A qualitative exploration of the experience of autistic females in Hong Kong.
Hong Kong autistic women say professionals and families dismiss them, so we need culture-smart, female-shaped screening and support.
01Research in Context
What this study did
Lam et al. (2025) talked with autistic women living in Hong Kong. They asked open questions about daily life, feelings, and how others treat them.
The team recorded the interviews and looked for repeating themes. They wanted to hear, in the women’s own words, what it feels like to be autistic in a Chinese city.
What they found
Three big themes came up again and again. The women felt deep emotional pain, they shaped their identity around society’s false ideas, and both family members and professionals brushed off their needs.
One woman said doctors told her she was ‘too pretty to be autistic’. Stories like this show how cultural views add extra weight to the usual female diagnostic delay.
How this fits with other research
The findings echo Lineberry et al. (2023) in Australia and Seers et al. (2021) in the UK. All three teams used interviews and heard the same tune: professionals miss autism in women because they still look for boy-type signs.
An earlier Hong Kong study, Ho et al. (2014), showed parents of young kids also hit a brick wall during diagnosis. Lam et al. (2025) now reveal that the wall is still there when those girls grow up.
Kanfiszer et al. (2017) first mapped how adult-diagnosed women talk about gender and social roles. The new paper extends that map eastward, showing Chinese cultural ideas tighten the pressure to act ‘normal’.
Why it matters
If you assess or support autistic women, remember that dismissal is double-layered: gender plus culture. Build intake questions that ask about camouflaging, emotional burnout, and family beliefs. Offer written resources in Chinese that explain autism in women, not just boys. Small moves like these can turn the first ‘you don’t look autistic’ into a validating ‘tell me more’.
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02At a glance
03Original abstract
There are fewer females than males diagnosed with autism, but autistic females are said to be under-identified and underrepresented in the existing diagnostic and service systems. The gender discrepancy may potentially be attributed to the lack of accurate understanding of autistic females and their needs. Emerging research has begun to document the experiences of autistic women in Western countries, but their experience in Eastern cultures is almost unknown. This study aimed to investigate the lived experience of autistic women in Hong Kong. Thirteen formally diagnosed or self-diagnosed autistic women completed semi-structured interviews, discussing how they identified with autism, their diagnostic experience, and their understanding of autism. Results based on thematic analysis revealed Hong Kong autistic women commonly experienced emotional problems and encountered autistic models on the way they came to identify with autism, despite often being dismissed by families and professionals. They found an autism diagnosis or identity meaningful to their self-understanding. Societal misunderstanding toward autism had a great impact on their self-identity as an autistic female. Findings can inform improved services for autistic women in Hong Kong and provide insights to enhance understanding of autism in Chinese culture.Lay abstractThere are more males than females with autism. One of the reasons can be that we do not understand autistic females well. Some research in Western cultures has begun to document the lived experience of autistic females, but no such studies are conducted with Chinese autistic females. This study explored the first-person experience of living with autism in Hong Kong autistic women. We conducted qualitative interviews with 13 women with a formal diagnosis of autism or self-diagnosed as autistic. We used semi-structured interviews to discuss how they came to recognize or identify with autism, their diagnostic experience, and their understanding of autistic females. We summarized several broad themes that depicted their experience. Participants recognized autism in themselves when seeing other autistic people. They indicated mental health challenges that led them to seek help from professionals, who might sometimes reject their concerns about autism. Participants found it meaningful to have an autism diagnosis or identity, but other people's judgment would affect their self-understanding. Participants also described themselves different from the stereotypes of autism, not the same as autistic males, and were perceived by others as not autistic enough. Our findings suggested autistic women in Hong Kong faced challenges in identity development and support services. There is a need to increase awareness and knowledge about autism in professionals and the public. Understanding how unique cultural factors that influence the identity of autistic women or individuals in Chinese cultures is important to promote their well-being.
Autism : the international journal of research and practice, 2025 · doi:10.1177/13623613241295318