Autism: Autism may be just as common in females as in males, according to new research that challenges long-standing assumptions driven by childhood diagnosis patterns.
The study, published in The BMJ, found that while autism diagnoses are higher in boys during early years, rates in girls rise noticeably in adolescence, suggesting many females are being identified later rather than being less likely to be autistic.
Researchers examined diagnosis patterns across the life course by tracking about 2.7 million people born in Sweden between 1985 and 2022, following individuals from birth up to age 37. Overall, 2.8% were diagnosed with autism, with an average diagnosis age of 14.
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The timing differed by sex. Diagnosis rates peaked for boys between ages 10 and 14, while girls were most often diagnosed between 15 and 19. By age 20, the male-to-female ratio had narrowed to nearly 1:1, indicating a “catch-up” effect among girls during the teenage years.
The findings add weight to concerns that many autistic females are being missed in childhood, potentially because their traits present differently, are less obvious in school settings, or are masked by stronger social coping strategies. A later or missed diagnosis can leave people without support during key years, which researchers and advocates say may contribute to significant mental health strain.
The study did not assess genetic or environmental drivers, and it did not fully separate autism from related conditions that can influence how and when people are diagnosed, such as ADHD or intellectual disability. Even so, the large population size and long follow-up strengthen the case that current detection patterns may be undercounting autism in girls earlier in life.
