A Qualitative Exploration of Self-Harm Among Autistic Women.
Autistic women describe self-harm as a tool to calm overload or punish social mistakes—replace these functions, don’t just remove the behavior.
01Research in Context
What this study did
Rebbettes et al. (2025) talked with autistic women about why they hurt themselves.
They used long interviews so women could speak in their own words.
The study looked at two jobs self-harm does: calming overload and punishing the self.
What they found
Women said they used self-harm to shut down loud feelings or pain in their bodies.
They also used it to punish themselves after social mistakes, like saying the wrong thing.
Both needs grew bigger when doctors, family, or friends did not believe they were autistic.
How this fits with other research
Lam et al. (2025) and Pollock et al. (2026) heard the same thing: being dismissed hurts. Their autistic women felt burnout and shame after years of "you don’t look autistic."
Hutchins et al. (2020) showed that hiding autistic traits, called camouflaging, predicts suicidal thoughts. Jessica’s work adds that when women can’t hide anymore, self-harm can feel like the only tool left.
Seers et al. (2021) found that rejecting deficit talk and owning autistic identity protects well-being. This matches Jessica’s hint that belief and respect from others may lower the need to self-punish.
Why it matters
If you assess an autistic woman who self-harms, first ask, "What job does this do for you?" Tailor safety plans to give alternate ways to regulate sensation and to offer self-compassion after social slip-ups. Simple swaps—noise-canceling headphones, a cold shower, or a brief compassion script—can replace the harm function and keep her out of the ER.
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02At a glance
03Original abstract
BACKGROUND: Autistic individuals, particularly females, demonstrate a higher prevalence of self-harm compared to those who are not autistic. Core cognitive, affective, and sensory differences inherent to autism are linked to the increased vulnerability within autistic populations. However, these factors are not sufficiently explored in relation to individuals' social and environmental contexts, resulting in a gap in understanding the self-harm experiences of autistic females. METHODS: Eleven autistic women participated in semi-structured interviews to explore their experiences of self-harm. Data was transcribed and analysed using reflexive thematic analysis. RESULTS: Three key themes were identified: Regulation of Emotional States, highlighting self-harm as a coping mechanism for managing high and low energy affective states; Navigating a Neurotypical World, exploring how societal and interpersonal challenges influence these behaviours; and Changes in Self-Harm Over the Lifespan, examining the evolution of self-harm across different life stages. CONCLUSIONS: Findings reveal that self-harm in autistic women stems from both autism-related differences and unique experiences, vulnerabilities, and societal expectations. Influences of delayed diagnosis, burnout, and victimisation, required self-harm for self-punishment and regulation. Mislabelling and misdiagnosis throughout participants' lives exacerbate risks and demonstrates an ongoing misunderstanding of distress of autistic females. Future research should focus on adapting interventions to better address the challenges unique to this population, and improving diagnosis and identification by considering the functions of these behaviours.
Journal of autism and developmental disorders, 2025 · doi:10.1016/j.cpr.2003.10.001