How Autism Appears in Men vs. Women

Exploring the Similarities & Differences

Did you know that autism presents itself differently in men and women?

This was certainly news to me when Gavin first mentioned to me that I could be autistic. I immediately thought of a little boy playing with trains and having a meltdown at a change in routine. That didn’t sound like me at all.

When I was in school, I was taught the stereotypical view of autism: The kind that normally presents itself in men. But there is a whole other side to the spectrum—various autistic traits that appear much more frequently in women than men.

Why were women left behind?

Well, when the criteria for autism was being developed, researchers only considered the experiences of young boys. Now, there are two ways to look at this: Through the lens of a moral failing or a scientific failing. Early researchers may have only focused on boys because they were sexist, dismissing women as too emotional or too sensitive. At the same time, women are often high maskers, causing their autistic traits to go unnoticed. It could’ve also been a mix of both. However you choose to look at it, thanks to those early researchers, autistic females have often been misdiagnosed or underdiagnosed.

Now, however, our knowledge is continuing to expand because people are beginning to acknowledge that autistic women have unique traits that differ from men.

Note: This is not men vs. women in "Who has it harder?" Both sexes have their own challenges being autistic in an allistic world. I am here to shed light and understanding on the more feminine side of the spectrum because that is my experience and it has been ignored for a very long time.

First, let’s first go over what both autistic men and women have in common. Then we’ll dive into some of the most common male autistic traits and compare them with the most common female autistic traits. These are general traits. I will probably say this a million times, but it’s crucial to understand: If you’ve met one autistic person, you’ve met one autistic person.

I’m not going to spend a ton of time on the overlapping traits, because I’ve already discussed them in detail in another post. If you need a refresher on the base criteria for autism, check out my post: What is Autism? Decoding the DSM-5 Criteria for Autism Spectrum Disorder (ASD).

Overlapping Autistic Traits

• Social communication challenges

• Executive functioning challenges (like organization, planning, time management, etc.)

• Hypo- and/or hyper-sensitive to sensory stimuli

• Emotional regulation challenges that lead to meltdowns, shutdowns, autistic rage, and/or burnout

• Executive functioning challenges (like organization, planning, time management, etc.)

Comparing Common Autistic Traits in Men & Women

Note: These are general autistic traits.

Autistic Men	Autistic Women
Social communication challenges may be more externalized. For males, autism is more externally observable and less internally felt, which may lead to more meltdowns than shutdowns.	Social communication challenges may be more internalized. For females, autism is less externally observable and more internally felt, which may lead to more shutdowns than meltdowns.
Less likely to mask their autistic traits to blend in with neurotypical men, likely due to being less socially motivated than women.	More likely to mask their autistic traits to blend in with other neurotypical women at the detriment to their own mental health due to being more socially motivated than men.
Typically are less motivated to avoid standing out, so they may not be as good at mimicking the behavior of their peers.	Often learn to mimic neurotypical behavior (facial expression, tone of voice, etc.) to avoid standing out, and they can do it well.
Special interests are more noticeably different from neurotypicals. Technical subjects and games are common avenues of special interests for men.	Often have special interests that appear socially acceptable, like animals, literature, and the arts.
Tend to exhibit more overt physical stims, like hand flapping, rocking back and forth, pacing, and even head banging.	Tend to exhibit more subtle stimming behaviors, like twirling hair, fidgeting with jewelry, tapping fingers.
Often avoid group activities, preferring structured one-on-one time with others or to be alone.	Often hyperfocus and place a high importance on friendships and/or romantic relationships.
Misdiagnosis and underdiagnosis are much less common.	Frequently misdiagnosed with other conditions (bipolar disorder, anxiety, depression, etc.).

Why Autism is Harder to Diagnose in Women

Masking Hides Autistic Traits

Autistic women often go undiagnosed because they've learned to mask their autistic traits. From a young age, they're taught to blend in, observing and imitating their peers. Being more socially inclined than autistic men, they often mimic the mannerisms, facial expressions, and vocal tones of their neurotypical female friends. This masking is a survival mechanism, allowing them to navigate social situations by appearing to be neurotypical.

Common Examples of Masking in Autistic Women

• Mirroring how people talk or express themselves

• Adjusting their voice or expressions to seem more approachable or natural or normal

• Stimming in “acceptable” ways like hair twirling, tapping their fingers, or blinking, etc.

Most people mimic others to a degree, but autistic women lose a sense of themselves because they are constantly mimicking others. Their performance becomes a part of their identity, and most of the time, masking is subconscious, leading them to feel like they don’t know who they really are.

Internalized Social Communication Challenges

Autistic women often find small talk overwhelming. They perceive it as shallow and struggle to engage in topics that lack genuine meaning, leading to anxiety and a tendency to avoid social situations or give brief replies. They may mask their consistent discomfort behind a mask of politeness. Most neurotypical women feel socially drained after social interactions, but for autistic women, this is exacerbated because they feel as if they are performing rather than forming a true connection with others.

For many autistic women, social interactions don’t end when they leave; they often mentally replay the entire encounter, meticulously analyzing every word, tone, and pause. This intense scrutiny comes from a deep-seated fear of rejection and a strong need for social approval, leading them to worry they said the wrong thing or offended someone. Unlike typical overthinking, this can become an obsessive cycle that can even keep them up at night.

Special Interests Appear More Acceptable

Autistic women absolutely have special interests, but they often go unnoticed because they gravitate towards topics considered more socially acceptable for women. This can include things like makeup, animals, fashion, literature, media, various arts, or psychology. This can also extend to relationships as well. Generally, autistic women place a higher importance on relationships than autistic men. They often hyperfocus on friends and/or romantic partners, sometimes to the brink of burnout. They may spend a significant amount of their energy maintaining these connections, even if they're unfulfilling, abusive, or one-sided. For many autistic women, this can be taken to an extreme. They might agree to things they don’t want to do, driven by a deep-seated fear of rejection.

However, having a hyperfocus on relationships doesn’t always mean they are desperate for love; it can happen at random. Anyone can be the fixation, but once it’s there, the autistic person cannot turn the fixation off at will. This intensity of emotion and focus doesn’t end there—it also extends to any special interest for both men and women.

Internalized & Undetected Sensory Issues

While autistic men often externalize sensory overwhelm, autistic women tend to internalize it, often bottling up their discomfort to please others. This suppressed overwhelm frequently erupts once they’re in a safe space, manifesting as extreme fatigue, anxiety, autistic rage, meltdowns, or shutdowns.

These intense emotional reactions are frequently mislabeled as “overly sensitive,” “dramatic,” or “rude.” However, these responses are typically a combination of sensory overload, emotional dysregulation, and/or difficulty processing complex emotions in real-time. It’s not that they’re more emotional; rather, they’re reacting to stimuli others might not even notice, such as a bothersome clothing tag, an overwhelming noise, unexpected changes in plans, or feeling misunderstood. These aren't signs of being “too much,” but rather an inability to filter and process internal and external stimuli as neurotypical individuals do.

Much like many other things, these sensory issues often go unnoticed—even by the autistic woman herself—due to societal conditioning. Taught to be quiet, kind, and compliant, autistic women learn to internalize their overwhelm, leading to significant suffering. Yet, if they do voice their sensory needs, they risk being dismissed as “dramatic” or “too sensitive.” This creates a double bind, often leading them to ignore their sensory challenges or rationalize them as mere preferences or quirks.

Overlooked Emotional Regulation Issues

Autistic individuals often struggle with regulating their emotions, making it difficult for them to process, express, and convey their feelings. Autistic women, while generally more social than neurotypical men, are typically less social than neurotypical women, which can make their emotion regulation challenges more noticeable than autistic men. However, an autistic girl experiencing a meltdown is often overlooked or dismissed precisely because she’s female.

For many autistic women, emotions are not merely felt; they are experienced with an intense, all-consuming force. Their way of processing emotions often clashes with how others expect them to be expressed. It’s not that they don’t feel things. Quite the opposite! Their expressions just might not conform to “socially acceptable” norms like visible tears or outward upset. While neurotypical women are often socialized to suppress emotions, autistic women often lack the intuitive grasp of social cues that would help them express their feelings in a contextually appropriate manner.

Likely due to emotional regulation issues, autistic women deeply crave routine and predictability (it makes them feel safe by giving them some sense of control). However, they’ve been conditioned to suppress this need and push through changes, often at the expense of their own mental well-being. This can lead them to meticulously maintain order in their private lives, while appearing flexible and easygoing to others—all while enduring immense internal stress. While most people find change uncomfortable, autistic women experience an intense internal chaos when plans shift. They struggle to move past or “shake off” these disruptions, even when they outwardly pretend to be unbothered.

Misdiagnosed and/or Underdiagnosed

Autism in women is significantly underdiagnosed and misdiagnosed compared to men, largely because the diagnostic criteria and understanding have historically focused on masculine autistic traits. This has led to a severe lack of recognition for how autism manifests in females. While co-occurring conditions like anxiety or depression are common, they often overshadow the cause. This leads to a great number of missed diagnoses, because the fact is, for many autistic women, the intense mental health toll of masking their autistic traits is often the root cause of these co-occurring conditions. When misdiagnosed and treated for something other than autism, the prescribed medications or therapies can sometimes worsen their struggles, posing a serious risk to their well-being.

After a late diagnosis, they may not know who they are, and it could take a lifetime to find out. Personally, there are so many layers to the mask I have created, I had to take a few off before I really started noticing my glaringly obvious autistic traits. So much of my mask was subconscious—a way to fit in and not stand out so I could avoid rejection—that it’s almost impossible to actually know who I am and how I’d actually react.

Sometimes I still wonder: If I could take away all the fear and rejection, who would I be if I was allowed to openly be myself?

Final Thoughts

If you find yourself relating to a lot of the experiences I mentioned, I encourage you to look into an autism diagnosis. It might shake your world, but it will also lead you and others to a greater understanding of yourself, which is beneficial for growth and relationships.

And always remember: Every autistic person, whether your traits align with the more masculine or feminine side of the spectrum, has something beautiful and unique to offer this world.

If you made it to the end of this blog post, thank you! Your support means the world to me. If you would like to become a mushroom among wildflowers, please consider subscribing to my blog below, or my YouTube channel. Both are appreciated, and I will see you in the next one.