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The purpose of this paper is to review the barriers that girls and women face in receiving an accurate and timely autism diagnosis. The journey to late-in-life diagnosis will be explored with a focus on mental health and well-being. The aim is to improve the awareness of the female autism phenotype to provide access to early identification and appropriate supports and services.

The author’s clinical experience as an individual, couple and family therapist specializing in girls and women with autism informs the paper. Research on co-occurring mental health experience and diagnoses are reviewed and combined with case examples to outline the themes leading to and obscuring autism diagnosis.

Females with autism are less likely to be diagnosed or are identified much later than their male counterparts. Living with unidentified autism places significant mental strain on adults, particularly females. Achieving a late-in-life diagnosis is very valuable for adults and can improve self-awareness and access to limited support.

Mental health professionals will develop a better understanding of the overlap between autism and psychiatric conditions and should consider autism in females who are seeking intervention.

This paper provides a clinical approach to working with autistic girls and women. This knowledge can complement the existing research literature and help build the foundation for a greater understanding of the female autism phenotype.

Over the next 25 years, STEM (science, technology, engineering, and mathematics) occupations will increase at rates higher than those in any other professional field. The inevitable rise in career opportunities, and the multiplicative impact across technology in a wide range of fields, will continue to create gaps that can and should be filled by professionals with diverse skill sets. It is essential to increase equitable access to future available jobs for historically underserved populations, such as women with autism, as they possess skills and perspectives that offer different approaches to job tasks in STEM fields. Considering the intersectional barriers that women face in the workforce, we have written this chapter to bring much needed attention to the interventions that employers can and should enact to support the women of Generation A. We offer the FACES framework (Facilitation, Awareness, Connection, Exposure, Support) as a guidepost for companies and organizations that endeavor to support women with autism in professional preparation and on-the-job development. We corroborate our framework recommendations with labor market data that offers insight into future projections regarding STEM fields and the associated opportunities and careers.

The purpose of this paper is to outline a clinical framework developed for autistic women. INVEST (Identify Needs, Validate, Educate, Strengthen and Thrive) is a strengths-based neurodiversity therapeutic approach. Autistic individuals are treated with respect and are believed to have the capacity to make meaningful changes in their lives.

The author’s clinical experiences working as an individual, couple and family therapist specializing in girls and women with autism inform this paper. The innovative therapeutic approach will be described including reasons for seeking therapy, the theoretical underpinnings and case examples that bring each component of INVEST to life.

Women with autism are very responsive to a therapeutic process that validates their experiences. Helping individuals and their support systems learn more about autism and their unique profile can enhance understanding and self-acceptance. Strategies to increase emotional awareness and reduce victimization are emphasized. Understanding sensory triggers and executive functioning challenges enable individuals to make useful adaptations. Building skills and setting parameters on time and energy help to stave off autistic burnout.

The impact of the INVEST model goes beyond the therapist’s office and can be applied to multiple settings. All professionals have the opportunity to treat autistic women with respect, validation and an assumption of competence.

Clinical program are scarce for individuals with autism, especially women. The INVEST model is the beginning of a discussion of what can help autistic women thrive.

Autistic women and girls have received comparatively less attention within clinical practice and research. Research suggests women tend to be diagnosed later than men, and are more likely to experience misdiagnosis.

This paper aims to report a narrative literature review that examines research on the presentation, recognition, and diagnosis of autistic women and girls.

Findings suggest that autistic females present differently to males and highlight low recognition of the female presentation of autism among the general public, in social spheres, educational, clinical and forensic settings. This lack of recognition appears to affect the likelihood of females being referred for diagnosis, the reliability of diagnostic assessments and subsequent access to support.

Recommendations for clinical practice focus on initiatives to increase awareness of the female presentation of autism, improving the diagnostic process for females, increasing female representation within autism training and for future research to support these goals.

The purpose of this paper is to explore the perspectives of healthcare professionals on autism in adult females with intellectual disability (ID), including regarding the gender ratio of autism, the clinical manifestation of autism in females, and the recognition, screening and diagnosis of autism.

The questionnaire was developed following a review of the relevant literature and distributed to professionals within three healthcare trusts as well as members of two clinical research groups. The questionnaire was completed by 80 ID healthcare professionals. Data were aggregated and analysed using Microsoft Excel.

ID healthcare professionals had a lack of recognition of the smaller gender ratio of autism in patients with ID as compared to those without ID. Most respondents reported believing that autism manifests differently in females; with women demonstrating a greater ability to mask their symptoms. A considerable proportion of participants reported feeling less confident in recognising, screening and diagnosing autism in female patients, with many endorsing a wish for additional training in this area.

These findings suggest that ID healthcare professionals are keen to improve their skills in providing services for women with autism. Training programmes at all levels should incorporate the specific needs of women with ASD, and individual professionals and services should actively seek to address these training needs in order to promote best practice and better outcomes for women with autism.

This is the first published questionnaire exploring the perspectives of healthcare professionals regarding autism in adult females with ID.

Recent research has proposed a specific female phenotype within autism spectrum disorder (ASD). It suggests females exhibit differences in social communication styles with higher levels of camouflaging and compensatory strategies, as well as variance in restrictive repetitive behaviours (RRBs); however, many existing studies have been based on either small, disproportionate or child and adolescent samples, leaving questions about the specific phenotype. This study aims to explore the sex difference and phenotype in a clinic sample of individuals diagnosed with autism.

A service evaluation of sex/ gender differences on 150 historical ASD assessment reports (75 males, 75 females) using a 103-item questionnaire developed from a quantitative review of existing literature was undertaken.

Females camouflaged more significantly than males in five different areas (thinking how to act next, preparing conversation in advance, making lists of prompts/social responses, wearing a mask/acting, less monotone voice); however, these were not maintained in post-analysis correction.

This study points the evidence towards a different phenotype of Autism that is more common in women than men rather than a unique female phenotype.

From the authors’ personal and professional experiences, they have observed that autistic women are uniquely at risk of interpersonal trauma. Given the tendency for autistic women to be overlooked in research and practice, this study aims to rectify this by exploring the relevant literature and including the voices of autistic women throughout this paper.

This study completed a literature review of quantitative and qualitative data relating to exposure to interpersonal trauma in autistic women. This study also reviewed relevant discursive evidence available on in memoirs and reports. This study also included dialogue between us as authors from an auto/“Autie”-ethnographic position.

Both clinical literature and discursive evidence support the idea that autistic women are uniquely at risk of interpersonal trauma, in particular, sexual victimisation. Explanatory factors are considered. Studies exploring rates of post-traumatic stress disorder (PTSD) were less consistent. Further evidence is required to better understand how autistic women experience and express PTSD and to inform assessment and treatment modifications.

To the best of the authors’ knowledge, this is the first paper to integrate clinical literature and discursive evidence on the topic of interpersonal trauma in autistic women. It provides useful insights into the experiences of autistic women in this space, directions for urgently needed future research and modifications to clinical practice.

Literature about autistic females remains scant despite the amount of research about the autism spectrum substantially increasing over the previous decade. This chapter begins with an examination of the discrepancies between research about autistic males and females. It then examines three reasons why autistic females have rarely been researched, followed by some of the main topics that have been researched about autistic females. This chapter concludes with several suggestions for the creation of research about autistic females.

The original contribution that this chapter makes to the field of autism spectrum research is to explain the lack of research about autistic females. This objective is accomplished by presenting a synthesis of the literature about some of the barriers that prevent females from being diagnosed as autistic.

Mental health conditions are known to be more common amongst autistic than non-autistic people. To date, there is little work exploring gender differences in mental health amongst autistic people and no work including non-binary/trans people. This paper aims to address this gap.

This was a large-scale online study, with 948 participants between 18 and 81 years old. Participants self-reported autism, anxiety, depression and eating disorder status. Analyses were run examining gender differences in the rates of these conditions in each group.

Autistic people are more likely to have anxiety and depression than non-autistic people of all genders. Autistic women and non-binary people experienced mental health issues at higher rates than men and at similar rates to each other. Autistic people were twice as likely as non-autistic people to have all eating disorders. Further, gendered patterns of eating disorders seen in the non-autistic population are also present in the autistic population.

There are inherent issues with self-report of diagnoses online, but this study showed that using screening questionnaires is effective.

This is the first paper to look at gender differences in common mental health issues amongst autistic and non-autistic adults. It highlights that there are significant gendered patterns in the prevalence of mental health issues in both the autistic and non-autistic population and that these have an impact for how treatment should be approached to be effective.

This paper aims to describe the way in which autism spectrum disorder (ASD) is identified, defined and diagnosed; and how changes in the conceptualisation and understanding of autism have impacted on clinical practice and research findings. Specific issues relating to the nature of Asperger syndrome and the profile of females with ASD are discussed. Finally, the apparent increase over time in the incidence of autism is considered.

The paper is a non‐systematic review of the current literature relating to the diagnosis and epidemiology of autism.

Despite its diverse presentation and complex aetiology, the autism spectrum is increasingly well understood amongst professionals and the general public. Diagnostic criteria are revised periodically and new versions of the formal definitions are due to be published soon. The prevalence of ASD appears to be in the region of 1 per cent. There is a clear perception that the true incidence of autism is on the increase and, despite several well‐conducted epidemiological studies, it remains impossible to confirm or refute this notion.

Diagnosis in clinical practice should involve some reference to the formal criteria, the use of standardised diagnostic instruments and should ideally take place within a multi‐disciplinary team setting.

This paper provides an up‐to‐date review of current diagnostic practice for all professionals working with children and adults with ASD.