Why Diagnosing Autism in Adult Women Matters
Why I Went for a Diagnosis
It all started because of depression.
At that time, I had just gone through a divorce and come out about my sexuality.
There were so many complications in my relationships with women,
and those problems snowballed until I realized how hard it was for me to fit into what people call a “refined” social circle.
I went to see psychiatrists many times and also read a lot about autism in women.
The combination of being both “female” and “an adult” makes autism particularly difficult to diagnose.
Eventually, my psychiatrist referred me to an autism specialist,
and I went through multiple rounds of clinical assessments.
Later, I did even more research and realized this has been studied for many years.
Autism in women is often overlooked because we’re too good at mimicking and masking.
Little girls are generally different from little boys:
since girls usually have stronger social needs,
we learn early to observe others—to copy facial expressions, tones, and emotional timing—
so over time we appear “normal.”
Boys, on the other hand, tend to give up on socializing altogether,
so autistic traits in boys are often more obvious.
For adults, it becomes even harder,
because after adolescence, both men and women on the spectrum become more “socialized.”
Many people with Asperger’s have no language delay and perform well at work,
so it’s difficult for others to notice anything unusual.
What “Compensation” Really Means
In adulthood, many people on the spectrum appear perfectly fine—
no language barriers, good jobs, functional lives.
But that’s only because we’re constantly compensating.
Compensation means mimicking other people’s behavior, reactions, and expressions,
and suppressing the parts of ourselves that don’t fit social expectations.
It’s not something we do occasionally—it happens every day, every moment.
On the outside, it looks like we’ve blended in,
but in reality, we’re performing all the time.
You might ask: Don’t all people act a little in social situations?
What’s the difference between ordinary social acting and autistic masking?
To use language as a metaphor:
For most people, social “acting” is like speaking their native tongue.
They know they’re being polite, adjusting their image, or fitting into the situation—
but they’re still using their own language.
For people on the spectrum, it’s like speaking a foreign language.
We have to study the grammar, memorize the vocabulary,
and sometimes we still don’t understand why things are said that way.
And that’s just one small example—there are many other differences.
High-Functioning but Still Exhausted
Many people on the spectrum are considered “high-functioning.”
The most common example is Asperger’s.
You can imagine it like being a foreign-language expert—
someone who’s learned to imitate so well that no one can tell it’s not their mother tongue.
But over time, that level of mimicry consumes enormous energy.
Emotional regulation becomes harder; anxiety, burnout, and conflicts with loved ones start piling up.
That’s why many people—especially women—don’t realize what’s going on until adulthood,
sometimes even after having children or reaching middle age,
when they finally get diagnosed.
The Diagnosis Process in Ibiza
My own diagnosis took almost a year: because this is Ibiza — there’s a serious shortage of doctors here.
I started with a general practitioner,
then got referred to psychiatry.
After multiple appointments, was sent to the autism clinic.
By the time it was over, a whole year had gone by.
I went to the general practitioner because of depression.
Before that, I had already tried therapy here in Ibiza.
I still remember that therapist asking me,
“You said you like that girl—could it be that you’re not in love, but obsessed?”
I felt very uncomfortable.
I thought, Really? After finally coming out about my sexuality,
now I have to question it all over again?
So I stopped going.
A year later, after receiving my diagnosis,
I realized maybe I had misunderstood her.
Maybe she had already noticed my autistic traits?
Test Results and Clinical Findings
Here’s what my medical report says:
ASQ (Autism Spectrum Quotient)
A questionnaire that measures the likelihood of being on the spectrum.
Cutoff score: 46. My score: 71—above the threshold.
ADOS-2 (Autism Diagnostic Observation Schedule)
A clinical observation scale scored between 0 and 3:
- 0–1 = typical range
- 1.5–2 = borderline
- ≥2 = within the autism spectrum
My score: 2.71, clearly within the spectrum.
Clinical observations:
- Binary or concrete thinking patterns
- Preference for social interaction through shared interests
- Heightened sensory awareness
- Strong recognition of patterns, rules, and structure
- Finds comfort through repetitive actions
- Excellent attention to detail and logical reasoning
The doctor described me as “high-functioning,” meaning I can manage life independently.
Because adults like me usually handle daily living well,
I was referred to a community program (the local Asperger’s Association).
But I didn’t join—it was too expensive for me at the time.
Common Misunderstandings About Autism
Explaining autism to others is surprisingly difficult.
Most people respond with, “You don’t look autistic.”
After all, the public image of autism is still a child who seems intellectually impaired,
or someone doing strange repetitive actions—like head-banging—
or the “math genius” stereotype.
I’m one of those so-called fake extroverts, so even I’ve doubted about it many times.
But after learning more about the characteristics of autism, I knew for sure that I was on the spectrum.
Because I’m also highly functional, what convinced me most were the physical and sensory traits:
extreme sensitivity, unusual perceptual abilities, and other odd experiences I’d never been able to explain before.
It’s actually quite fascinating—and I’ll write another post about that someday.
These traits are just difficult to explain, that’s all.
When I read descriptions of autism, I immediately understand what they mean.
But for most people, it’s hard to imagine what those traits actually look like in daily life.
The kind of obvious autistic traits I mentioned earlier are what my brother shows—his traits are very visible.
We’re not sure who we inherited them from, because honestly, both my parents seem a bit on the spectrum too…
Yes, they’re both a little weird, haha.
After the whole diagnostic process, I only told my ex-husband about it.
At first, he didn’t really believe me—many people still think autism is almost the same as intellectual disability.
But when I explained the characteristics to him, he kept nodding and said: “That’s totally you.”
Since he had lived with me every day, he’d seen all my quirks, strange tempers, and unusual ways of interacting with people—so it all made sense to him.
Throughout the diagnosis process, I discovered a lot—some things were about rediscovering myself,
and others were tiny details I had never noticed before.
I’ve come to feel that these experiences are worth sharing.
Partly because there’s more and more discussion about autism now, but not many people talk about what it’s really like in daily life; and partly because I hope that people who are questioning themselves, or those newly diagnosed, can find a bit of resonance in these stories.