Autistic Girls Often Missed in Childhood Diagnoses, Study Shows

Published: 05 February 2026. The English Chronicle Desk. The English Chronicle Online.

A new study highlights that autistic girls are much less likely to be diagnosed than boys during childhood, raising serious concerns. Autism diagnosis rates have historically skewed heavily toward males, yet researchers now suggest this may reflect underdiagnosis of females rather than actual prevalence differences. Experts emphasize that gender should not affect access to timely autism assessments or support services in any circumstance.

The research, conducted by the Karolinska Institutet in Sweden, examined autism diagnosis patterns for 2.7 million people born between 1985 and 2020. Of these, 2.8% received an autism diagnosis between ages two and 37. The study found that boys were three to four times more likely than girls to be diagnosed under ten, while girls often received a diagnosis later, typically around 15.9 years compared to boys at 13.1 years. By age 20, diagnosis rates between men and women nearly equalized, suggesting earlier disparities reflect delayed recognition rather than true prevalence differences.

Lead author Dr Caroline Fyfe explained that the gender gap in autism prevalence is narrower than previously thought. “Our findings indicate that many girls remain undiagnosed or receive a delayed diagnosis, which has profound implications for their support and care,” she said. The research underscores the urgent need to refine diagnostic tools and methods to address these biases, particularly in childhood.

The study, published in the BMJ, shows that although gender disparities persisted for children under ten over the past three decades, they diminished in older age groups. This finding suggests that late diagnoses among girls are increasingly common, reflecting systemic challenges rather than an actual difference in autism incidence.

Patient advocate Anne Cary stressed that diagnostic biases, rather than biological differences, largely explain lower autism identification in girls. She explained that undiagnosed girls may be mislabelled with psychiatric conditions such as anxiety or depression, forcing them to advocate for recognition themselves. “Girls who would ultimately qualify for an autism diagnosis historically have had less than a third of the chance of being diagnosed before age ten,” she said.

Autism charities also called for urgent action to overcome gender stereotypes. Dr Judith Brown of the National Autistic Society highlighted that masking behaviours in girls often obscure autism traits, delaying identification. “Misdiagnosed autistic women frequently experience coexisting mental health difficulties, and support must be tailored to their needs,” she added.

Jolanta Lasota, CEO of Ambitious about Autism, noted that autistic girls’ experiences differ significantly from boys, yet their needs have historically been overlooked. Misunderstood or misattributed behaviours have prevented timely interventions, sometimes leading to mental health crises. Lasota emphasized the necessity of adapting support services to better address these disparities, particularly as awareness grows.

Dr Conor Davidson, former autism champion at the Royal College of Psychiatrists, also observed that many autistic girls remain undiagnosed until adolescence or early adulthood. UK adult neurodevelopmental clinics are seeing increasing numbers of women seeking assessments, reflecting improved recognition. However, lengthy waiting lists continue to hinder timely access to care. Davidson stressed that psychiatrists must consider autism when evaluating female patients presenting with mental health challenges, as symptoms can differ from childhood presentations.

The findings underline a broader issue: systemic biases in diagnosis and gendered assumptions have historically limited recognition of autism in girls. This has long-term consequences, including missed educational, social, and clinical support, affecting mental health and overall quality of life. Experts agree that developing gender-sensitive assessment protocols is essential for early detection and intervention.

Current diagnostic practices often rely on symptom checklists that may reflect male-centric presentations, inadvertently disadvantaging girls whose autism may manifest differently. Studies indicate that girls are more likely to mask traits or develop coping strategies, delaying visible signs of autism. Without tailored approaches, these individuals risk late or misdiagnosis, compounding challenges in education and employment.

The research emphasizes the importance of awareness among parents, educators, and healthcare providers. Recognizing early signs in girls—ranging from social difficulties to repetitive behaviours—can facilitate prompt referrals for assessment. Equally important is providing comprehensive post-diagnostic support to address coexisting mental health issues and help individuals navigate daily life challenges.

Policy implications are clear: expanding access to diagnostic services, investing in training for clinicians on gender differences in autism, and supporting families during assessment processes are crucial steps. By bridging the gender gap in autism diagnosis, society can ensure equitable care and improve long-term outcomes for all individuals on the spectrum.

Ultimately, the study demonstrates that while autism has historically been perceived as male-dominated, prevalence may be far more balanced. Recognizing and addressing diagnostic inequities can transform care for girls and women, ensuring they receive the same timely interventions afforded to their male counterparts. Experts urge continued research and advocacy to refine screening tools, challenge stereotypes, and support autistic females throughout life.

The research is an important reminder that gender bias in medical practice can obscure conditions and prevent equitable care. As public understanding grows, early recognition, tailored intervention, and adequate mental health support can significantly improve life trajectories for autistic girls and women. Stakeholders, from healthcare providers to policymakers, are called upon to respond to these findings with urgency and action.

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