MHM Magazine

24 | MENTAL HEALTH MATTERS | 2025 | Issue 3 MHM “She can’t be autistic — she’s got friends.” “She makes eye contact, though!” “She’s just quirky.” “She’s doing well in school — she can’t be struggling.” If these phrases sound familiar, you’re not alone. Autistic girls and women often fly under the radar because the traditional diagnostic framework has been shaped by male-centric research and conceptualisation. It struggles to capture the more subtle, internalised, and socially camouflaged traits that are common in autistic females. The Female Autism Profile: Why It’s Different Autistic boys are typically identified in early childhood, yet in contrast, girls are frequently diagnosed much later — in adolescence, their 20s, or even adulthood. This is not due to lower prevalence. Current diagnostic ratios (4.3:1 male to female) reflect a recognition gap, not a real difference in incidence. Many autistic girls go undetected because their traits are less obvious, more socially adapted, and often misinterpreted. How Autism May Present Differently in Girls Social Interaction & Communication • Girls may use observational mimicry rather than initiating authentic, reciprocal play. • They often appear socially attuned, sometimes labelled as “little psychologists.” • Rehearsed scripts and highly practiced social routines can mask underlying difficulties. • Echolalia (repeating others' words) may appear as advanced language skills. • Emotional expressiveness may be high — but this can conceal alexithymia (difficulty identifying or describing internal states). By Lauren Creese Clinical Psychologist creeselauren@gmail.com FLYING UNDER THE RADAR: IDENTIFYING AUTISM IN GIRLS — A GUIDE FOR GPS MHM | 2025 | Volume 12 | Issue 3 | Flying Und r the Radar: Identifying Autism in Girls — A Guide for GPs