Late Diagnosis in Women and Gender-Diverse Adults
Research consistently shows women are diagnosed later than men, and are more likely to receive an initial misdiagnosis of anxiety, depression, borderline personality disorder, or eating disorders (Bargiela et al., 2016; Lai & Baron-Cohen, 2015).
Contributing factors
- Diagnostic tools historically normed on boys.
- More social camouflaging on average (Hull et al., 2020).
- Special interests that appear socially typical (animals, literature, people).
Gender-diverse adults
Autistic adults are 3-6x more likely to identify as gender-diverse than the general population (Warrier et al., 2020). Affirming care requires clinicians to hold both identities without pathologizing either.
What helps after late diagnosis
- Community with other late-diagnosed adults.
- Affirming therapy (not social-skills training).
- Time to grieve the years of self-blame.
Sources
- Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions. Journal of Autism and Developmental Disorders, 46(10), 3281-3294. https://doi.org/10.1007/s10803-016-2872-8
- Lai, M.-C., & Baron-Cohen, S. (2015). Identifying the lost generation of adults with autism spectrum conditions. The Lancet Psychiatry, 2(11), 1013-1027. https://doi.org/10.1016/S2215-0366(15)00277-1
- Hull, L., Petrides, K. V., & Mandy, W. (2020). The female autism phenotype and camouflaging: A narrative review. Review Journal of Autism and Developmental Disorders, 7, 306-317. https://doi.org/10.1007/s40489-020-00197-9
- Warrier, V., et al. (2020). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications, 11, 3959. https://doi.org/10.1038/s41467-020-17794-1