"I was always on the outside, watching quietly": Autistic women reflect on school experiences

The study addresses the limited knowledge of autistic girls’ and women’s experiences, particularly in schooling, amid concerns about underdiagnosis and misdiagnosis that impede supports and accommodations. Framed by Critical Autism Theory and Intersectionality Theory, the research centers autistic women’s voices as expert knowledge and recognizes layered vulnerabilities at the intersections of gender, disability, race, class, and sexuality. The purpose was to explore autistic females’ lived schooling experiences (K–12 through college), elevate their perspectives on needs and challenges, and derive recommendations for change.

The review notes that autism research and diagnostic tools historically reflect male experiences, contributing to under-identification of females. DSM-5 consolidated related diagnoses into autism spectrum condition and reported high prevalence, though official male-to-female ratios may be biased; some evidence suggests many females remain undiagnosed into adulthood. Literature on autistic girls and women emphasizes diagnostic masking, gendered presentations, co-occurring conditions, and heightened risks of bullying and victimization. Few qualitative studies directly capture autistic females’ school experiences; existing work indicates needs often go unnoticed, social challenges are masked, and academic underachievement can occur. A gap persists in U.S.-based qualitative studies spanning all school levels and directly centering autistic female voices.

Design: Qualitative phenomenological approach to elicit lived experiences as expressed by autistic women themselves. Participants and sampling: A pilot with 6 participants preceded the full study (total N=14). Participants were purposefully recruited via Indiana autism service organizations, social media, and a psychologist specializing in autistic women. Inclusion criteria: formal autism (or prior Asperger’s) diagnosis; age >18; residence or K–12 schooling in Indiana or nearby rural states; attendance at public or private K–12. No compensation was provided. Most participants were diagnosed in adulthood; the sample included multiple generations and sexual identities. Pilot and instrument refinement: The pilot revealed strong preferences for receiving questions in advance and for specific, concrete questions. Photo-elicitation was tested; responses were mixed—helpful for some, distressing or unhelpful for others—so participation in photo viewing was optional and prompts were refined accordingly. Data collection: Semi-structured interviews (mostly virtual, some in-person) often required 2–3 sessions due to breadth and depth. Interviews were audio-recorded with consent, transcribed, and de-identified. The interviewer practiced reflexivity, journaling, and bracketing to mitigate bias and prioritized participant comfort. Data analysis: Following Braun and Clarke’s thematic analysis steps, transcripts were coded and themes iteratively developed. Data segments were organized in spreadsheets for coding. Two researchers independently analyzed and compared findings. Credibility was supported via triangulation across interviews and member checking of preliminary themes. Researcher positionality: The first author has professional experience supporting autistic women, personal connections to autism, and identifies as neurodivergent; the second author’s research centers marginalized communities’ schooling experiences. Reflexive practices were used throughout.

• Six themes emerged:

1. Accuracy of diagnosis matters: Most participants were diagnosed in adulthood (11/14), describing barriers such as stereotypes, lack of clinician expertise with female presentations, cost/access issues, and frequent misdiagnosis or missed diagnosis. Diagnosis provided validation, self-understanding, access to accommodations, and community.
2. Details matter: Participants emphasized precision and contextual details as central to meaning-making and fairness (e.g., grading disputes). Routines and environmental specifics (e.g., food, seating, timing) were crucial for comfort and functioning.
3. Meaning of sensory and emotional experiences: Sensory environments in schools (fluorescent lights, noise, crowded spaces, smells) were often overwhelming or painful and intertwined with emotional distress and anxiety, affecting attendance, focus, and performance.
4. Invisibility/not belonging: Many felt unseen by peers and teachers, “flying under the radar” through masking or social echolalia, with stronger connections to predictable adults than peers. College was often a better fit due to flexibility and alignment with interests but executive function challenges persisted.
5. Relationship and friendship challenges: Difficulties reading social cues and group norms led to isolation, lowered self-esteem, and reliance on a few close friendships when available. Some found interactions with men more straightforward than with women.
6. Layers of vulnerability: A majority (9/14) reported bullying, often unaddressed or mishandled by schools, and some experienced abusive relationships or sexual abuse. Participants noted compounded risks from ableism post-diagnosis, intersectional marginalization, and challenges recognizing/managing manipulation.

• Recommendations: Increase educator, counselor, and clinician training on female autism presentations; improve early, accurate diagnosis; ensure accommodations are implemented; promote strengths-based approaches; expand visibility of autistic women in media and culture.

Findings illuminate how under- and misdiagnosis, sensory-emotional burdens, and social invisibility during schooling contribute to adverse academic and psychosocial outcomes for autistic women. Aligning with Critical Autism Theory, the study centers autistic women’s expertise, revealing systemic barriers (ableism, lack of supports, inadequate accommodations) and pointing to institutional responsibilities. Intersectionality highlights compounded vulnerabilities from overlapping identities and contexts. Participants’ accounts underscore that early accurate diagnosis is foundational but insufficient without culturally responsive training for educators and health providers, reliable accommodation implementation, and safe, inclusive school climates that recognize diverse autistic presentations and needs. The results emphasize that improving K–12 experiences may mitigate later risks, while college environments with greater flexibility can better support autistic learners when appropriate supports and executive function scaffolds are present.

This study contributes an in-depth, participant-led account of autistic women’s school experiences across K–12 and college, identifying six core themes spanning diagnosis, sensory-emotional terrain, belonging, relationships, and layered vulnerability. It elevates practical recommendations for educators, administrators, and school mental health professionals to improve early identification, implement accommodations, and cultivate inclusive, strength-based practices. Future research should broaden inclusion to self-identified autistic individuals, expand geographic scope, intentionally include autistic women with higher support needs or less advanced language, examine trauma experiences and systemic responses, and investigate school personnel’s knowledge and attitudes toward autism in girls and women.

• Small sample (N=14) and geographic concentration primarily in Indiana/surrounding rural states may limit transferability.
• Broad study scope (spanning K–12, college, and some parent perspectives) may diffuse depth in specific subdomains.
• Inclusion required formal diagnosis, potentially excluding undiagnosed/self-identified autistic women due to access and cost barriers.
• Participants were generally highly verbal and cognitively able, so experiences of women with higher support needs or less advanced language skills are underrepresented.
• Generational differences in schooling contexts may affect comparability across participants.