Does camouflaging predict age at autism diagnosis? A comparison of autistic men and women

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Milner, V., Colvert, E., Hull, L., Cook, J., Ali, D., Mandy, W., & Happé, F. (2023). Does camouflaging predict age at autism diagnosis? A comparison of autistic men and women. Autism Research, 17(3), 626-636. https://doi.org/10.1002/aur.3059

Publication date: 29 Nov 2023 Added to AutiHub: 14 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
7
Publication authors identified as autistic
1 / 7 (14.3%)
  1. Victoria Milner
  2. Emma Colvert
  3. Laura Hull
  4. Julia Cook
  1. Dorota Ali *
  2. William Mandy
  3. Francesca Happé

Abstract

Abstract It is frequently reported that females are likely to receive an autism diagnosis at a later age than their male counterparts, despite similar levels of autistic traits. It has been suggested that this delay in diagnosis may in part reflect the propensity of females, more than males, to engage in camouflaging behaviors that reduce the appearance of autism‐related traits. This article presents two studies which examined the relationship between gender/sex, camouflaging, and age at diagnosis in two samples of (cis‐gender) autistic adults. Study 1 included data from three online samples including 242 autistic men and 570 autistic women aged 18–75 years. Study 2 included data from a longitudinal population‐based sample including 24 autistic men and 35 autistic women aged 20–24 years. Camouflaging was measured with the self‐report Camouflaging Autistic Traits Questionnaire (CAT‐Q). Overall, the results showed that, on average, females were diagnosed later than males. There was a stronger relationship between camouflaging and age at autism diagnosis (AaD) for females, compared with males. Within sample one, there was a significant camouflaging‐by‐sex interaction; high‐camouflaging females had a later AaD. The role of autistic traits and changes in attitudes towards female autism and camouflaging need further exploration. These findings highlight the need for greater clinician and key stakeholder awareness and understanding of camouflaging behavior, particularly for females, during the diagnostic process.

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Cited bibliography overview

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Cited references
51
With a DOI
45
Without a DOI, from raw bibliography text
5
3 / 51 (5.9%) cited references include at least one author identified as autistic.
References with data to complete
1 / 51 (2.0%)
References with detected author names
50 / 51 (98.0%)
Without detected author names
1
Without a structured title
1
Without a stable identifier
5
References with raw author names still to review
1
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
245
From DOI or external metadata
245
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
1
116 / 245 (47.3%) names are linked to an author already present in AutiHub. 129 / 245 (52.7%) names are not yet linked.
Names linked to a person identified as autistic
3 / 245 (1.2%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 3 / 116 (2.6%). Distinct people identified as autistic: 3 / 193 (1.6%).
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