When Canadian singer Grimes revealed she had just been diagnosed with both autism and ADHD at age 37, news of her announcement sparked empathy, curiosity, and, above all, conversation.
Her post on X wasn’t a personal reflection but instead pointed to a much broader, underreported issue: girls are slipping through the cracks regarding early diagnosis of autism.
“I feel like, had we known this when I was a child, I would have worked so much less hard… so many of the weird obsessions and motivations I had would have been seen as pathological,” she said candidly.
And she isn’t alone. According to the CDC, one in 36 children in the US is diagnosed with autism, but boys are diagnosed nearly four times more often than girls. That disparity isn’t because autism affects boys more-it’s because the system isn’t built to see how it shows up in girls.
The Hidden Struggle: Masking and Mislabeling
According to Ralph Moller, the Director of Operations at Above & Beyond Therapy, the reason these girls often go undiagnosed is that they exhibit different patterns than boys. They are more likely to devise strategies that mask their autism traits as a way of better fitting in.
Translation? They adapt. They imitate. They do neurotypical behavior so well; parents and teachers often miss the signs.
It can look like “being shy,” “quirky,” or “gifted.” A girl who looks like she is unusually advanced in her language skills may actually be hyper-focusing on language as a way to mask underlying social difficulties.
And when girls do speak up about sensory overload, social fatigue, or emotional exhaustion, they’re too often misdiagnosed with anxiety or depression, sometimes both. It is not just a diagnostic oversight; it’s a systemic failure with lifelong consequences.
Meltdowns Behind Closed Doors
“Girls on the spectrum often spend enormous amounts of energy holding themselves together in public,” Moller explains. “It’s common for them to come home from school or social events and have emotional meltdowns. They’ve been ‘performing’ all day.”
These are the moments that get written off as mood swings, puberty, or stress. But when they become a constant theme, and especially coupled with rigid routines, hyperfixations, or social withdrawal, it’s time to dig deeper.
What makes this particularly damaging is that many girls internalize the idea that they’re simply “bad at life.” They grow up thinking their exhaustion or social challenges are personal failures, not symptoms of a neurodevelopmental condition that could be supported with the right intervention.
What to Watch For: The Subtle Signs of Autism in Girls
Moller points out a number of red flags that are often overlooked in girls:
- Advanced vocabulary: May look like high intelligence, yet may be another form of hyperfixation.
- Eye contact: rather than avoiding this, some girls learn to force it-to give the impression of neurotypical communication.
- Social mimicry: Girls may imitate others’ social behavior without really understanding it.
- Fixations: Unlike stereotypical “boy” fixations, such as with trains or numbers, girls may become obsessive about animals, books, or fictional characters-interests considered “normal.”
- Exhaustion from masking: Emotional outbursts or shutdowns often occur in private.
These aren’t always easy to spot, especially when a child is doing well academically or seems socially functional. But early diagnosis can make all the difference in the world.
The Cost of Missing It
An early diagnosis means access to better tools, therapies, and self-understanding. Without it, many women go through their lives feeling alienated, burnt out, or misdiagnosed. As Grimes reflected, “So many of the weird obsessions and motivations I had would have been seen as pathological… I’m glad I overcame them, but I wish it hadn’t been so hard.”
“As Moller points out, “When a girl shows difficulties with social relationships but has learned to mask them, it is easy to dismiss her struggles as anxiety or insecurity.” But early intervention leads to better outcomes, especially in building self-esteem and social understanding.
What Parents and Caregivers Can Do
Let’s start by paying closer attention to the emotional and behavioral patterns that don’t match the neurotypical expectations, even when they seem “mild.”
- Talk to your pediatrician if you notice a consistent struggle to regulate emotions or social cues.
- Request developmental screenings, and do not be afraid to get a second opinion if you feel like your concerns are not taken seriously.
- Watch for the cumulative signs rather than wait for a “classic” presentation. Diagnoses aren’t about naming and labeling; they are about understanding, creating a support network, and empowering an individual to find their own best way of flourishing.
The Bottom Line
Grimes’ story isn’t just a headline-it’s a wake-up call. Girls with autism aren’t less common. They’re just less visible.
And in a world where visibility often determines care, we owe it to the next generation to do better. Because no person should have to wait 37 years to feel seen.