‘Neglecting and causing harm’: Overlooking autistic and ADHD women has been the norm for generations. Gender bias in this field is a public health concern. I walked into the gym and froze. The kettlebells had been moved. Their colours were in a new order. The cardio equipment had been relocated. Nothing seemed how it was. I felt uneasy and exclaimed to my personal trainer: “Everything’s wrong! They’re meant to be by the window!” This wasn’t the first time I had experienced a visceral reaction to changes in my environment. I once became particularly distressed at the sofa being changed in my counsellor’s room. I used to torture myself over why I was like this. Why did I get so upset about things that didn’t seem to bother others? I was intelligent and a high achiever despite leaving my work until the last minute and operating on a constant rollercoaster of high productive peaks and deeply depressed troughs. Yet the many decisions, steps and multi-tasking involved in cooking a meal could send me over the edge. It didn’t make sense. I was constantly exhausted. People exhausted me. Life exhausted me. I now know I am dyspraxic, autistic and ADHD. The depression, anxiety and panic attacks I struggled with for years were likely burnout and sensory overload. Neurodivergent women and girls have been overlooked by the medical profession for decades. Traditionally, ADHD and autism have been perceived as male conditions, contributing to a two– to fourfold higher likelihood of diagnosis in males compared to females. The diagnostic criteria for ADHD and autism exhibit a male bias — partly because researchers historically recruited only boys and men to scientific studies. This has led to clinicians failing to identify women’s presentations of these conditions. Clinicians, accustomed to recognising autistic features in boys, may also overlook or misdiagnose autism in girls. That’s if they are referred at all. Research shows girls are less likely to be referred for diagnosis despite exhibiting characteristics of both conditions. The chances of recognition are even slimmer if you aren’t white or middle-class. Women also often display less overt inattentive symptoms of ADHD; these differ from the externalised hyperactivity symptoms predominantly observed in males, resulting in underdiagnosis of ADHD in girls. Reading Sarah Hendrickx’s Women and Girls with Autism Spectrum Disorder was a lightbulb moment. She was describing me, my childhood, my unique weirdness. I couldn’t cope with uncertainty and change, however small. The wrong texture of clothes could drive me to losing my temper. I was an extremely bland and fussy eater. I couldn’t stand when things were ‘wrong’ or unjust. I would get fixated on what others could easily let go of. I spent my whole life trying to figure out what others meant when they spoke, because they never said what they meant. I would become obsessed with topics and immerse myself, shutting everything else out. Animals were my biggest allies. I couldn’t master gears in a car, I was clumsy; I had overwhelming emotional outbursts that I should have grown out of decades ago; I was always late, I lost everything. If I can’t see something, it no longer exists — I have multiple copies of things, having forgotten I’d already bought them. I feel like I have multiple monkeys in my brain that all need to be kept busy at the same time in order for me to wrestle control over my mind and body. The racing thoughts never stop. When I discovered I was autistic, I suddenly realised: It wasn’t just me. There wasn’t something deeply wrong with me. I wasn’t failing at life and unable to cope with the same mundane tasks others breezed through. I experience the world in a different way. But this wasn’t the whole story. I didn’t fit neatly into the ‘autistic’ box. Learning about ADHD explained why — I was AuDHD. My story is not unique. My research about late-diagnosed women’s experiences of autism and ADHD shines a light on the rollercoaster lives, misdiagnoses, mental health difficulties, and negative self-perceptions of AuDHD women who lived a life undiagnosed. Girls with ADHD and late-diagnosed autistic females often engage in effective “masking” behaviours (that is, the emulation of neurotypical behaviours) because there is more pressure on girls to conform, to behave, to silence their struggles. Masking can make these conditions less visible and less likely to be diagnosed. Masking is protective but it can also be harmful, causing neurodivergent individuals to feel “disconnected” from their true sense of identity, and being linked to higher rates of depression, anxiety and suicidal ideation.