It is a worry. Interestingly the Maudsley screens for autism on being admitted to their ED units as they follow the peace pathway and traditional treatment doesn't always help autistic girls . They are going to need to tread very carefully with autism in women and girls due to the difference in presentation, masking and how it can impact life.
Many autistic girls and women are misdiagnosed for years with standalone conditions like anxiety, depression, borderline personality disorder, or eating disorders. Recognising autism and ADHD early( which is easier before crisis) and accurately ensures that mental health struggles are treated with an understanding of their neurodivergent root cause.
Early diagnosis of autism and ADHD for women and girls can significantly reduce the risk of them developing more serious or co-occurring mental health conditions.Because autism assessments have historically relied on male-centric criteria, girls are frequently diagnosed much later in life than boys—often only after reaching a mental health crisis point. Identifying autism early serves as a critical preventative measure in several key ways:
- Reduces the Exhaustion of "Social Camouflaging"
Autistic girls are highly prone to masking consciously or unconsciously mimicking social behaviours, forcing eye contact, and hiding their natural traits to fit in. While masking helps them blend in, it requires massive cognitive effort. Chronic masking is heavily linked to severe mental health exhaustion, burnout, depression, and anxiety. Early diagnosis allows girls to understand their differences early on, reducing the pressure to mask seamlessly.
- Prevents Diagnostic Overshadowing and Misdiagnosis
When an autistic girl’s primary traits are missed, she is frequently misdiagnosed with other conditions, such as: BPD, EDs and severe generalised anxiety or depressive disorders
This is known as diagnostic overshadowing, where healthcare professionals treat the surface-level mental distress without realising the root cause is unsupported autism or ADHD. Standard psychiatric treatments (like traditional eating disorder therapies) are often less effective if they aren't tailored to an autistic person's cognitive and sensory profile. Early identification ensures they get the right type of care from the beginning.
- Fosters Self-Acceptance Over Self-Blame
Without a diagnosis, undiagnosed autistic girls often grow up feeling fundamentally broken, alienated, or confused about why daily life feels so overwhelming. This internal distress frequently manifests as internalising disorders like depression and self-harm. An early diagnosis provides a framework for self understanding. Learning that they are neurodivergent—rather than "defective"—protects their self-esteem and fosters self-advocacy.
- Enables Timely, Tailored Support
An early diagnosis opens the door to targeted environmental adjustments at home and school before chronic stress takes a toll.
There is an equality and safeguarding issue here. It will be interesting to see how it plays out as waiting until girls are at risk of not attending school, engaging in more visible and serious self harm, having more serious eating disorders, are engaging in more severe self medication and risky behaviour before they get answers, correct diagnoses, support and treatment is not ok. It’s often not apparent that help is needed before the wheels fall off so leaving them until it gets to a point when struggles are visible is hugely dangerous.
Leaving women and girls until later for diagnosis and when they start to struggle because their autism or ADHD impacts others less than boys and men is also not ok. An undiagnosed girl with adhd who struggles to sit still or focus, who is constantly admonished for fidgeting, constantly admonished for untidiness and disorganisation, who is constantly admonished for wandering or asking for the loo( because they need to move)and denied, who hates herself because she’s capable of so much more, who quietly starts to engage in hidden self harm with slight scratches under clothes turning deeper,who doesn’t know what is wrong with her and is lead to believe she’s bad and at fault needs to know early what the problem is and have access to treatment. She should not be denied early diagnosis and support because she’s not chucking chairs or shouting out and engaging in less disruptive coping strategies.
An autistic girl who just wants to fit in as women are programmed to do and can’t understand why she can’t, who doesn’t understand her repetitive behaviours that can often turn harmful, who doesn’t understand why she struggles with huge overwhelm and burnout everyday after holding everything together outwardly, whose special interests aren’t stereotypical,who is ashamed of her stims, who is easily bullied should not be denied diagnosis because her struggles are less visible, seemingly less problematic on the surface or not stereotypically autistic.
I think the biggest worry for me is that for women and girls with autism and ADHD struggles are often not apparent until crisis so if diagnosis is going to hinge on “the most needy” after a period of support based on “need” they are going to be diagnosed even later than they are now and thus crisis will be worse.
The guy that wrote this seems to have some good points and ideas however the lack of awareness re how Autism and ADHD presents in women and girls with the later diagnosis they are subjected to being practically a footnote in the report and the actual importance of early diagnosis not even acknowledged is a big worry.