The Little Known World of Autistic Women
Marina Sarris
Date Published: August 27, 2025
This article mentions suicide. For help 24/7, please contact the U.S. Suicide and Crisis Lifeline at 988.
Maire Claire Diemer, a researcher, wanted to peek inside the little known world of autistic women, who are rarely studied.
Some of what she found alarmed her.
Diemer analyzed data from surveys completed by 1,424 independent women in SPARK, the nation’s largest autism study. Like other women in the U.S., many of the SPARK participants worked, married, and raised children. But they also reported high rates of some serious problems.1
The analysis found that:
- 34 percent of the women have thought about suicide,
- 21 percent have tried to harm or kill themselves,
- 62 percent have had depression, and
- 9 percent have been diagnosed with substance use disorder, which is an addiction to drugs and/or alcohol.1
The findings about suicidal thoughts “is what really stops me in my tracks every time I think about this study. It’s just so high across the board. It’s really alarming,” says Diemer, a clinical psychologist at the Medical University of South Carolina. “It brings up worries about access to care for suicidality.”
“We grew up thinking that we’re wrong and broken….”
The study by Diemer’s research team is one of the largest U.S. studies of the health and biographical information of autistic women who do not have guardians. Autistic girls and women have been studied less often than autistic boys and men, who outnumber them by almost 4 to 1.
Diemer’s team looked at the women’s medical diagnoses, education, employment, marital status, and other things. This study did not seek to explain why the women experienced high rates of depression, thoughts of suicide, and self-harm.
But Marie Holst, 59, a SPARK participant, has some ideas, based on her experiences as an autistic woman. Holst, a community advisor to SPARK, was diagnosed with autism as an adult, as were two-thirds of the women in Diemer’s study.
As a child, she was bullied for being different, as are many on the spectrum. Mental health problems may be a result of growing up without knowing you are autistic — and without receiving the help and understanding that the diagnosis can bring, she says. Women who missed out on a childhood diagnosis likely also missed out on the therapies and school services that autistic children may receive.
“We grew up thinking that we’re wrong and broken and weird and different. We were on the autism spectrum, and we didn’t know it,” says Holst, who was diagnosed when she was 49.
She believes people are less accepting of girls who are quirky and socially awkward than they are of boys with those traits. “Women weren’t allowed to be like that,” she says.
Suicide Risk in Autistic People
Other studies have found that autistic youth and adults face a suicide risk that is two to seven times higher than the risk for people who do not have autism. The data on teenage girls and women have varied. One large study in Sweden found that one in five females who had both autism and ADHD (but not intellectual disability) had attempted suicide at least once. But several smaller studies have not found a higher risk in girls and women.
The results in Diemer’s SPARK study may have been affected in part by the large percentage of autistic women who identify as LGBTQ+. Of the 1,424 women, 9 percent were nonbinary people assigned female at birth, almost 1 percent were transgender women, and 33 percent were gay, bisexual, or asexual.
Studies have shown that people who are gay, bisexual, or have other sexual identities experience more depression and suicidal thoughts than heterosexual people.2,3 As members of a minority group, they may face stress from stigma, discrimination, and rejection that affects their health, according to research.
Forty-one percent of the study participants who were LGBTQ+ reported thinking about suicide, compared to 26 percent of the women who were heterosexual and cisgender.1 Cisgender people identify with their sex assigned at birth.
Similarly, 27 percent of LGBTQ+ participants had a history of trying to hurt or kill themselves, compared with 14 percent of the heterosexual, cisgender women.
The results are alarming, say Goldie A. McQuaid, Ph.D., and Gregory L. Wallace, Ph.D., who were not involved in this study. “These are really high numbers of individuals indicating a very high level of distress,” says McQuaid, assistant research professor at George Mason University.
But they were not surprised by the findings, which are similar to what they have found in their research of autistic adults who are gay, bisexual, or have other sexual identities.4
The stress of being in two minority groups — LGBTQ+ and autistic — “seems very likely to be exerting an influence here,” says Wallace, professor at The George Washington University. “What we need to do is probe further to understand the true cause, as best as we can.”
Alcohol and Drug Use Among Autistic Women
Diemer’s study is one of the few U.S. studies to examine the rate of addiction in independent autistic women, including the differences between those diagnosed with autism as children and those diagnosed in adulthood. A future study will examine the lives of autistic women who have legal guardians, Diemer says.
Ten percent of the women who were diagnosed with autism as adults reported a substance use disorder diagnosis. By comparison, 7 percent of the women with a childhood autism diagnosis also had a history of substance use disorder. Similarly, the women with an adult diagnosis of autism were more likely to report depression and eating disorders than those with childhood autism diagnoses.1
Anthony Spirito, Ph.D., a substance use expert who was not involved in this study, was not surprised by these findings. He is co-leading a team that is researching substance use among autistic teens and young adults.
“We also see a lot of psychiatric [co-occurring conditions] in persons diagnosed [with autism] as adults — the rate of substance use disorders is higher than the general population and likely primarily driven by these co-occurring disorders. Nonetheless, it does show that substance use disorders should be assessed in persons with autism, especially those diagnosed in adulthood, and treated as needed,” says Spirito, a psychiatry professor at Brown University.
Health Conditions Reported by Autistic Women
The SPARK women as a group reported high rates of other diagnoses:
- Anxiety (70 percent)
- Sleep disorder (32 percent)
- Bipolar disorder (18 percent)
- Eating disorder (17 percent)
Despite those challenges, the study also found that many autistic women have “positive outcomes.” More than half of the SPARK women had full-time or part-time jobs, 53 percent were married or had a romantic partner, and 38 percent were parents.1
The SPARK women were employed at the same rate as other women, but their household income was lower than the national average. Despite lower incomes, the SPARK women were well educated. Almost half had some college or trade school, 23 percent earned a bachelor’s degree, and 14 percent had a graduate/professional degree.
Previous studies have documented the struggles autistic adults have with finding or keeping jobs.
Differences Based on Age of Autism Diagnosis
Diemer’s study found some differences based on whether women received their autism diagnosis as children or as adults.
Those diagnosed as adults were more likely than those diagnosed as children to work full-time, marry, have a college or graduate degree, and use alcohol and drugs. They also had a higher household income than those diagnosed in childhood. Diemer says it is hard to draw conclusions about why these differences exist without more research.
Another difference: despite their achievements, the adult-diagnosed group showed less confidence in their ability to accomplish a task or succeed than the women who were diagnosed as children.
“Different is Beautiful”
Marie Holst, the SPARK participant, said that she understands why the adult-diagnosed group may have lower self-confidence despite their academic or job successes.
“I grew up very much thinking that I was just a broken individual with no social skills, and the only thing that I had going for me was that I was smart,” she says. She excelled in school and her job as a computer programmer, but she did not relish her promotion to manager. As a manager, she had to be a “people person” and hide her autistic traits. Trying to fit in socially exhausted and frustrated her, and she asked to return to programming.
Some studies show that many people on the spectrum, particularly women, try to hide their autistic traits, and that this effort is linked to mental health problems.5
Holst hopes that autistic girls receive early diagnoses so they can grow up with better self-esteem than she did. “They can be happy with who they are and know that they’re wired differently, and that’s not wrong. It’s different, and different is beautiful.”
Interested in joining SPARK? Here’s what you should know.
Photo credit: iStock
References
- Diemer M.C. et al. Autism Res. Epub ahead of print PubMed
- Hottes T.S. et al. Am. J. Public Health 106, e1-e12 (2016) PubMed
- Marshal M.P. et al. J. Adolesc. Health 49, 115-123 (2011) PubMed
- McQuaid G.A. et al. Autism Adulthood 5, 139-153 (2023) PubMed
- Bradley L. et al. Autism Adulthood 3, 320-329 (2021) PubMed