What Can the Retrospective Experiences of Autistic Women Reveal About Supporting Autistic or Potentially Autistic Girls in School? An Exploration of School Experiences Based on Diagnosis During or Post-School

Authors

Abstract

Autism is a neurodevelopmental condition that is often characterised by differences in social communication, sensory processes, and cognition. Due to the underdiagnosis of autism in women and girls, their voices are often missing from research, limiting our understanding of their experiences at school. This study addressed the gap around the factors which impacted women’s late and/or pre-diagnosed experiences of school by using semi-structured interviews with ten autistic women; among them, eight were diagnosed after school. The interviews were analysed through reflexive thematic analysis. Three themes and areas of insight were constructed from the data: (1) The impact of social norms on peer relationships. (2) We found ways of coping, but at what cost? (3) How schools could help someone like me. The findings show that all women in the study had negative school experiences, with diagnosis during school also being linked to identity and mental health difficulties. Schools should enhance pastoral support, foster positive relationships, improve communication, and use strengths-based approaches to improve outcomes for autistic girls. Proactively adopting neuroaffirming modifications may improve support during autistic girls’ formative years, leading to a lasting impact on their lives. This is particularly important for autistic girls, who face marginalisation on two levels: neurotypical expectations for females and stereotyped expectations of autism. The implications of these findings are discussed with suggestions for future research and practical implementations within mainstream school settings.

1. Nicole L. Kreiser , Susan W White (2014). ASD in females: Are we overstating the gender difference in diagnosis? Clin. Child Fam. Psychol. Rev., 17(1), 67. Springer Science and Business Media LLC.

   Type: Article DOI: 10.1007/s10567-013-0148-9 OpenAlex: https://openalex.org/W2014169114

   Crossref OpenAlex
2. González Moreno, Andrés Santiago (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5 . American Psychiatric Association.

   Type: Book DOI: 10.1176/appi.books.9780890425596 OpenAlex: https://openalex.org/W4247665917

   Crossref OpenAlex
3. Anna Madill , Abbie Jordan , Caroline Shirley (2000). Objectivity and reliability in qualitative analysis: Realist, contextualist and radical constructionist epistemologies . Br. J. Psychol., 91(1), 1. Wiley.

   Type: Article DOI: 10.1348/000712600161646 OpenAlex: https://openalex.org/W2021253980

   Crossref OpenAlex
4. Lynsey Calder , Vivian Hill , Elizabeth Pellicano (2013). ‘Sometimes I want to play by myself’: Understanding what friendship means to children with autism in mainstream primary schools . Autism, 17(3), 296-316. SAGE Publications.

   Type: Article DOI: 10.1177/1362361312467866 OpenAlex: https://openalex.org/W2073421628

   Crossref OpenAlex
5. Rachel Loomes , Laura Hull , William Mandy (2017). What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis . Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466. Elsevier BV.

   Type: Article DOI: 10.1016/j.jaac.2017.03.013 OpenAlex: https://openalex.org/W2604697269

   Crossref OpenAlex
6. Rachel M. Hiller , Robyn L. Young , Nathan Weber (2014). Sex Differences in Autism Spectrum Disorder based on DSM-5 Criteria: Evidence from Clinician and Teacher Reporting . Journal of Abnormal Child Psychology, 42(8), 1381-1393. Springer Science and Business Media LLC.

   Type: Article DOI: 10.1007/s10802-014-9881-x OpenAlex: https://openalex.org/W2077948545

   Crossref OpenAlex
7. Robert McCrossin (2022). Finding the True Number of Females with Autistic Spectrum Disorder by Estimating the Biases in Initial Recognition and Clinical Diagnosis . Children, 9(2), 272. MDPI AG.

   Type: Article DOI: 10.3390/children9020272 OpenAlex: https://openalex.org/W4212916079

   Crossref OpenAlex
8. Mary Ann Winter-Messiers (2007). From tarantulas to toilet brushes . Remedial Spec. Educ., 28(3), 140. SAGE Publications.

   Type: Article DOI: 10.1177/07419325070280030301 OpenAlex: https://openalex.org/W2151278763

   Crossref OpenAlex
9. Donald Maciver , Anusua Singh Roy , Lorna Johnston , Marie Boilson , Eleanor Curnow , Victoria Johnstone-Cooke et al. (2026). Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland . Autism, 30(2), 375. SAGE Publications.

   Type: Article DOI: 10.1177/13623613251383343 OpenAlex: https://openalex.org/W4415649999

   Crossref OpenAlex
10. Rachel M Hiller , Robyn L Young , Nathan Weber (2016). Sex differences in pre-diagnosis concerns for children later diagnosed with autism spectrum disorder . Autism, 20(1), 75-84. SAGE Publications.

    Type: Article DOI: 10.1177/1362361314568899 OpenAlex: https://openalex.org/W2156654264

    Crossref OpenAlex
11. Allison B. Ratto , Lauren Kenworthy , Benjamin Yerys , Julia Bascom *Autistic author. Learn more… , Andrea Trubanova Wieckowski , Susan W White et al. (2018). What About the Girls? Sex-Based Differences in Autistic Traits and Adaptive Skills . Journal of Autism and Developmental Disorders, 48(5), 1698-1711. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-017-3413-9 OpenAlex: https://openalex.org/W2775059339

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex
12. Felicity Sedgewick , Vivian Hill , Rhiannon Yates , Leanne Pickering , Elizabeth Pellicano (2016). Gender Differences in the Social Motivation and Friendship Experiences of Autistic and Non-autistic Adolescents . Journal of Autism and Developmental Disorders, 46(4), 1297. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-015-2669-1 OpenAlex: https://openalex.org/W2199714476

    Crossref OpenAlex
13. Urie Bronfenbrenner (1979). The Ecology of Human Development . Harvard University Press.

    Type: Book DOI: 10.4159/9780674028845 OpenAlex: https://openalex.org/W2254735081

    Crossref OpenAlex
14. Laura Fox , Kathryn Asbury (2024). “I need them for my autism, but I don’t know why”: Exploring the friendship experiences of autistic children in UK primary schools . Autism & Developmental Language Impairments, 9, 23969415241275934. SAGE Publications.

    Type: Article DOI: 10.1177/23969415241275934 OpenAlex: https://openalex.org/W4402335472

    Crossref OpenAlex
15. Sarah Bargiela , Robyn Steward *Autistic author. Learn more… , William Mandy (2016). The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype . Journal of Autism and Developmental Disorders, 46(10), 3281-3294. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-016-2872-8 OpenAlex: https://openalex.org/W2494524772

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex
16. Mark Tomlinson , Caroline Bond , Judith Hebron (2020). The school experiences of autistic girls and adolescents: A systematic review . Eur. J. Spec. Needs Educ., 35(2), 203. Informa UK Limited.

    Type: Article DOI: 10.1080/08856257.2019.1643154 OpenAlex: https://openalex.org/W2958836109

    Crossref OpenAlex
17. Michelle Dean , Robin Harwood , Connie Kasari (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder . Autism, 21(6), 678-689. SAGE Publications.

    Type: Article DOI: 10.1177/1362361316671845 OpenAlex: https://openalex.org/W2559694411

    Crossref OpenAlex
18. Graber, J. A. (2013). Internalizing problems during adolescence. Handbook of Adolescent Psychology, John Wiley & Sons, Inc.

    Type: Other

    Crossref
19. Kristen Gillespie‐Lynch , Steven Kapp *Autistic author. Learn more… , Patricia J. Brooks , Jonathan Pickens , Ben Schwartzman (2017). Whose Expertise Is It? Evidence for Autistic Adults as Critical Autism Experts . Frontiers in Psychology, 8(1), 438. Frontiers Media SA.

    Type: Article DOI: 10.3389/fpsyg.2017.00438 OpenAlex: https://openalex.org/W2601691194

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex
20. Barbara Carpita , Benedetta Nardi , Cristiana Pronestì , Francesca Parri , Federico Giovannoni , Ivan Mirko Cremone et al. (2023). May Female Autism Spectrum Be Masked by Eating Disorders, Borderline Personality Disorder, or Complex PTSD Symptoms? A Case Series . Brain Sciences, 14(1), 37. MDPI AG.

    Type: Article DOI: 10.3390/brainsci14010037 OpenAlex: https://openalex.org/W4390458973

    Crossref OpenAlex
21. Jessica V. Smith , Goldie A. McQuaid , Gregory L. Wallace , Emily Neuhaus , Andrea Lopez , Allison B. Ratto et al. (2024). Time is of the essence: Age at autism diagnosis, sex assigned at birth, and psychopathology . Autism, 28(11), 2909. SAGE Publications.

    Type: Article DOI: 10.1177/13623613241249878 OpenAlex: https://openalex.org/W4396808065

    Crossref OpenAlex
22. Anna Cook , Jane Ogden , Naomi Winstone (2018). Friendship motivations, challenges and the role of masking for girls with autism in contrasting school settings . European Journal of Special Needs Education, 33(3), 302-315. Informa UK Limited.

    Type: Article DOI: 10.1080/08856257.2017.1312797 OpenAlex: https://openalex.org/W2607052951

    Crossref OpenAlex
23. Julia Parish-Morris , Mark Y. Liberman , Christopher Cieri , John Herrington , Benjamin Yerys , Leila Bateman et al. (2017). Linguistic camouflage in girls with autism spectrum disorder . Molecular Autism, 8(1), 48. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1186/s13229-017-0164-6 OpenAlex: https://openalex.org/W2758446026

    Crossref OpenAlex
24. Kelda Sproston , Felicity Sedgewick , Laura Crane (2017). Autistic girls and school exclusion: Perspectives of students and their parents . Autism & Developmental Language Impairments, 2, 239694151770617. SAGE Publications.

    Type: Article DOI: 10.1177/2396941517706172 OpenAlex: https://openalex.org/W2613788039

    Crossref OpenAlex
25. Felicity Sedgewick , Vivian Hill , Elizabeth Pellicano (2019). ‘It’s different for girls’: Gender differences in the friendships and conflict of autistic and neurotypical adolescents . Autism, 23(5), 1119. SAGE Publications.

    Type: Article DOI: 10.1177/1362361318794930 OpenAlex: https://openalex.org/W2894712382

    Crossref OpenAlex
26. Laura Hull , K.V. Petrides , C. Allison , P. Smith , S. Baron-Cohen , Meng-Chuan Lai et al. (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions . Journal of Autism and Developmental Disorders, 47(8), 2519-2534. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-017-3166-5 OpenAlex: https://openalex.org/W2616560149

    Crossref OpenAlex
27. Sarah Mae Simcoe , Charlotte Brownlow , Michelle Sarah Garnett *Autistic author. Learn more… , Agnieszka Rynkiewicz , Tony Attwood *Autistic author. Learn more… (2018). Profiling Autism Symptomatology: An Exploration of the Q-ASC Parental Report Scale in Capturing Sex Differences in Autism . Journal of Autism and Developmental Disorders, 48(2), 389-403. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-017-3324-9 OpenAlex: https://openalex.org/W2766445107

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex
28. Eilidh Cage , Zoe Troxell-Whitman (2019). Understanding the Reasons, Contexts and Costs of Camouflaging for Autistic Adults . Journal of Autism and Developmental Disorders, 49(5), 1899-1911. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-018-03878-x OpenAlex: https://openalex.org/W2909219349

    Crossref OpenAlex
29. Julia Cook , Laura Hull , Laura Crane , William Mandy (2021). Camouflaging in autism: A systematic review . Clinical Psychology Review, 89(102), 102080. Elsevier BV.

    Type: Article DOI: 10.1016/j.cpr.2021.102080 OpenAlex: https://openalex.org/W3198172085

    Crossref OpenAlex
30. William Mandy , Elizabeth Pellicano , Beaté St Pourcain , David Skuse , Jon Heron (2018). The development of autistic social traits across childhood and adolescence in males and females . J. Child Psychol. Psychiatry, 59(11), 1143. Wiley.

    Type: Article DOI: 10.1111/jcpp.12913 OpenAlex: https://openalex.org/W2800125913

    Crossref OpenAlex
31. Lauren D. Berkovits , Christine T. Moody , Jan Blacher (2020). “I don’t feel different. But then again, I wouldn’t know what it feels like to be normal”: Perspectives of Adolescents with Autism Spectrum Disorder . J. Autism Dev. Disord., 50(3), 831. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-019-04309-1 OpenAlex: https://openalex.org/W2989982020

    Crossref OpenAlex
32. Craig Goodall , Alison MacKenzie (2019). Title: What about my voice? Autistic young girls’ experiences of mainstream school . Eur. J. Spec. Needs Educ., 34(4), 499. Informa UK Limited.

    Type: Article DOI: 10.1080/08856257.2018.1553138 OpenAlex: https://openalex.org/W2904963594

    Crossref OpenAlex
33. Morewood, G., Tomlinson, C., and Bond, C. (2019). Meeting the needs of autistic girls at secondary school. Education and girls on the autism spectrum: Developing an integrated approach. Education and Girls on the Autism Spectrum: Developing an Integrated Approach, Jessica Kingsley Publishers.

    Type: Other

    Crossref
34. Georgia Lockwood Estrin , Victoria Milner , Debbie Spain , Francesca Happé , Emma Colvert (2021). Barriers to autism spectrum disorder diagnosis for young women and girls: A systematic review . Review Journal of Autism and Developmental Disorders, 8(4), 454. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s40489-020-00225-8 OpenAlex: https://openalex.org/W3095823263

    Crossref OpenAlex
35. Alexandra Leedham , Andrew R. Thompson , Richard Smith , Megan Freeth (2020). I was exhausted trying to figure it out': The experiences of females receiving an autism diagnosis in middle to late adulthood . Autism, 24(1), 135. SAGE Publications.

    Type: Article DOI: 10.1177/1362361319853442 OpenAlex: https://openalex.org/W2947577397

    Crossref OpenAlex
36. Kathryn Urbaniak *Autistic author. Learn more… , Miranda D'Amico (2025). Disability barriers autistic girls face in secondary education: A systematic review . Autism, 29(4), 1019. SAGE Publications.

    Type: Article DOI: 10.1177/13623613241294189 OpenAlex: https://openalex.org/W4404328937

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex
37. Ella-Mae White *Autistic author. Learn more… , Laura Fox (2026). “It felt like all my friendship issues suddenly made sense”: The friendship experiences of late-diagnosed autistic women . Res. Neurodivers., 2, 100028. Elsevier BV.

    Type: Article DOI: 10.1016/j.rin.2026.100028 OpenAlex: https://openalex.org/W7160183401

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex
38. Paula Hamilton , Katie Roberts (2025). “It’s not as clear cut as autistic boys versus autistic girls.” Exploring autistic girls’ experiences of mainstream secondary education . J. Res. Spec. Educ. Needs, 25(4), 836. Wiley.

    Type: Article DOI: 10.1111/1471-3802.70011 OpenAlex: https://openalex.org/W4409695193

    Crossref OpenAlex
39. Meng-Chuan Lai , Peter Szatmari (2020). Sex and gender impacts on the behavioural presentation and recognition of autism . Curr. Opin. Psychiatry, 33(2), 117. Ovid Technologies (Wolters Kluwer Health).

    Type: Article DOI: 10.1097/yco.0000000000000575 OpenAlex: https://openalex.org/W2996084520

    Crossref OpenAlex
40. Elizabeth K. Jones , Mary Hanley , Deborah M. Riby (2020). Distraction, distress and diversity: Exploring the impact of sensory processing differences on learning and school life for pupils with autism spectrum disorders . Research in Autism Spectrum Disorders, 72, 101515. Elsevier BV.

    Type: Article DOI: 10.1016/j.rasd.2020.101515 OpenAlex: https://openalex.org/W3003675070

    Crossref OpenAlex
41. Carla Tomlinson , Caroline Bond , Judith Hebron (2022). The mainstream school experiences of adolescent autistic girls . European Journal of Special Needs Education, 37(2), 323-339. Informa UK Limited.

    Type: Article DOI: 10.1080/08856257.2021.1878657 OpenAlex: https://openalex.org/W3125488454

    Crossref OpenAlex
42. Laura Hull , K.V. Petrides , William Mandy (2020). The Female Autism Phenotype and Camouflaging: a Narrative Review . Review Journal of Autism and Developmental Disorders, 7(4), 306-317. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s40489-020-00197-9 OpenAlex: https://openalex.org/W3004137504

    Crossref OpenAlex
43. Mati Zakai-Mashiach (2023). “I Was Like a Bird Without Wings”: Autistic Women’s Retrospective Experiences in General Schools . Journal of Autism and Developmental Disorders, 53(11), 4258-4270. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-022-05717-6 OpenAlex: https://openalex.org/W4293874529

    Crossref OpenAlex
44. Marcia Eckerd (2020). Detection and diagnosis of ASD in females . J. Health Serv. Psychol., 46(1), 37. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s42843-020-00006-1 OpenAlex: https://openalex.org/W3005890071

    Crossref OpenAlex
45. Alana Whitlock , Kate Fulton , Meng-Chuan Lai , Elizabeth Pellicano , William Mandy (2020). Recognition of Girls on the Autism Spectrum by Primary School Educators: An Experimental Study . Autism Research, 13(8), 1358-1372. Wiley.

    Type: Article DOI: 10.1002/aur.2316 OpenAlex: https://openalex.org/W3032154611

    Crossref OpenAlex
46. Laura Gray , Ella Bownas , Lucy Hicks , Emma Hutcheson-Galbraith , Sandra Harrison (2021). Towards a better understanding of girls on the Autism spectrum: Educational support and parental perspectives . Educ. Psychol. Pract., 37(1), 74. Informa UK Limited.

    Type: Article DOI: 10.1080/02667363.2020.1863188 OpenAlex: https://openalex.org/W3119828000

    Crossref OpenAlex
47. Jo Halsall , Chris Clarke , Laura Crane (2021). “Camouflaging” by adolescent autistic girls who attend both mainstream and specialist resource classes: Perspectives of girls, their mothers and their educators . Autism, 25(7), 2074-2086. SAGE Publications.

    Type: Article DOI: 10.1177/13623613211012819 OpenAlex: https://openalex.org/W3161750644

    Crossref OpenAlex
48. Gillian J. Beck , Una O’Connor‐Bones , Jackie Gracey , Greg Kelly , Glenda Walsh (2021). In need of review: Developing Sensory Provision in Northern Ireland’s Mainstream Primary classrooms . J. Res. Spec. Educ. Needs, 21(3), 268. Wiley.

    Type: Article DOI: 10.1111/1471-3802.12519 OpenAlex: https://openalex.org/W3168795944

    Crossref OpenAlex
49. Eya-Mist Rødgaard *Autistic author. Learn more… , Kristian Jensen , Kamilla Woznica Miskowiak , Laurent Mottron (2021). Autism comorbidities show elevated female-to-male odds ratios and are associated with the age of first autism diagnosis . Acta Psychiatr. Scand., 144(5), 475. Wiley.

    Type: Article DOI: 10.1111/acps.13345 OpenAlex: https://openalex.org/W3179391009

    AutiHub · Autistic Autism Scholarship Project Crossref OpenAlex
50. Braun, V., and Clarke, V. (2021). Thematic Analysis: A practical Guide, SAGE Publication.

    Type: Other

    Crossref
51. Wei Ai , William A. Cunningham , Meng-Chuan Lai (2022). Reconsidering autistic ‘camouflaging’ as transactional impression management . Trends in Cognitive Sciences, 26(8), 631-645. Elsevier BV.

    Type: Article DOI: 10.1016/j.tics.2022.05.002 OpenAlex: https://openalex.org/W4281707972

    Crossref OpenAlex
52. Aoife Munroe , Michele Dunleavy (2023). Recognising autism in girls within the education context: Reflecting on the internal presentation and the diagnostic criteria . Ir. Educ. Stud., 42(4), 561. Informa UK Limited.

    Type: Article DOI: 10.1080/03323315.2023.2260371 OpenAlex: https://openalex.org/W4387023152

    Crossref OpenAlex
53. Elizabeth M. Radulski (2022). Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity . Human Development, 66(2), 113-127. S. Karger AG.

    Type: Article DOI: 10.1159/000524122 OpenAlex: https://openalex.org/W4287738988

    Crossref OpenAlex
54. Suzanne Smith (2023). Engaging potential: Using the UDL principle of engagement to motivate year 7–8 learners with autism in writing tasks . Kairaranga, 24(1), 57. Massey University.

    Type: Article DOI: 10.54322/kairaranga.v24i1.344 OpenAlex: https://openalex.org/W4384024671

    Crossref OpenAlex
55. Yung-Ting Tsou , Lilla Veronika Kovács , Angeliki Louloumari , Lex Stockmann , Els M. A. Blijd-Hoogewys , Alexander Koutamanis et al. (2026). School-Based Interventions for Increasing Autistic Pupils’ Social Inclusion in Mainstream Schools: A Systematic Review . Review Journal of Autism and Developmental Disorders, 13(1), 45-68. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s40489-024-00429-2 OpenAlex: https://openalex.org/W4391781777

    Crossref OpenAlex
56. Alyssa M. Alcorn , Sarah McGeown , William Mandy , Dinah Aitken , Sue Fletcher-Watson (2024). Learning About Neurodiversity at School: A feasibility study of a new classroom programme for mainstream primary schools . Neurodiversity, 2, 27546330241272186. SAGE Publications.

    Type: Article DOI: 10.1177/27546330241272186 OpenAlex: https://openalex.org/W4402336129

    Crossref OpenAlex
57. Bargerhuff (2013). Meeting the needs of students with disabilities in a STEM school . Am. Second. Educ., 41, 3.

    Type: Other

    Crossref