I have encountered many of the below barriers or have communicated with women who have. I can take no credit for the following information but it was too good not to share.
Many autistic women don’t receive a diagnosis until they reach middle age. Those of us who are being diagnosed today in mid-life grew up during a time when Asperger’s was not yet an available diagnosis in the DSM. By the time we reached adulthood, we’d often mastered basic social skills, masking many of our autistic traits. It’s not until we learn about autism–often by chance, sometimes as part of researching a son or daughter’s diagnosis–that we have an aha! moment. Armed with our research, we set out on the road to confirming our suspicions, and eventually join the ranks of the late-diagnosed. That was my experience and I think it’s become the apocryphal late-diagnosis story.
In fact, one of the most commonly cited reasons for not getting diagnosed as an adult is the prohibitive cost of an autism evaluation, which can range from $1500 to $3000 or more in the US. While some women are successful in obtaining a formal or informal ASD diagnosis in the course of therapy, others eventually give up in frustration, often losing faith in the mental health system in the process.
There is a widely held belief that many women are simply “missed” by the mental health system because they’re more likely to develop compensatory strategies early in life.
Many women have similar memories of childhood–either of being explicitly taught social rules or of learning to model the social behaviors of peers. Growing into adulthood, we often learn to hide in plain sight, suppressing our more obvious autistic traits while going through our days feeling as if we’re faking social interactions.
Often, women seek a diagnosis because they can’t escape the feeling that something is fundamentally wrong. Society expects women to have strong intuitive social skills. Many autistic women talk of their belief that one day they would “mature” or simply “get it.” When they reach adulthood or midlife and that still hasn’t happened, they begin looking for another explanation.
Unfortunately, by that point, many women have become so adept at passing that mental health professionals refuse to believe they’re autistic.