“Unmasking the Gaps: Why Neurodiversity Diagnosis Fails Women and Minorities”

The understanding and diagnosis of neurodiversity, covering conditions like autism, ADHD, and dyslexia, have changed dramatically over time. Yet, while awareness has grown, the way we diagnose these conditions has often failed women and minorities, leaving many undiagnosed or misdiagnosed for years.

This blog explores how diagnostic frameworks have evolved, why they’ve been problematic for these groups, and what can be done to make neurodiversity diagnosis fairer for everyone.

What Is Neurodiversity?

Neurodiversity is the idea that differences in how people think, learn, and interact with the world are a natural part of being human, not mistakes that need to be fixed. This term gained popularity in the late 1990s, thanks to advocates who challenged the old view that conditions like autism and ADHD were simply disorders. Instead, they argued, these are just different ways of experiencing the world.

How Diagnosis Has Changed

Early Days: Rigid Labels

For decades, doctors used strict checklists to diagnose neurodivergent conditions. For example, autism was split into several types, like Asperger’s syndrome and “classic” autism. These categories were based on studies that mostly involved boys and men, which set the stage for problems later on.

The Spectrum Approach

In 2013, the main diagnostic manual (DSM-5) grouped all types of autism under one umbrella: autism spectrum disorder (ASD). This was meant to reflect the wide range of experiences autistic people have. While this change helped some people get recognised, it also made things more confusing for others, especially those whose traits didn’t fit the old stereotypes.

Why Diagnosis Has Been Problematic

Gender Bias: Why Are Women Overlooked?

One of the biggest issues is that women and girls are much less likely to be diagnosed with neurodivergent conditions than men and boys. There are several reasons for this:

• Male-Centered Research: Most early research and diagnostic tools were based on boys and men, so the “typical” signs of autism or ADHD were drawn from male experiences.

• Different Traits in Women: Girls and women often show their traits in less obvious ways. For instance, they may be quieter, better at masking their difficulties, or present with more internal struggles like anxiety or depression rather than the “classic” signs doctors look for.

• Masking and Camouflage: Many women and girls learn to hide their differences to fit in, a process called masking. This can make their struggles invisible to teachers, doctors, and even family members.

• Misdiagnosis: Because their challenges are less visible, women are often misdiagnosed with other conditions like anxiety, depression, or eating disorders, instead of autism or ADHD.

This means many women don’t get the help they need until adulthood, if at all.

The impact can be huge: years of feeling misunderstood, missed opportunities for support, and mental health struggles caused by not knowing why they feel different.

As one psychologist put it, “Neurodivergent women have been falling through the cracks for such a long time for many different reasons… Girls’ presentations tend to be more internalised, so they’re easier to miss.”

Racial and Ethnic Disparities

Minority groups, especially Black and other racialised children, also face major barriers to diagnosis:

• Later and Incorrect Diagnoses: Studies show Black children are more likely to be diagnosed late, misdiagnosed, or not diagnosed at all compared to white children.

• Stereotypes and Bias: Teachers and clinicians may misunderstand the behaviours of minority children, sometimes labelling them as behavioural problems rather than signs of neurodiversity.

• Socioeconomic Barriers: Families from minority backgrounds often face extra hurdles, such as fewer resources, less access to specialists, and fear of stigma or discrimination.

• Diagnostic Overshadowing: Sometimes, professionals attribute challenges to social or emotional issues rather than considering neurodiversity, especially when children are in foster care or have experienced trauma.

For example, Black children who meet the criteria for autism are more likely than white children to be misdiagnosed with other conditions, such as adjustment disorders or ADHD, before finally receiving the correct diagnosis, if they ever do.

Research has shown that the average age of diagnosis for Black children is significantly later than for white children, and that white children are much more likely to receive a timely diagnosis. These disparities are not just about individual bias—they reflect deeper, structural inequalities in healthcare, education, and society.

The Consequences of Missed Diagnoses

Missing or delaying diagnosis isn’t just a paperwork issue, it has real effects on people’s lives:

• Unmet Needs: Without a diagnosis, people can’t access the support they need at school, work, or home.

• Mental Health Struggles: Years of feeling misunderstood or unsupported can lead to anxiety, depression, or burnout, especially in women who mask their struggles.

• Lost Opportunities: Early diagnosis can open doors to therapies, accommodations, and community support that make a big difference.

Moving Toward Fairer Diagnosis

Experts and advocates are calling for big changes:

• Better Research: We need studies that include women and minorities to develop fairer diagnostic tools.

• Training for Professionals: Teachers, doctors, and psychologists should learn how neurodiversity looks different in girls, women, and minority groups.

• Listening to Lived Experience: People with neurodivergent conditions should have a say in how diagnosis and support systems are designed.

• Flexible, Person-Centered Approaches: Diagnosis should look at the whole person, not just a checklist of symptoms based on outdated stereotypes.

Conclusion

The way we diagnose neurodiversity has come a long way, but it still leaves too many people out, especially women and minorities.

By understanding these gaps and working to close them, we can build a world where everyone’s differences are recognised and supported.

Neurodiversity isn’t a problem to be solved; it’s a part of what makes humanity rich and varied.

If you’re navigating the challenges of a late diagnosis, remember that you are not alone.

Many adults are only now discovering their neurodivergent identity and may feel overwhelmed by questions, emotions, or uncertainty about the future.

Willful Steps

Willful Steps is here to support you on this journey.

Through personalised coaching, we help you understand your unique strengths, develop practical strategies for everyday life, and build confidence in your neurodivergent identity.

Whether you’re looking to improve focus, explore personal mantras, or simply need a compassionate guide, our services are designed to empower you at every step.

Together, we can turn self-understanding into meaningful action and lasting change.

References

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Hull, L., Mandy, W., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., Petrides, K. V., & Mandy, W. (2020). Development and validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders, 50(3), 819–833.

Lexxic. (2024). Gender Bias in Neurodiversity: Why Are Women Often Overlooked? Lexxic Blog. Available at: lexxic.com/blog/gender-bias-in-neurodiversity

Mazurek, M. O., & Kanne, S. M. (2010). Friendship and Internalizing Symptoms Among Children and Adolescents with ASD. Journal of Autism and Developmental Disorders, 40, 1512–1520.

Riches, C., & North, A. (2024). Why are so many neurodivergent women misdiagnosed? Australian Psychological Society. Available at: psychology.org.au/insights/why-are-so-many-neurodivergent-women-misdiagnosed

Rosenberg, R. E., Landa, R., Law, J. K., Stuart, E. A., & Law, P. A. (2011). Factors affecting age at initial autism spectrum disorder diagnosis in a national survey. Autism Research and Treatment, 2011, 874619.

Williams, D. R., & Mohammed, S. A. (2013). Racism and health I: Pathways and scientific evidence. American Behavioral Scientist, 57(8), 1152–1173.