The invisible girls on the Autism Spectrum

The invisible girls on the Autism Spectrum

I recently helped a friend with her niece, who had just been diagnosed with Borderline Personality Disorder. My friend strongly felt that this diagnosis was wrong, and after reading more about my symptoms and experiences with ASD believed that her niece “Anne” (name changed) was actually Autistic. The symptoms were all there – social issues, anxiety, depression, sensory issues, self-harm… the list goes on. After hearing about Anne’s personal experiences, including being bullied at school due to a simple social misunderstanding, I urged my friend to get Anne reassessed for a proper diagnosis. I felt instantly connected to Anne – we both experienced bullying at school due to not fully understanding social rules and etiquette and our inability to “read between the lines”, we both experienced depression, anxiety, self-harmed and were even both diagnosed with BPD… It was as if I was watching teenage me struggling all over again. I felt the pain, the frustration at being misunderstood and the confusion of misunderstanding the world around me.

I followed up with my friend about Anne’s progress about a week later. She had just met with her school counsellor and shared her belief that she may be autistic. This was what the counsellor said:

“You can’t be autistic. You have friendships!”

After hearing this, I was furious. 30 years of self-doubt and frustration washed over me as I remembered the misdiagnosis, the misinformation, and the misunderstandings. My whole life I had exhibited the classic signs of my unique form of Autism, but due to a lack of knowledge and research I had been missed. And it was still happening.

We are different, so why doesn’t anyone know about us?

After I calmed down, I realised that it is not this counsellor’s fault. They are the product of the lack of research and knowledge about girls with Autism. Why is this so? Why do we have a voice but nobody seems to listen? As Dr Lori Ernsperger, PhD, BCDA-D explains:

“Obtaining an ASD diagnosis for a female can be very challenging with scant research and available answers from professionals. Autism was first reported by Leo Kanner in 1943 and since that time there has been thousands of journal articles and wide-spread international attention. Yet, there is a paucity of scholarly research focused on females with ASD” (Ernsberger n.d.).

How are we different?

Many people I have encountered have expressed disbelief that I am Autistic. Their experiences with Autism showed a complete disparity to their observation of my behaviour. To my friends and acquaintances, I seemed perfectly normal. I made friends, was sociable, intelligent and had a sense of humour. In their eyes I had never exhibited any of the commonly known Autistic behaviours – I made eye contact, I acted “normally”, I was well-spoken and thoughtful, I didn’t “meltdown” or hit myself or others. To them, I was just like everybody else. However, appearances can be deceiving.

According to Dr Ernsberger, girls on the spectrum often exhibit –

  1. Skills in social imitation – we observe the behaviour of those around us and replicate that behaviour, as to not appear different or attract attention.
  2. A desire for social interaction – while large groups can be overwhelming, many girls on the spectrum enjoy one on one or small group interactions, which is in direct conflict with the perception that those with ASD are “shut off” from the world and do not socialise.
  3. Passive and shy behaviours – being shy is not uncommon, this symptom is often overlooked and passed off as normal.
  4. Better imagination – girls on the spectrum can often use their imagination to create and express ideas, not just imitate or copy.
  5. Better linguistic capabilities, especially during developing years – many girls on the spectrum have a well formed vocabulary from a young age, whereas people may perceive people with ASD to be non-verbal or have a limited vocabulary.
  6. Interest that focus on animals or people – most children have an interest in a particular animal or their favourite celebrity or hero, so it is often overlooked when girls with ASD show this tendency.

The problem with recognition and getting a proper diagnosis

ASD girls know we’re different. We constantly observe others and see the differences, we feel them. Inside, we know something is wrong. Translating that feeling into words and getting a professional to understand us is often difficult, and it’s frustrating when they try to tell us we are “normal” or when they entertain ideas of personality disorders. We know we’re not “normal”, and we know we’re not curable – we know we have been this way our entire lives.

“…no matter how high my score was on the assessment I took a couple of years ago at the age of 50, my psychologist insisted that those characteristics were caused by childhood trauma, not Asperger’s” (Unknown author n.d., quoted in Ernsberger 2016.).

Some physicians will downright refuse to consider ASD, even when all the facts are right there. Don’t try and tell us our issues are caused by traumas, our traumas are caused by Autism! Similarly, they can often be too quick to jump to personality disorders, perhaps because they are more familiar.

“When women walk through the door with the subtle characteristics of ASD, the doctor will shift to other disorders (Happe 2013, quoted in Ernsberger 2016). These disorders include personality disorders, mood disorders, depression, anxiety, OCD, or even eating disorders.”

With all of these hurdles in place, it is no surprise that girls and women on the spectrum are undiagnosed. It is estimated that amongst intellectually able individuals with ASD, the ratio of girls to boys is 1:10 (Dworzynski et al 2012, quoted in Egerton and Carpenter 2016). This means that for every ten intellectually able boys diagnosed; only one girl is diagnosed. How can this be right? Is Autism in girls simply less prevalent due to biological or genetic factors, or is it a case of misrepresentation? I believe the latter. If I went undiagnosed for over 30 years, and if girls like Anne are being told they can’t be Autistic because they have friends, how many other girls and women out there are flying under the radar?

What we can do

To battle these statistics and overcome the lack of knowledge about girls with ASD, we need to talk about it. Create conversations with other parents, your doctor, your family, your psychologist, and your friends. Blog about it, post Facebook statuses about it, share articles and information. The “Girls and Autism: Flying under the Radar” booklet listed in the references is a fantastic tool to handout to professionals and teachers involved in your children’s life to increase their awareness of our differences. The more awareness we create, the more we can overcome the adversity that girls on the spectrum face every day. The more awareness created, the more public interest, funding, fundraising and research is generated. This creates a trickle-down effect to health care professionals and those that are taking care of our children.

I don’t want to see girls like Anne go through what I went through, the isolation, the ostracism, the anxiety and the frustration. The world is hard enough without having to go it alone.




Egerton, Jo and Barry Carpenter. 2016. “Girls and Autism: Flying Under the Radar.”

Ernsberger, Dr Lori. 2016.  “Girls and Women on the Autism Spectrum.” Accessed June 1st,

Getting the right diagnosis – TIPS

Getting the right diagnosis – TIPS

So I finally found a really awesome psychiatrist! It was hit and miss, I had to try a few before I found one who really knew his stuff when it came to Autism – and women with Autism. We clicked immediately, he made me feel comfortable and I had high hopes for a concise and detailed diagnosis. So, where to begin?

Fortunately, this time I came prepared. I had spent far too much time and money trying to fully explain to doctors exactly how I felt, and the things that I experienced. Too often I entered an appointment and immediately forgot everything I wanted to say. When I was asked questions I would totally draw a blank, or give a half bumbling explanation that didn’t nearly cover everything I wanted to say. At times I would get emotional or focus on a particularly troubling point in my life which led to diagnoses that centred around that one thing. Sometimes the psychiatrist would ask leading questions that took me in the total opposite direction and led to strange and unrelated diagnoses (as if I went into the appointment as an apple, and they told me I was a banana), and being shy and submissive I just sat there and let it happen without speaking up. This time I was determined to get everything off my chest, so I made The List.

THE LIST (aka Being Prepared)

The List was four pages long, my laundry list of symptoms, concerns, mannerisms and issues that I experienced on a daily basis. It took me two days and multiple conversations with family members and friends who knew me best. Prior to my initial psychologist’s ASD diagnosis I had assumed many of my behaviours were normal (doesn’t everyone hit their head when frustrated or burst into tears when something doesn’t go as expected?) so it took me some time to search through these behaviours and identify what was typical and what was different.

When compiling The List, I organised my points under headings such as Social & Interaction, Sensory, Relationships, Visual & Mind, Routine & Change, Verbal and Communication, Anxiety, Sleep, Memory and Day to Day. Because I am not good with categorising, I got my sisters to help me place each symptom in it’s related category. Here is an example of some of the symptoms on The List:

Social & Interaction

  • Can’t answer the phone – I need to recognise the number and be prepared to talk to that person. Even when I recognise the number often I can’t face talking to that person because I need time and energy to prepare for social interaction
  • Don’t understand or enjoy small talk – don’t see point of it, also don’t know how to generate small talk or respond
  • Find it difficult to maintain conversation – when there is a lull in conversation, I panic and don’t know what to do or say so I often say strange things
  • Don’t like going out, social interaction. Get overwhelmed quickly
  • Misunderstand social cues & social etiquette (ie: someone who often helps me will hint that they need help, I will miss this and the person will get upset and feel I have ignored them). I can be abrupt with people and am considered rude, especially when overwhelmed.
  • I hide a lot of my personal traits and try to act “normal”, this is exhausting


  • Touch – lightest touch (eg slight rubbing on skin) is painful
  • Can’t handle tags, zips, buttons or seams in clothing – have to remove them before wearing
  • Only wear certain fabrics like viscose/elastin
  • Lights, sounds, movement, I am constantly on high alert (fight or flight mode)
  • Smells – a lot of smells make me sick – can’t be in same room when someone sprays perfume or deodorant
  • Can’t touch certain fabrics

Visual & Mind

  • Can’t “connect the dots” – struggle to understand how Point A gets to Point B without having the process explained
  • Don’t understand generalisations, can’t think of examples
  • Can’t categorize (I got help with this list)
  • Need things written down/visual eg questions, instructions, etc to enable me to follow so I can refer back as soon as I forget
  • Find patterns soothing, hypnotic – I will stare at patterns, my eyes unfocus and I lose track of time. Patterns often calm me

Routine & Change

  • I have a daily routine that I keep and I get anxious/overwhelmed if this routine is interrupted or changed, even by something as simple as the doorbell ringing
  • HATE sudden changes, I get anxiety/overwhelmed, have meltdowns – from childhood (eg: stopping off at the supermarket on way home from school when I expected to go straight home – this was incredibly anxiety inducing and made me frustrated and angry)
  • Hate unexpected visitor drop ins or late notice drop ins

Verbal & Communication

  • When I am overwhelmed (social interaction, processing information, etc) I will shutdown and become non-verbal. People talk to me and ask questions and I just can’t respond. I feel pain and confusion when they interrupt this shutdown time, like I am physically and mentally being torn away from my thoughts
  • Can’t verbalise or explain things – especially things about me
  • Can’t go “off-topic” eg: I am doing something or talking about something and somebody interrupts/distracts me by bringing up another topic, I cannot return to my train of thought or activity without severe confusion, it causes cloudiness and confusion to change topics
  • Lose train of thought midway through conversations, sentences, if I am distracted (by light, patterns, noises) or interrupted


  • Have to find a chair with my back to the wall, in corners, etc
  • Always have fight/flight mode engaged in public (exhausting)
  • When I have to somewhere new or unknown


  • Have trouble falling asleep every night since I was a baby, can’t slow down my mind or stop thinking
  • Get fidgety, agitated, can’t relax
  • Sometimes in bed I get super energetic until I express that energy (eg: pushing and poking, laughing hysterically, jumping around, throwing my arms around until I am calm and fall asleep)

That isn’t the complete list, just a few examples under some headings to get an idea of the kind of behaviours I considered out of the ordinary. If you are particularly knowledgeable about ASD you may read this list and think wow, she’s super dooper Autistic, how did it take 31 years to get diagnosed? The answer is simple – ACTING. Some of my friends from over the years have contacted me since I went public with my diagnosis and they have said they don’t believe I am autistic, there is “no way” because I seem so normal. The thing is, they have no idea how hard I have worked over the years to appear that way.


From a young age I observed people. I watched them interact with each other, with me, what they said and the mannerisms they exhibited. I learned what made people laugh, what offended people, what made them happy. I learned to mimic these behaviours because deep down, I had no idea how to behave. Nothing came naturally to me, I had to force every interaction, every conversation, even just walking down the street was an act. I had to walk like everyone else, act like everyone else, smile and nod like everyone else.

So of course, I was a social chameleon, mimicking the behaviours of my friends and always came across as just another normal girl. Extracting who I really was and separating that from the controlled behaviours that I had learned over the years was a part of the process in creating this List, and frankly would not have been as easy without my psychologist’s previous ASD diagnosis. I have learned so much about myself in the year since her diagnosis.


So, here I was sitting in the Doctor’s office and sweating profusely. I had never been here before so I was nervous and didn’t know what to expect. I shifted uncomfortably in my seat and tapped my foot. When the Doc asked me what brought me to him that day, I handed him The List, and told him that I struggled to remember and verbalise everything that I experienced, so I had prepared a list to help me help him in identifying what was wrong with me. I told him that in the past I had been been diagnosed with many disorders and illnesses, so this time I wanted to make sure everything was covered off and that he had a complete picture of everything I experienced. I also made it clear that while my previous diagnosis of Autism seemed to fit me best, I was not attached to any particular diagnosis or label, I just wanted someone to understand what I went through and hopefully help me in the best way possible.

I also told him I brought school reports ranging from primary school to high school, which I felt gave valuable insight into how I struggled as my school years progressed and social interactions became more complex.

Then I waited as he read The List. He underlined things, made notes, nodded, smiled, asked some questions, then after he finished all four pages he moved on to my school reports. He commented on how they all had a similar theme – “Catherine is distracted easily. She is intelligent and capable of so much more but she has trouble staying engaged”.

As my list was so detailed and my school reports gave a history, he said he felt like he knew me already, and was able to ask direct and relevant questions.As I had just spent days preparing all of this information, it was fresh in my mind and the answers to his questions came easily. For once I was quite concise and insightful, and once our hour was nearly complete he had quite the picture of my life that normally would have taken many sessions to establish.

Then came the diagnosis that I have been waiting for:

“Autism Spectrum Disorder with comorbid Attention Deficit Disorder, Obsessive Compulsive Disorder, Generalised Anxiety Disorder, Sensory Processing Disorder and situational Depressive Disorder”

Or, as I like to call it ASDADDOCDGADSPDSDD (not really). Every single one of those things completely and totally fits with me, and are the missing puzzle pieces. Finally I went into a doctor’s office as an apple and he looked at me said, you are an apple.

So there we have it, I got my Expensive Piece of Paper (if you’ve read my previous posts you may know what this means). I can now move forward and get the assistance I need to help me live independently and hopefully be much happier, now that I know exactly why I am the way I am.



Women on the Spectrum – How many fly under the radar?

Women on the Spectrum – How many fly under the radar?

Something happened to me today that completely and utterly deflated me, undoing all the progress I had made yesterday in setting my life in a new, positive direction.

Firstly I would like to thank anonymouslyautistic for posting about this, which pretty much sums up the many issues women and girls with ASD face – being underdiagnosed or even misdiagnosed as so many of our symptoms overlap with other things. This is the problem I faced today.

I was apprehensive about going to a psychiatrist. I have always left appointments more confused and miserable then when I went in. I had hoped today’s visit would be more positive – I have a clear understanding of what I have, I know how it affects me. I can describe in detail all the little things that I used to think were normal – banging my head when frustrated, the issues I experience from sensory overload – instead of leaving them out and considering them just normal and not interesting enough to discuss. Armed with all this new information I have learned about myself since my diagnosis from my long term psychologist who specialises in ASD, I thought “maybe this time will be different”.

Why bother going? Without going into too much detail about my personal circumstances, I need a diagnosis from a doctor or a psychiatrist in order to put in place some things that will help me integrate into a supportive workplace and be more financially independent. I have found that my diagnosis, although recognised and acceptable to most organisations and people I deal with, is now not good enough for the government. This is most upsetting but unfortunately, the way it is. So even though I have never had a correct diagnosis from a psychiatrist, back I go and spend $400 that I don’t have to get a piece of paper that tells me what I already know.

TL;DR: I have a piece of a paper. It’s not good enough for government. Need a more expensive piece of paper.

The psychiatrist was fine, don’t get me wrong. I am not down on psychiatrists at all, they do fantastic work with a lot of people and I am not undermining that. It just so happens that the ones I have seen in the past saw something in me that made sense to them, and they ran with it. My point being, it is such an easy thing to do with girls on the spectrum. We camouflage ourselves well, it is a skill we have developed to fit in and not appear different, and so many of our symptoms align with many other conditions it is no surprise that it is missed. But today was a let down, I had what I consider to be an open and shut case of Autism. So why was it ignored, again?

Firstly, the psychiatrist kept interrupting me. For anyone on the spectrum you will know that this completely derails you. I kept forgetting my points, forgetting to include parts of my behaviour that really cemented my ASD diagnosis, trailing off and losing my focus. Because of this I felt like I wasn’t able to properly articulate myself, and I found myself being guided down avenues that weren’t particularly relevant, for example, I would be trying to explain my sensory issues and how they affect my daily life. What I wanted to say that places with a lot of people and noises and lights and unexpected movements frighten me, and explain the methods I have of dealing with these fears (eg: putting on sunglasses to avoid bright lights, wearing noise-cancelling headphones in noisy places, etc). But what actually happened is this:

“…so when I go outside I get bad anxiety from all the movement and all the people, like for instance when I avoid going to busy shopping centres because…”

“Have you always avoided going to places you know people will be?”

“…Well, yes, but…”

“And when you were growing up, you mentioned you were bullied by other children at school. Did this make you avoid school?”

“Yes…” And suddenly we are talking about past traumas and things and I am thinking, here we go, another diagnosis of Borderline Personality Disorder or some such thing and before you know it, he is talking about Avoidant Personality Disorder. I had never heard of this before, so I didn’t have the knowledge to know whether it fit me or not. Since arriving home I have done some research and no, it does not fit whatsoever.

“People with avoidant personality disorder experience long-standing feelings of inadequacy and are extremely sensitive to what others think about them. These feelings of inadequacy leads to the person to be socially inhibited and feel socially inept. Because of these feelings of inadequacy and inhibition, the person with avoidant personality disorder will seek to avoid work, school and any activities that involve socializing or interacting with others” (Bressert, 2015)

Ok, I guess this kinda fits? But there’s more:

“…They desire affection and acceptance and may fantasize about idealized relationships with others.”

NOPE. I can’t stand affection. Don’t really need acceptance, either. I’m just fine living life by myself and playing video games. And fantasizing about idealized relationships? I guess? But only when I’ve been really unhappy with my life, and who doesn’t fantasize about having things differently when they are in a pit of despair?

The more I read, the more I realised that this didn’t fit at all. The psychiatrist did not diagnose me with it, but he tossed around the idea and now I am reading more about it, I understand where he was trying to go with his line of questioning. As it has happened before, it seems that something I have said has triggered an idea centering on a particular condition, which directs the line of questioning, which may produce more evidence (or not) to back up this idea, and then suddenly it’s entrenched in the professional’s mind that this is what you have and they don’t really look at anything else.

What happened today reminded me of the Girls with Autism: Flying under the Radar post, and I had to go back and read it in more detail and reading through the mini-guide was a revelation. Sure enough, it echoed the issues I have faced my entire life. And that got me thinking further, how many girls and women are still struggling through their lives, not knowing why they are different and getting many different but incorrect answers from health professionals? Girls on the spectrum don’t usually want to make waves, so how many of them just meekly accept these diagnoses and continue on without the tools or knowledge to help them live a more fulfilling and easy life?

So, rather than change the name of my blog to “Everyday Borderline Personality Disorder and Avoidant Personality Disorder with co-morbid Major Depressive Disorder and Anxiety Disorder Blog”, I might just stick with “Everyday Autism Blog” and continue in my search for that piece of paper. Wish me luck.



Bressert, Steve. 2015. “Avoidant Personality Disorder Symptoms.” Psych Central.

Egerton, Jo and Barry Carpenter. 2016. “Girls and Autism: Flying Under the Radar.” Accessed June 1st,