Why Do Women Feel Like Impostors in Autism
Yesterday I read a girl's post on Threads, and it really stayed with me. Probably because I had felt the same way when my psychiatrist told me I had ASD.
"I couldn't bring myself to do it for a long time. It was terribly scary, but I finally took two tests for ASD. I just can't accept it. According to the results, the level is high, but it feels like this isn't me at all. Masking since childhood, and an atypical family too. I feel like an impostor. As if I claimed a 'trendy' diagnosis for myself."
And this is a very common story, when a person doesn't fit the dry diagnostic criteria or differs from stereotypes. And I myself remember reading them and thinking:
==“No, I don't have any special interests or stimming, I make eye contact, and I understand humor and sarcasm.”==
And there you are, sitting and thinking: did I make all this up? Maybe I don't have ASD at all? But the more I learned about how autism manifests in women, the more memories and realizations surfaced.
Where the “correct” image of an autistic person even came from
Autism as a clinical category was formed starting in the 1940s based on observations of boys. Leo Kanner described children with very pronounced features: avoidance of contact, echolalia (uncontrolled, automatic repetition of words or phrases heard from other people, like an echo), repetitive rigid behavior (the need to perform actions in a strictly defined order, for example eating only from dishes of a certain color, strictly following a routine, being unable to tolerate changes in plans, etc.). Hans Asperger also described boys with obvious external markers: a lack of ability for nonverbal communication, limited empathy, and physical awkwardness.
This image: a boy who doesn't make eye contact, flaps his hands, doesn't understand jokes, and isn't interested in people - became a cultural template. And it entered the diagnostic criteria. Not because autism looks like that in everyone. But because the people being studied were the ones who were easy to notice.
==There were almost no women in these samples. They simply weren't diagnosed, because they didn't look “autistic.”==
I became curious: where can you even find descriptions of the female ASD phenotype? And I came across the wonderful book by Sarah Hendrickx Women and Girls on the Autism Spectrum: Understanding Life Experiences from Early Childhood to Old Age
Sarah Hendrickx is an autistic diagnostician and researcher from the UK. She has conducted more than a thousand assessments of autistic women and girls, trained psychiatrists in diagnosing female autism, and is herself on the spectrum. That matters: she describes not abstract patients, but people whose experience she knows from both the inside and the outside.
Masking: work that no one notices
The central idea of the book is masking, or camouflage.
Masking is when an autistic person consciously or unconsciously adapts their behavior to neurotypical norms in order to “pass.” They copy intonations, gestures, reactions. They rehearse conversations in their head before they happen. They learn to make eye contact - not because it is natural, but because otherwise people consider you strange.
Hendrickx emphasizes that girls do this earlier, more intensely, and more effectively than boys. There are several reasons for this. Social pressure on girls in terms of “proper” behavior is higher. Girls are generally better at learning social scripts through observation.
And - this is an important point - girls' special interests more often fall into “socially acceptable” categories: <u>==books, psychology, animals, people.==</u> This doesn't attract attention.
As a result, you get a person who makes eye contact, understands humor and sarcasm, doesn't flap her hands in public, wears makeup, and goes to meetups. And after every such meetup, she lies face down in a pillow for a day and a half.
Hendrickx describes it like this:
==A facade for years, so good that when it finally crumbles, people around her are genuinely surprised. Because on the outside everything looked fine.==
That is why masking is associated not only with diagnostic difficulties, but also with long-term health consequences: anxiety disorders, depression, autistic burnout. All of this is to a significant extent the result of years of work maintaining the mask.
What it looks like in real life: examples from the book
The book is full of quotes from real women, and that is one of the reasons people read it with the feeling of “this is me.”
One of the women describes how she reacts to changes in plans: she says “it's fine,” because that's what you're supposed to say. But then, when the person leaves, she gets a headache from the effort of rearranging her entire internal schedule. “It is never fine. It has never been fine,” she writes. And yet outwardly - flexible, understanding, no problems.
Another describes the moment when a friend asks her opinion about a new handbag. She runs through all possible answers and finds none - because she literally has no opinion about handbags. This is alexithymia in action: not an absence of feelings, but difficulty recognizing and naming them.
==A third says that all her life she heard “you're an introvert” and “you're just shy” until at 40 she received a diagnosis and realized that what she had taken for a personal character trait had a neurobiological explanation.==
Why we don't believe ourselves
Let's return to the Threads post: “I feel like an impostor, as if I claimed a trendy diagnosis.” This is the result of several processes happening at once.
- First: masking is so effective that we ourselves stop seeing how much effort we are spending. The exhaustion is there, but the cause is invisible. It's like working for a long time without days off and sincerely not understanding why you always want to sleep.
- Second: stereotypes, for years we were convinced that we were “too normal” for a diagnosis. Specialists said “everyone experiences that.” Loved ones said “don't make things up.” We ourselves compared ourselves with the image of an autistic person from textbooks and didn't match.
- Third. Hendrickx writes about this directly: many women perceive acknowledging limitations as personal inadequacy. ==Asking for help, naming difficulties, accepting a diagnosis - all of this feels like surrender==. But I used to cope before! To admit that you were always different, to acknowledge your needs and limitations, to give up the dream of being like everyone else and stop setting unrealistically high expectations for yourself is very hard. I run into this myself from time to time)
- And fourth - ==impostor syndrome around the diagnosis is fueled by real experiences of gaslighting==. If a specialist says “you need to walk more and socialize” in response to a description of sensory overload, that is not just bad advice. It is an experience that teaches you not to trust your own perception.
What a diagnosis gives, and why you might need it at all
==“And what will this diagnosis give me? Maybe I'm just looking for an excuse”== - Hendrickx heard this question hundreds of times. And she answers it in the book through the stories of women who received a diagnosis late.
What these stories have in common is: finally. Hendrickx describes it as “the right to be oneself, established for the first time” - the feeling that you can stop explaining to yourself why you get so tired from things that do not tire other people. Stop seeing it as a personal failure.
A diagnosis does not change who you are. It gives context to what you already know about yourself, only before it was called “weirdness,” “weakness,” or “not wanting to try.”
What to read
Sarah Hendrickx, Women and Girls on the Autism Spectrum: Understanding Life Experiences from Early Childhood to Old Age - there is a Russian translation from Sensus. If you recognize yourself in every other paragraph, that is already information.
The second edition in English (Women and Girls on the Autism Spectrum, Second Edition, 2024) is expanded, with new chapters on autistic burnout, AuDHD, and late diagnosis. If you read English, get that one.