The experiences of autistic women navigating psychological and psychiatric care continue to highlight critical gaps in diagnostic frameworks and therapeutic practices, a new qualitative study reveals. Drawing from in-depth interviews with five participants, the research finds that many autistic women feel misrecognised or dismissed by mental health professionals due to outdated, male-centric models of diagnosis. The findings were published in the journal ISPCE Bulletin.
The study underscores how autistic females frequently camouflage their traits to meet societal expectations. Unlike typical male presentations of autism, which are often more overt, many women exhibit internalised behaviours such as anxiety or obsessive routines. These are easily misinterpreted by clinicians, who may instead diagnose depression, personality disorders or generalised anxiety. Some participants were even told they could not be autistic because they maintained eye contact or had friends – criteria long outdated within current autism research.
Palak Jain, a researcher from L.S. Raheja College of Arts & Commerce, noted: “The study revealed the use of outdated criteria and modalities in treating autistic women. The treatment reflected a lack of updated knowledge and lack of curiosity about lived experience and seemingly ‘irrelevant’ information like mutism in childhood.”
Many of the women interviewed shared similar frustrations with clinicians who dismissed their concerns or relied on checklists that failed to capture their lived experiences. One participant described the entire process as invalidating, while another reported being diagnosed with other conditions despite showing classic autistic traits. These findings suggest that mental health services continue to apply rigid diagnostic measures, leaving a significant portion of the population without appropriate support.
Jain explained how her own research interest was sparked by a personal encounter: “The idea to investigate the psychological care experiences of autistic women came after a conversation with an autistic friend who expressed similar treatment. I wanted to know if this was a specific problem or a general one, and that’s where the research began. It was clear from the review of literature that this was a concerning pattern across clinical interactions.”
Access to formal diagnosis remains another key barrier. For those who self-identify as autistic, the pathway to clinical assessment is often blocked by financial costs, lengthy waiting periods and geographical limitations. Several participants noted that they had turned to self-education, online communities and neurodivergent social networks to better understand their condition. These women viewed their self-diagnosis not as a substitute for clinical evaluation but as an empowering step in the absence of adequate professional support.
Jain remarked, “It also made clear the subjective importance of diagnostic labels as guideposts to discovering community, a sense of belongingness and resources.”
Despite the challenges, many participants also expressed a deep sense of pride in their autistic identity. They spoke about the unique ways autism influenced their creativity, empathy and focus on special interests. This perspective reflects a broader cultural shift towards the neurodiversity movement, which sees autism not as a deficit but as a variation of human experience.
Yet, traditional therapy models appear poorly equipped to meet the needs of autistic clients. Most participants reported that talk therapy – often the default recommendation – did not offer the kind of practical or sensory-sensitive support they needed. Some noted success with alternative approaches like EMDR, but these remained exceptions rather than the norm. This suggests an urgent need to reframe therapeutic practice for autistic women, focusing less on introspection and more on strategies for daily living and emotional regulation.
The study also touches on the intersection of autism and gender diversity. Several participants were assigned female at birth but identified with different gender identities. Their inclusion highlights the importance of recognising how sociocultural and biological factors intersect in diagnostic settings.
Looking ahead, Jain shared her aspirations for expanding the research landscape: “One of my future plans is to incorporate objective measures of clinical competence into the assessment of mental healthcare experiences along with client reports and investigate biopsychosocial causes behind differing phenotypes of autism. A more ambitious goal is to integrate, not just add, the female experience more clearly into the essential neurodivergence literature.”
