Does camouflaging predict age at autism diagnosis? A comparison of autistic men and women.
High self-reported camouflaging ties to later autism diagnosis, especially in women.
01Research in Context
What this study did
Milner et al. (2024) asked autistic adults to fill out a camouflaging survey. They then looked at who got their autism diagnosis later in life.
The team compared men and women to see if heavy camouflaging pushed back the age of diagnosis.
What they found
Women were diagnosed later than men.
The link between high camouflaging and late diagnosis was strongest in women.
How this fits with other research
Huang et al. (2021) already showed that women get diagnosed later. Victoria’s team adds the reason: camouflaging explains part of that delay.
Jorgenson et al. (2020) saw the same sex gap in camouflaging, but their kids were 11-14 years old. The new study shows the pattern still holds in adults.
Fleury et al. (2018) found toddler girls had more social-communication red flags yet looked mild overall. Victoria’s results suggest these girls grow into women who mask well, so the delay stretches into adulthood.
Hutchins et al. (2020) warned that heavy camouflaging hurts women’s mental health. Together with Victoria’s findings, we see a chain: girls mask, diagnosis slips, distress rises.
Why it matters
If you assess adults for autism, add a short camouflaging scale to your intake. When a woman scores high, dig deeper even if her eye contact and small talk look typical. Spotting her now can open services and protect mental health later.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add the Camouflaging Autistic Traits Questionnaire to your adult intake packet.
02At a glance
03Original abstract
It is frequently reported that females are likely to receive an autism diagnosis at a later age than their male counterparts, despite similar levels of autistic traits. It has been suggested that this delay in diagnosis may in part reflect the propensity of females, more than males, to engage in camouflaging behaviors that reduce the appearance of autism-related traits. This article presents two studies which examined the relationship between gender/sex, camouflaging, and age at diagnosis in two samples of (cis-gender) autistic adults. Study 1 included data from three online samples including 242 autistic men and 570 autistic women aged 18-75 years. Study 2 included data from a longitudinal population-based sample including 24 autistic men and 35 autistic women aged 20-24 years. Camouflaging was measured with the self-report Camouflaging Autistic Traits Questionnaire (CAT-Q). Overall, the results showed that, on average, females were diagnosed later than males. There was a stronger relationship between camouflaging and age at autism diagnosis (AaD) for females, compared with males. Within sample one, there was a significant camouflaging-by-sex interaction; high-camouflaging females had a later AaD. The role of autistic traits and changes in attitudes towards female autism and camouflaging need further exploration. These findings highlight the need for greater clinician and key stakeholder awareness and understanding of camouflaging behavior, particularly for females, during the diagnostic process.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3059