In the complex landscape of neurodiversity in India, a significant and often overlooked population remains in the shadows: girls and women on the autism spectrum. While public awareness of autism spectrum disorder (ASD) has grown, the narrative continues to be dominated by male experiences, leading to a vast number of females going undiagnosed, misunderstood, and without critical support.
The Masking Phenomenon and Diagnostic Bias
A primary reason for this disparity lies in the fundamental difference in how autism often manifests across genders. The classic diagnostic criteria, largely based on studies of boys, emphasize externalizing behaviors like repetitive movements, intense fixations, and social withdrawal. However, many autistic girls develop sophisticated coping strategies known as "social camouflaging" or "masking."
They may painstakingly observe and mimic their neurotypical peers, learning to make eye contact, rehearse conversations, and suppress stimming behaviors in public. This exhausting performance can make their struggles invisible to parents, teachers, and even clinicians. Dr. Vibha Krishnamurthy, founder of Ummeed Child Development Center in Mumbai, emphasizes that girls are often better at masking their social difficulties, leading to their challenges being attributed to shyness, anxiety, or simply being "quirky."
The Consequences of Late or Missed Diagnosis
The failure to recognize autism in girls has profound and lifelong consequences. Without an understanding of why they feel different, these girls often internalize their struggles, leading to severe anxiety, depression, and plummeting self-esteem. They may be labeled as difficult, sensitive, or lazy in school, missing out on essential educational accommodations.
As they enter adolescence and adulthood, the social demands become more complex, and their coping mechanisms may begin to fracture. The rate of co-occurring mental health conditions is alarmingly high among undiagnosed autistic women. Furthermore, they are at a greater risk of exploitation and abuse, as difficulties in reading social cues and asserting boundaries can be misinterpreted.
Building an Inclusive and Gender-Sensitive Framework
Addressing this crisis requires a multi-pronged approach centered on awareness and systemic change. First, there must be a concerted effort to educate healthcare professionals, educators, and the public about the female presentation of autism. Diagnostic tools and criteria need to evolve to be more gender-inclusive, capturing the subtler, often internalized, signs.
Parents and caregivers must be empowered with knowledge. If a girl exhibits intense emotional meltdowns at home after holding herself together all day at school, has deeply passionate but narrow interests, or experiences extreme sensory sensitivities, these could be key indicators. Creating safe spaces in schools and communities where neurodivergent girls can be themselves without judgment is crucial.
Ultimately, recognizing autism's invisible half is not just about diagnosis; it's about validation, support, and unlocking potential. It's about shifting the narrative from a deficit-based model to one of neurodiversity, where different ways of thinking and experiencing the world are acknowledged and valued. For thousands of girls and women across India, this shift can mean the difference between a life of struggle and isolation and one of understanding, support, and self-acceptance.
