#NonBinaryAndAutistic

[drblied]

Autism in Individuals Assigned Female at Birth (AFAB)

Autism in individuals assigned female at birth (AFAB)—including women, girls, non-binary, and trans-masculine individuals—is frequently underdiagnosed. Research reveals that as many as 80% of autistic AFAB individuals remain undiagnosed by age 18. Their symptoms often manifest differently than those seen in individuals assigned male at birth (AMAB), leading to delayed or missed diagnoses.

Recognizing the distinct signs of autism in AFAB individuals and offering appropriate support is crucial. This topic is explored in depth in Autism in Girls: Why Signs of Neurodivergence Are Overlooked by Karen Saporito, PhD, published by ADDitude Magazine, which informed this newsletter.

Autism in AFAB Individuals

Desire for Social Connection: AFAB individuals with autism frequently have a strong desire to build social connections. In order to navigate social spaces, they may engage in masking—adopting neurotypical behaviors to blend in—which, while making their challenges less apparent, can be mentally exhausting. Furthermore, many experience heightened rejection sensitivity, which can intensify the emotional impact of social interactions.

Consequences of Masking: Masking can contribute to increased anxiety, diminished self-esteem, and challenges in forming authentic relationships. Additionally, it can complicate clinical evaluations, leading to delays in diagnosis and access to support and resources.

Restricted and Repetitive Behaviors: AFAB individuals may engage in repetitive behaviors in more subtle ways, such as finger tapping or hair twirling, compared to AMAB individuals. Their special interests may also be more socially conventional, such as a focus on animals or celebrities, rather than the more overt fixations often observed in AMAB individuals.

Myths About Autism

To effectively identify autism in AFAB individuals, it’s crucial to understand the myths surrounding it. Below is a list of common myths and the corresponding truths, as outlined by Dr. Saporito:

Supporting Neurodivergent AFAB Individuals

Early Detection: Identifying autism early is essential for providing tailored support and minimizing feelings of shame or uncertainty.

Routine & Structure: Consistent routines help alleviate anxiety and support smoother transitions.

Support Emotional Regulation: Teaching coping techniques like mindfulness, healthy stimming, and breathing exercises enable better management of emotional challenges.

Adopt a Neurodiversity-Affirming Approach: Celebrating the strengths of neurodivergent individuals fosters self-confidence, empowers self-advocacy, and encourages a positive sense of identity.

I provide formal assessments for Autism and ADHD for individuals ages 8-48 in California, both in-person and online (my online assessment option is for ages 18+). For more information, and to check your PPO insurance reimbursement benefits with the Mentaya tool, please visit my website.

I also encourage you to explore these tools to promote your well-being:

Empowerment Through Understanding Modules: Dive deeper into ADHD and Autism with this online course to improve self-awareness, self-advocacy, and personal growth. Learn more here.

AuDHD Strong App: A helpful app for neurodivergent individuals with tools for organization, task management, and self-care. Download it today from the App Store or the Google Play Store!

Faces of Health App: This app offers valuable mental health and well-being resources. Download it today from the App Store or the Google Play Store!

For more valuable insights, I encourage you to explore my blog at https://drblied.com/blog/. For a selection of wellness resources, please visit the resources page on my website at https://drblied.com/resources/.

Reference

Saporito, K. (2025). Autism in girls: Why signs of neurodivergence are overlooked. ADDitude Magazine. https://www.additudemag.com/autism-in-girls/?ecd=wnl_additude_250123_cons_adhd_treatment&goal=0_d9446392d6-0d1a445a20-301885002