Here’s a startling fact: autistic girls are far less likely to receive a diagnosis compared to boys, even though autism may be just as prevalent in females as in males. But here’s where it gets controversial—could our diagnostic tools and societal biases be failing an entire group of people? A groundbreaking study published in the BMJ (https://www.bmj.com/content/392/bmj-2025-084164) sheds light on this alarming disparity, revealing that boys are up to four times more likely to be diagnosed with autism in childhood than girls. Led by the Karolinska Institutet in Sweden, the research tracked 2.7 million individuals born between 1985 and 2020, finding that only 2.8% were diagnosed with autism between the ages of two and 37.
One of the most eye-opening findings? By age 20, diagnosis rates between men and women were nearly identical, challenging the long-held belief that autism is more common in males. And this is the part most people miss—girls are diagnosed, on average, nearly three years later than boys, with median ages of 15.9 for girls and 13.1 for boys. While boys under 10 are three to four times more likely to be diagnosed, girls seem to ‘catch up’ by age 20, thanks to a surge in diagnoses during adolescence.
Dr. Caroline Fyfe, the study’s lead author, emphasizes, ‘Our findings suggest that the gender gap in autism prevalence is far smaller than previously thought, largely because girls and women are either underdiagnosed or diagnosed much later.’ This raises a critical question: Are we overlooking autistic girls due to systemic biases in diagnosis, or is there something more at play? Patient advocate Anne Cary argues that diagnostic methods may be inherently biased, leaving autistic girls with less than a third of a chance of being diagnosed before age 10. As a result, many girls are misdiagnosed with psychiatric conditions like mood or personality disorders, forcing them to self-advocate for proper recognition and care.
Autism charities are sounding the alarm, urging a reevaluation of gender stereotypes in diagnosis. Dr. Judith Brown of the National Autistic Society points out, ‘Gender should never be a barrier to diagnosis or support.’ Historically, autism was wrongly assumed to be a predominantly male condition, but we now know that girls and women often ‘mask’ typical autistic traits, making their challenges harder to identify. This masking can lead to coexisting mental health issues like anxiety and depression, underscoring the urgency of addressing this oversight.
Jolanta Lasota, CEO of Ambitious about Autism (https://www.theguardian.com/society/autism), adds, ‘Autistic girls have been overlooked for far too long. Their needs are often misunderstood or dismissed, leaving them without vital support and, in some cases, pushing them to a mental health crisis.’ The study also highlights that while gender disparities persist for children under 10, they diminish significantly in older age groups, suggesting the male-to-female ratio in autism may be far lower than previously believed—possibly indistinguishable by adulthood in Sweden (https://www.theguardian.com/world/sweden).
Dr. Conor Davidson, a former autism champion for the Royal College of Psychiatrists, notes that autism in girls often goes undetected in childhood, with signs emerging only in adolescence or adulthood. ‘Psychiatrists in adult neurodevelopmental clinics are now seeing more women than men,’ he says, ‘but long waiting lists for assessments remain a significant barrier.’ This leaves countless autistic women undiagnosed, unable to access the care they need.
Here’s the controversial question: Are we failing autistic girls and women by clinging to outdated diagnostic criteria and stereotypes? And if so, what can we do to ensure they receive the recognition and support they deserve? Share your thoughts in the comments—let’s spark a conversation that could change lives.
