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In recent months, one pattern has become increasingly clear in my practice. More adult women are reaching out with a quiet, persistent question: “Is it possible this was missed?” They are often thoughtful, insightful, and self-aware. Many have spent years, sometimes decades, navigating anxiety, burnout, or a sense of feeling different without a clear explanation. Some have received prior diagnoses, while others have simply learned to adapt. Underneath it all is a growing curiosity about whether autism may have been overlooked. When these women and girls show up in my practice, they are ready to not only understand themselves, but are ready to be kinder to who they intuitively are.
April is Autism Awareness Month, and it feels important to pause here, not only to raise awareness, but to reconsider who we have been aware of. For a long time, autism has been understood through a relatively narrow lens, one shaped largely by how it presents in boys. This has influenced early research, diagnostic criteria, and clinical training, contributing to a gender gap in identification (Loomes et al., 2017; Hull et al., 2020). As a result, many girls and women have gone unrecognized.
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