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Psychiatrists used to think autism was rare among women and non-binary people, but we now know autistic traits can express themselves differently. Professor Francesca Happé, an expert in autism from the Institute of Psychiatry, Psychology and Neuroscience in London, says that historically research has mainly focused on men. This has shaped how autism is understood and diagnosed. It means that “we carry around a male stereotype of autism, so we’re less likely to think about autism when we see a girl struggling socially.”

It’s not only a gender issue. Psychologist Dr Stephen Stagg of Anglia Ruskin University says the low numbers of NHS referrals suggest autism is being under-diagnosed among black and Asian people too. But there’s not yet a lot of research into this.

Eloise is an Oxford psychology graduate. She says that although she felt different to other people, she didn’t link it to autism “because no one had ever explained to me what an autistic woman was like, what it feels like, what it looks like.” It wasn’t until adulthood that she got a diagnosis. “I started my PhD and basically had what I now think was an autistic breakdown, which comes from the world being overwhelming and confusing and not really knowing why. I was really poorly, and I couldn’t function at all... And then, eventually I saw a psychiatrist who said, ‘You’re autistic’. And it just sounded so simple.”

People with autism, especially women, often mask or ‘camouflage’ it by imitating how others behave. Happé explains: “We hear from autistic women and girls that they work quite hard to appear neurotypical, or non-autistic, often to avoid bullying or to be more accepted in a rather unfair world.” But this can have a substantial cost. Happésays camouflaging is not only exhausting (she likens it to speaking a language you don’t know very well), it also “seems to erode the sense of self – the sense that you’re presenting your authentic self, and therefore that the people who do love you, the people who are your friends, genuinely are appreciating you.”

Isabel was diagnosed with autism in her early sixties. She didn’t realise she was masking before, but says she now feels much more free. “I’ve been in places, for the first time in my life, where I have felt that I can be myself,” she says. “The field I’m in is performance and, you know, I’m good at it... But I still was not aware that I was performing in my everyday life.”

Dr Stephen Stagg has studied people’s experiences of getting an autism diagnosis after the age of 50. He says those he interviewed had found childhood difficult, struggled to make friends, and grown up feeling like “aliens” because “they just couldn’t work out why the world wasn’t working for them”. As adults, they tended to have had a lot of jobs, and often felt bullied or found it hard to deal with people at work. He says, “I was just surprised at how – to me – how obvious the autism was, and had been throughout their lives, and how it hadn’t been picked up.”

Chuck, who is trans, says their autism should have been recognised. “I’m bitter about the way that adults made me feel the whole time I grew up, just because they didn’t try to think a little bit further.” They say there were clear signs. “I didn’t talk for a really long time. It took me years and years and years and years to learn how to talk. But as soon as I was handed a guitar, within a week I was playing it to a level that you just wouldn’t expect a child to be able to play the guitar.”

Stagg thinks that for the people in his research, getting an autism diagnosis was “incredibly positive”, because it enabled them to understand their life experiences and “recast their history in a more positive light”. It also meant they could more easily ask for support and adjustments at work that would enable them to succeed in their careers.

Carmen is going through the process of getting a diagnosis in her mid-30s. “It’s not essential to get a diagnosis, but it can help with understanding things and also, I guess, feeling empowered when you do need support with something,” she says. Eloise has found that knowing she has autism has helped her use mindfulness to stop camouflaging and be herself. Isabelsays she’s stopped blaming herself for things she can’t do, and begun to embrace who she is. However, Chucksays they don’t need a formal diagnosis to know they’re autistic.