Understanding the gendered experiences of young people with autism and ADHD

Healthwatch Gloucestershire undertook research on the gendered experiences of younger people seeking an autism and/or ADHD assessment. They spoke to 36 women and gender diverse people aged 11 - 25.

Missed early recognition had long term impacts on wellbeing, education and self-understanding. Sophisticated masking strategies are often developed in early life due to gendered social pressures, making needs less visible to teachers and clinicians which contributes to late or missed diagnosis. 

Traits were overlooked or minimised because they did not match stereotypical, male-centred understandings of autism and ADHD meaning the need for support was not identified or offered until difficulties escalated. 

he language used during the autism assessment process was described as patronising by some. 

Not having a diagnosis hugely impacted accessing support from family and friends. However, fear of stigma, stereotyping, and discrimination can influence whether people disclose their neurodivergent identity to others.

Loneliness is common. Misunderstanding of how autism and ADHD present in women and gender-diverse people can mean that they experience ongoing difficulty maintaining friendships due to masking, burnout, difference in communication styles and unmet social needs – even when relationships are valued. 

Mental health needs were misunderstood. Some felt their distress was dismissed as “just part of being autistic or ADHD,” while others found their neurodivergent traits being overlooked as relating to poor mental health. 

Positive experiences with mental health support were attributed to being able to build trust through having a consistent therapist and non-clinical environments, whereas others described short-term, inconsistent, or overly clinical support as unhelpful or exhausting. As well as support for themselves, young women told us support for their parents and carers would also be beneficial. 

Sensory environments, bullying, and rigid systems contributed to distress and, in some cases, long-term harm. Positive educational experiences were usually linked to individual staff members who identified needs and adapted their approach. Greater autonomy, flexibility, and alignment with interests supported improved experiences in further and higher education.

Long NHS waiting lists are driving families to seek private diagnoses, creating inequity and additional barriers when private assessments are not consistently recognised or supported within NHS pathways. 

Being on a waiting list has a serious emotional, practical, and identity impact, leaving young people feeling stuck, invalidated, and at times unable to access reasonable adjustments, education support, or specialist services. 

Diagnosis was valued as a tool for validation, communication, and self-advocacy, particularly in education, work, and social settings. However, some people experience difficulties such as skill regression following diagnosis. Without support, the benefits of diagnosis can be limited when understanding and practical support are not available or consistent. 

Transitions between children’s and adult services could be abrupt and poorly supported. Turning 18 was described as a “sudden loss of support” with expectations of independence that did not reflect actual needs. 

Framing rising diagnosis rates as over-diagnosis risks undermining the legitimacy of people’s lived experiences and can reinforce stigma, particularly for those who already face significant barriers to being recognised and supported.