and adolescence. If you relate to anything you’ve read here, it is wise to seek an expert opinion. Contact an office near you today.