Autism in Women: TikTok Diagnosis or Self-Correction?

Mar 23

Is the rise in late autism diagnoses due to social media or new information?

Note: this a longer version of my essay in Psychology Today.

Four years ago, “Sara” came into my office for a therapy intake. When asked what brought her in, she tearfully recounted her reasons for seeking treatment with me. She shared that she had been using social media to watch videos about her hobbies and various interests, when the algorithms started filtering in content related to being a late diagnosed autistic adult. Wondering why these videos were showing up in her feed so often, she started to watch them. As she watched and learned more, she had the realization that she was likely autistic. She stated that before this, besides watching Rain Man when it came out in her middle school years, she hadn’t really known anything about autism. She wanted to meet with me to learn more. Along with the appointment at my office, she had also scheduled psychological testing with a clinical psychologist, and was eventually given an official diagnosis of autism spectrum disorder. Through our work together, she learned more about her new diagnosis, and processed and grieved the fact that there was this huge piece of information about herself that had been missing. She learned more about her communication, social interactions, sensory needs, and felt like she finally had answers to why certain things seemed so difficult for her. Her diagnosis gave her the permission and knowledge that she needed to take better care of herself, and her mental health improved quickly.

While Sara was the first “high masking,” late diagnosed woman to come into my office for therapy, she was not the last. I had other women come due to information found on social media. Several came in for treatment after their children were diagnosed and they realized that they should be evaluated as well. Some had friends who were autistic and they realized that they shared a lot of similar traits. Some were diagnosed after they experienced severe burnout at college or in the workplace. A few, were professionals who had been working with the autism community for years, and when they reviewed the latest research on how autism presents in women and girls, they realized that the reason they connected so well with the autism community was because they were part of it. I personally fall into this latter category.

When I did a deep dive in to the research on how autism and ADHD present differently in women and girls and began to realize that I was likely autistic and should seek out testing, I was embarrassed. How could I have worked with autistic people for over 20 years and not know I was autistic? I then realized that most of the research I was reviewing had been completed in the last 5 years. I already knew that the research on autism had focused primarily on males, which was why I had been so interested to look at the latest research on autistic females in the first place. Now I was seeing the impacts of this missing information not just in my therapy practice, but in my own personal experiences.

If you are unfamiliar with the history of autism as a diagnosis, in the United States, Leo Kanner led the research starting in the late 1930s, and started publishing his findings on early infantile autism in 1943. While he included a few girls in his original studies, he overwhelmingly focused on Caucasian males. Hans Asperger in Germany also included girls in his studies, but then focused on the boys, whom he referred to as his “little professors,” making the case that their lives should be spared as their unique brains would benefit the Nazi regime. This same case was not made for the girls in his studies, most of whom were put to death right in the medical clinics where they were being studied.

Due to this early focus on males, much of the data about autism was focused on how autism presents in males, and males continued to be the primary research subjects. This then led to testing measures that were normed and validated for male presenting traits of autism, which has led to the current diagnostic rate of about 3-4 boys for every 1 girl diagnosed. When you look at individuals with co-occurring intellectual disabilities however, this difference goes away, and the diagnosis rate is close to 1:1. Is this because autism is more likely to occur in males unless there is a co-occurring intellectual disability, or because the psychological community is not aware of, and therefore not looking for, signs of what autism looks like in women and girls?

A recent study in Sweden suggests the latter. In this study by Fyfe, et al. (2026), researchers followed 2.7 million individuals born between 1985 and 2020, and found that by early adulthood, the diagnostic gap between the genders disappeared. The recommendation was made that more research must be completed on how autism may present differently between genders in order to ensure that the psychological community is not missing the identification of as many as 75% of autistic women and girls.

For the women who were coming into my clinic with their own recent, adult diagnoses, most felt relief to finally have the answer that they had been looking for. They had always felt different or broken, but now they knew they were autistic. Many also expressed anger and grief over going so long without this key information about themselves. Many had been diagnosed previously with things like anxiety, depression, ADHD, PTSD, borderline personality disorder, etc. When they didn’t get better from typical treatments and medications, providers told them they just were not trying hard enough. They felt like they were not just failing life, but therapy as well. When they came to me with the additional information that they were autistic, I worked to support them in many of the same ways I had supported autistic clients with higher support needs over my career. Most of these women experienced progress in therapy in ways they never had before. This is likely because research shows autistic people need therapy interventions that are created for the unique needs of their specific neurotypes. Prior therapy had not been as helpful, not because they saw bad therapists or because they were not traying hard enough to get better, it was because the interventions were not tailored for their neurodivergent brains.

These last 4 years have brought more high masking individuals of all genders to my therapy practice, and I never once questioned whether or not they were autistic. For each individual, whether or not they were officially diagnosed, I felt that their reported traits were consistent with an autism diagnosis, and I had no reason to doubt that they were neurodivergent. I started to wonder if I was biased, so I turned to research and text books, coming across the book, The Adult Autism Assessment Handbook: A Neurodiversity-Affirmative Approach (2023). I was relieved to read that the clinical psychologists who had authored the book had had similar experiences to my own. They noted that most of the clients they were seeing for testing had done extensive research before seeking out a diagnosis, and that most of the time, their team had agreed that the individuals seeking testing were autistic.

Not every mental health or medical professional shares this experience or opinion however. More recently, I have been seeing pushback by providers against the rise in high masking women being diagnosed with autism. This pushback has included clients going to see other providers who have told them that they can’t be autistic for a variety of reasons like they are married, have empathy, or college degrees, despite having provided reports of neuropsychological tests completed by licensed psychologists. I have had colleagues share YouTube videos on social media with individuals claiming to be medical professionals who are mocking autistic women sharing their experiences, claiming that these are just girls with personality disorders seeking attention. This month, influential autism researcher Uta Frith gave an interview stating that she didn’t believe autism was a spectrum and, while she acknowledged that the many women now receiving autism diagnoses have “problems,” they should be identified as “hypersensitive,” rather than autistic.

This pushback against women being diagnosed with autism by the psychological community feels all too familiar. There is history of women being misunderstood, misdiagnosed, and mistreated due to mental health struggles that goes back to ancient times. This has included theories about hysteria and wandering uteri, women being put in asylums by their spouses without their consent when they became tiresome. In the 20th century, women were given lobotomies and tranquilizers at much higher rates than men. Women with mental health struggles, especially women of color, were more likely to be forcibly sterilized than their male peers in order to ensure that their substandard genes were not passed on to future generations. This is just a few examples, as the history of the mistreatment of women is extensive.

Is this comparison an over-exaggeration of the problem? Am I engaging in my own histrionics? Having sat across from client after client sobbing through the story about how their primary care physician, psychiatrist, or other medical professional told them that the autism diagnosis they had been given, which had made so much sense and led to so much progress, was incorrect because of some reason or another, it doesn’t seem overly exaggerated to me. In light of the history of how women have been treated by mental health professionals, it just seems like more of the same. So, while I will need to check my own bias and ensure that I am thinking critically through differential diagnoses, I recommend that other mental health professionals do the same. If you haven’t looked at the research on how autism presents in women and girls in the last few years, I highly recommend doing so. We as a profession need to ensure that we check out biases and continue to stay on top of research. This is how we ensure that we ‘do no harm.’

Autism in Women: TikTok Diagnosis or Self-Correction?

Is the rise in late autism diagnoses due to social media or new information?

Recommended Readings:

drjennifercork.com

drjennifercork@gmail.com

Autism in Women: TikTok Diagnosis or Self-Correction?

Is the rise in late autism diagnoses due to social media or new information?

Recommended Readings:

Book review: Is This Autism? A Companion Guide for Diagnosing by Donna Henderson, Jamell White, and Sarah Wayland.

drjennifercork.com

drjennifercork@gmail.com