When adaptation becomes a trap: Recognising autism in girls
The figures from current research are clear: around 80 percent of autistic girls are not diagnosed until the age of 18. In practice, this is evident every day – the diagnosis often only comes at 14, 16 or even later. After years of suffering. After countless visits to the doctor with incorrect diagnoses. After school careers that could have turned out differently.
When adaptation becomes a survival strategy
The reason for this is called masking. Autistic girls often learn to hide their autistic traits at an early age. They closely observe how others behave, copy facial expressions and gestures and force themselves to make eye contact. During the break, they stand in the group, even if they feel completely overwhelmed inside. They smile at the right time, even if they don’t understand the joke.
A recent study of over 2,500 young children shows something remarkable: in very young children, there are hardly any gender differences in autistic traits. The differences only emerge later – presumably precisely because of this social pressure to adapt.
The problem with the diagnostic criteria
This is where it gets tricky: the standard diagnostic tools such as the ADOS (Autism Diagnostic Observation Schedule) were mainly developed for boys. They capture the classic male autism symptoms well – stereotypical movements, pronounced special interests in trains or numbers, direct social behavior. What these tests often overlook, however, are many girls. They can spend hours on topics such as horses or books – interests that are quickly dismissed as “typical girl interests”. In social situations, they often appear inconspicuous because they have learned to blend in. Their exhaustion or excessive demands usually only become apparent at home.
What this means for school practice
Lindmeier’s new research from 2025 makes it clear: masking is not a harmless adaptability. It costs enormous amounts of energy and leads to psychological stress in the long term. Many autistic women report depression, anxiety disorders and a complete breakdown during puberty or in young adulthood – autistic burnout.
In concrete terms, this means taking a closer look at the quiet, well-adjusted girl who suddenly refuses to go to school. The pupil who hides in the toilet during the break. The teenager who functions perfectly but is constantly exhausted.
The diagnosis is the first step towards real support. It must not wait until the age of 16.
Find out more. Act early.
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Sources:
Lindmeier (2025): Masking or camouflaging as a central strategy – pedocs.de
Spektrum der Wissenschaft: Autism – Hardly any gender differences in young children
Spektrum der Wissenschaft: Why women are underrepresented in autism studies
