The Lost Girls of Autism: The Untold Story of Women on the Spectrum

by Gina Rippon

The history of autism is male. When autistic girls meet clinicians, they are often misdiagnosed with anxiety, depression, personality disorders, or are missed altogether. Many women only discover they have the condition when they are much older, missing decades of support and understanding. Autism’s ‘male spotlight’ means we are only now starting to redress this profound injustice.

In The Lost Girls of Autism, renowned brain scientist Gina Rippon delves into the emerging science of female autism, asking why it has been systematically ignored and misunderstood for so long. Generations of researchers, convinced autism was a male problem, simply didn’t bother looking for it in women. But it is now becoming increasingly clear that autism is manifestly different for women and girls, and that camouflaging – hiding autistic traits to fit in – is far more widespread than we thought. Urgent and insightful, this groundbreaking book is a clarion call for society to recognize the full spectrum of autistic experience.

Genres: Nonfiction, Psychology, Science, Autistic Spectrum Disorder, Mental Health, Feminism, Audiobook

353 pages, Kindle Edition

First published April 1, 2025

About the author

Gina Rippon is professor of cognitive neuroimaging at the Aston Brain Centre, Aston University, Birmingham. Rippon has also sat on the editorial board of the International Journal of Psychophysiology.

Her book, Gendered Brain: the new neuroscience that shatters the myth of the female brain, maintains biology plays no core role in differentiating female brains from male brains. As a watershed in the history of science, Rippon considers her findings comparable to "the idea of the Earth circling around the sun".

Rippon's research involves the application of brain imaging techniques, particularly electroencephalography,(EEG) and magnetoencephalography (MEG) using cognitive neuroscience paradigms to studies of normal and abnormal cognitive processes. This work has been applied to the study of Autistic Spectrum Disorders and to developmental dyslexia.

Source: https://en.wikipedia.org/wiki/Gina_Ri...

Reviews

[Neila · Rating 3 out of 5]

2.5⭐️

This felt more like an empirical review of research done so far and how girls were excluded from data and studies rather than anything about actual women and autism. The whole conclusion is that women with autism do exist (shocker) but they do more camouflaging and therefore they go under the radar (shocker). Women excluded from being represented in science? Wow never heard that one before.

I might sound a bit harsh but beyond it not being very digestible for a non-scientific audience it wasn’t also bringing much in terms of new data or science for those that have any type of knowledge about autism. I’m sad to see that the state of autism research in girls is at the same standstill as it was 10 years ago when I was studying psychology and neurosciences. It doesn’t seem to have any type of more specific diagnoses for girls, no studies conducted only on women with autism and no help for women on the spectrum. It seems like a pretty pointless exercise to come out in 2025 with a book that could have been published in 2015 with the exact same insights.

Bitterly disappointed, and I don’t see who the intended audience would be for this book as those studying it have heard of all this before and those who are not will find this format hard to digest with many gene strands names and neuroscience related jargon.

[emily · Rating 5 out of 5]

female-centred book on autism by an actual neurobiologist i manifested this, excellently written and i will be getting my hands on a physical copy. the more i learn about female history in regards to autism the angrier i get.

[Emma Deplores Goodreads Censorship · Rating 3 out of 5]

This is an okay book, though I’m not quite sure who it is for. It’s on the long side for the amount of material it contains, taking half the book to explain that autism shows up differently in women and girls and that they’ve gone overlooked and underdiagnosed and left out of studies, and then spending the second half diving into a lot of detail on brain scans and how those are different in autistic vs. neurotypical people. The author is a brain scientist so that makes sense as her area of expertise, but it's not quite what I was expecting, especially since brain science is still quite young. Also, she talks a lot about interviewing women and girls with autism, but we only get snippets of their comments and the author still seems pretty firmly ensconced in her medical perspective (which again, makes sense, but raises the question of who is this for?).

That said, I did get some things out of it so here are a few takeaways:

- While neurotypical brains do not show significant sex differences in structure or function, brains of people with autism do. Men and women also tend to have different features of autism (although it’s not a bright line; even very male-oriented definitions of autism still resulted in some women getting diagnosed).

- While men tend to have more social difficulties, special interests, and stimming/repetitive behaviors, women tend to be better at suppressing all that and camouflaging their autism. However, this commonly results in depression and anxiety, and often results in just surface-level “passing” rather than satisfying social lives. Women with autism also tend to have lots of sensory sensitivities.

- One reason the autism diagnosis matters is the frequency with which girls and women presenting with mental health symptoms are treated for the wrong thing. For instance, eating disorders: many women with autism have them, but it has nothing to do with body image or weight loss and everything to do with sensory issues around certain foods, or just being something they can control or even compete at.

- Cognitive vs. emotional empathy and “empathic disequilibrium”: women with autism may be good at recognizing how someone is feeling, but not at knowing what to do about it.

- A “female protective effect” (making women less likely to get autism) has been theorized, though as far as I can tell we don’t yet have enough of a handle on how many women actually have autism to know whether it’s real. Women diagnosed with autism using the current tests do tend to have more relatives with it than men, and more of the gene mutations associated with it, but this may just come back to gender biases in those tests and women being better able to mask, so that those with fewer neurotypical relatives to emulate or with a higher degree of autism are the ones who show up at all.

- Also, there’s a dark history to this assumption that autism is a male phenomenon: Hans Asperger, one of the early doctors to describe the condition (who said he’d never met a girl who had it) definitely did work with at least two girls quite similar to the boys he was studying. However, he was a Nazi, and chose to save the boys from the regime but not the girls. Also, a female doctor, Grunya Sukhareva, who worked in the Soviet Union, described autism case studies well before either Asperger or Leo Kanner but often isn’t credited. Unsurprisingly, she was able to find girls as well as boys.

- Weirdly, none of these sex-difference studies seem to involve the people with the most profound version of autism, which seems like the right group to study since that’s not something people can hide (though perhaps they might be mistakenly diagnosed with another developmental disability). However, indications are that the sex ratio for that group is much more even than the numbers usually thrown around.

At any rate, interesting enough but I think I’d have gotten about the same value out of a good magazine article. Only recommended for those especially interested in the topic.

[EmG ReadsDaily · Rating 4 out of 5]

Interesting insights into autism research, the brain science and the unique challenges of autistic women and girls.

[Anna · Rating 2 out of 5]

for being written by an autism expert, i found this painfully politically disconnected. a scientific approach to explaining the lack of AUTISTIC FEMALES (yuk) that does not take into consideration any factors that arent measurable...
crazy how she was able to basically say nothing for all these pages!
the accodmodations she suggests are valuable are... wait, what are accomodations? heh, never mentioned. this book made me feel awful. she could not bring herself to portray hans aspberger critically as far as his politics go. THIS IS THE PROBLEM OF SCIENCE ENTIRELY, THAT THEY DO NOT RECOGNISE THEIR BIASES AND THIS BOOK ONCE AGAIN PROVED IT TO ME, IF THESE ARE THE AUTISM RESEARCHERS I DONT WANT THEM...

i felt like this was written by a conservative bot? how do you actually claim to be an autism researcher for decades and have this little empathy? how did you not mention once the spectrum? how did you manage to mention trans and nonbinary autistic folks and make it feel so meaningless?

all i learned from this book that pre aspberger and kanner, ukrainian WOMAN doctor gunya sukareva recognised autism in girls and likely that both former men knew about her work but never mentioned her. any surprises there?

hands off this book i beg of u

[Kait · Rating 2 out of 5]

This book includes some really good and insightful info. I am, however, disappointed that the intersection of race and Autism was not examined -- though I do understand through their disclaimer that the data is just not there. I still feel there must have been some way in which this could have discussed or acknowledged in a way that is still impactful without relying on anecdotal evidence too much.

I am very frustrated that the author spent the entire first chapter overexplaining the nuances of language and word choices and the sensitivity read before publishing, yet immediately uses the term "find their tribe" and continues to use "tribe" throughout the book. They easily could have used the more appropriate term "community" or the like. [Tell me this book was written by Brits without telling me.]

[Sara · Rating 2 out of 5]

Tilannehan on se, että meitsillä pärähti tänään 36 vuotta tauluun ja autismiepäilystä kertova kirjaus tietokantaan. Prosessi on vasta alussa, enkä tiedä, mikä sen lopputulema on, mutta itsetutkiskelua on tänä keväänä saanut harjoittaa. Tiedonhankinta on luonnollinen osa prosessia.

Ripponin ropellus jätti kuitenkin toivomisen varaa. Kuiva ja jankkaavaan rasittavuuten asti toisteinen teos. Kuinka monta kertaa voi kirjailija toistaa, että naiset on unohdettu ja naisia ei ole tutkittu yhtä lailla kuin miehiä ja tutkimuksissa on ollut mukana vain miehiä ja naiset on sivuutettu ja naisia ei ole huomioitu ja tutkijat ovat ylenkatsoneet sukupuolen merkityksen ja naiset puuttuvat jne., tajuamatta itse sabotoivansa itseään? Ilmeisesti satoja. Loputonta toistoa ei voi perustella millään. Naisten sivuuttaminen käy ilmi jo ihan teoksen nimestä. Jos joku ei pysty paria virkettä pidempään pitämään mielessä, mistä aiheesta kirjaa lukee, kannattaa ehkä harkita jotain muuta aktiviteettia.

Toteamus naisten huomiotta jättämisestä autismitutkimuksissa myös esitetään joka kerta ikään kuin uutena löydöksenä tai yllätyksenä – vaikka näin olisi tehty edellisen kerran muutama virke takaperin. Osaavalle kustannustoimittajalle olisi todella ollut töitä. Teoksessa käytetään ylipäätään toistuvia muotoiluja ja sanavalintoja puistatukseen asti. En halua enää ikinä kuulla, miten autistiset naiset "fly beneath the radar".

En osaa oikein edes arvioida, kuinka paljon teoksesta olisi voinut karsia. Kolmas- tai neljäsosa nykyisestä pituudesta olisi aivan varmasti riittänyt tasapainoiseen kokonaisuuteen, joka ei saa silmiä kääntymään ja jumittumaan koilliseen.

Muiden julkaisemista arvosteluista voi lukea kritiikkiä mm. termien käytöstä ja kömpelyydestä, jolla sukupuolen moninaisuudesta kirjoitetaan.

Itse jatkan puhuttelevamman kirjallisuuden ja oman identiteettini etsimistä.

[Jessica · Rating 5 out of 5]

✨ Thanks to NetGalley and Seal Press for providing a digital version of this book in exchange for an honest review.

For years, we heard that autism was mostly a "boy's thing." Sure, girls could be autistic too, but they were seen as outliers. What if we were wrong? What if we couldn't find as many autistic girls simply because we weren't looking for them?

This book is written by a neuroscientist, so it comes with actual science, which was sometimes a bit tough to read (I found the behavioral part easier to digest than the neuroscience one, but that's just me). It was fascinating—and depressing—to see how girls are being failed at every step. They don't get as many referrals, and when they finally see a specialist, the tests meant to diagnose them miss the mark because they're designed for autistic boys. No diagnosis means no support. And it goes on and on because all the data we use for diagnosis is based on those already diagnosed (boys).

Here's a little story time: I'm one of those girls, even if I'm a woman now, obviously. I got tested and the results said, "Well, you don't meet our threshold, but you meet enough criteria for us to think you're not neurotypical." That's probably the worst answer to get. Now it's too late for me as an older millennial, but if things could change for the girls and women coming after me, that would be enough. The part about the tests (there's one set used basically everywhere to diagnose) was weirdly validating for me (even if it won't give me a diagnosis), so I'd like to thank the author for that.

It's also a super interesting read if you're into learning about how research works and how science constantly recalibrates itself. We learn along the way and make changes. It was really cool to see this process in the context of autism research.

[Ashli Hughes · Rating 3 out of 5]

I picked this up as a late diagnosed autistic girl thinking I would be able to find some useful information, deeper understanding and a community (spoiler, I didn’t)

this book stated that autistic girls usually go undiagnosed or get diagnosed later in life because studies excluded them for such a long time- which sounds interesting until you realise that autistic women (and probably our family/friends) are already aware of this. it also mentioned that girls are more likely to mask, less likely to be believed as autistic due to us not matching the autism representations in the media and our autism is different than that of boys. which again, none of this is a lie but it’s such a base level information that barely begins to scratch the surface of what it’s truly like to be a woman with autism.

there were some case studies and personal experiences dotted throughout but this was mere sentences here and there to further prove one of the basic points mentioned above. there was very little that actually explored:
1) autism in adulthood
2) methods of coping / surviving
3) autism and misogyny in the wilder world
4) autism when you’re a woman of colour

I feel like this is an okay starting point if you’re looking to understand more about autism, but if you want a deep dive that will provide you with something new? this isn’t it

[Enea · Rating 3 out of 5]

Vote: 3.4

Disclaimer: is not a full 4 stars only because by background I am a neuroscientist so I found the neuroscience part a bit too simple for me personally (which on the other hand is also one of the strengths of this book though).

I quite enjoyed the book. First of all, I was absolutely not aware of the gender issues within autism, also, despite being transmasc myself, I did not know about how higher the rates are for trans people.
I found the book very well written, especially for a non-expert audience. It is rare to come across scientists that are able to be detailed but understandable enough in their writing when they produce a book on their topic of expertise. The book is accessible both to a larger audience and to an audience of experts, while not boring the latter. It adds another evidence to the pile of evidences that show how research and science and medicine overall have been tailored around the needs of cisgender white men, and how this approach has left undiagnosed and untreated all those who did not fit in the box developed for them.
Most importantly, the book left me with a lot of curiosity and the interest to look further into the topic, and I love when my interest is triggered to the point I want to expand my knowledge even beyond what I read.
I do think some of the sentences in the part talking about autism among transgender people could have been phrased better, but overall the topic was handled graciously and efficiently in my opinion.

[Danny_reads · Rating 3 out of 5]

3.5⭐

After seeing the title, I instantly knew that this was something I wanted to read - as it is a topic that I am passionate about.

I think the author did a good job of explaining why women have been excluded from autism research, and how autism manifests differently in girls. It was kind of nice to see my own experiences reflected in a lot of these studies.

Unfortunately, I did think the writing in this felt a bit dry, and kept me from becoming fully engaged. I did find myself zoning out on multiple occasions.

Thank you so much to NetGalley for providing me with an ARC of this book in exchange for my honest review!

[Becky · Rating 2 out of 5]

There are some good ideas here, as a neuroscientist myself I appreciate the authors efforts to explain some very technical concepts. However, all of that is over-shadowed by the consistent ableism and implicit othering. I do not believe this was the author's intent, but they really need to reconsider their framing of ideas and the way they use language.

[Mal · Rating 4 out of 5]

One important thing to note about The Lost Girls of Autism is that it's not a pop-sci book. The author is a scientist and an author of scientific publications, which shows in both the structure of her book (down to the Conclusion chapter, which is reminiscent of conclusion sections of regular studies published in scientific journals) and the language she uses in her writing. There are some low-star reviews on here that made me a little apprehensive about picking The Lost Girls... up, but having finished it myself I suspect that the authors of those reviews may just not be very used to reading actual scientific texts.

Rippon references a multitude of studies, offers a critical view of some of their findings and methodology, and is, in a typical scientific manner, careful not to make definitive statements unless she can really back them up. The book is more of a summary of the current state of research when it comes to autistic women (which is rather abysmal), but it also showcases some promising initial findings, around which Rippon builds her own hypothesis and presents what she considers to be solid potential ways forward. As an autistic AFAB person, I found the contents interesting but unsurprising, though also validating in many ways. It's definitely not a collection of fun, easily digestible anecdotes if that's what someone is looking for - though learning about geneticists attempting to study autism's genetic components by giving autism to mice and fruit flies was a highlight of the book for me. Some days I wished I'd become a researcher instead of whatever I'm doing with my life right now.

I'd say that this is the go-to book for when you find yourself wanting to find actual scientific sources for popular (common?) claims about autism in women: there is a severe problem of us being underdiagnosed, caused primarily by the fact that autism presents differently in us, which in turn leads to the vicious loop of diagnostic tools being primed for screening autistic boys/men, who are then the majority if not the only participants in studies, further driving the male-specific definition of ASD as well as male-specific findings. Meanwhile, brain imaging has shown that while both autistic men and women struggle with understanding social contexts, the presentation and reasons for these struggles are often different. There is some hope in the fact that in recent years, researches and diagnosticians have shown increased awareness of these things, mostly due to self-advocacy efforts.

That's more or less it - if you already "know" these things, you likely won't learn anything new from Rippon's book; but it is, in my opinion, a decent scientific summary of these findings.

[Demena · Rating 4 out of 5]

Sad but relatable. Important, as far as I'm any judge, and it was a good read.
The second half of the book gets a bit more difficult to digest if you don't have a background in the fields of psychology and neuroscience, but the author did try to make it work admirably. I did miss the intersection of ADHD and autism in this book, when the author does explore other comorbidities.

A definite recommendation to all my fellow late-diagnosed friends.

[Kelly Lambert · Rating 5 out of 5]

Well researched and structured for an accessible flow. Respectful, engaging, and informative. This book did exactly what it promised and discussed the inadequacy of science in ’missing’ out women from data collection (this isn’t exclusive to autism, as we all know) but this book includes important literature and historical information akin to autism that everyone should know about!

[Izzy E · Rating 3 out of 5]

I don't think there was much here that I didn't already know, but then again - perhaps this book isn't really aimed at me...
That being said, I do now intend to have the phrase "no specific quantitative norms are provided" tattooed onto my forehead.

[GONZA · Rating 3 out of 5]

It is finally being realized that autism takes different forms if you are a man or a woman, and lately there are several books on the subject. I liked this one because the author doesn't have trouble acknowledging her own and others' mistakes that were made until they continued to consider the autistic male, as the standard. Hopefully, these studies will continue.

Finalmente ci si sta accorgendo che l'autismo prende forme diverse se sei un uomo o una donna e ultimamente ci sono parecchi libri sull'argomento. Questo mi é piaciuto perché l'autrice non fa fatica a riconoscere gli errori suoi e di altri, commessi fino a quando si continuava a considerare il maschio autistico, come lo standard. Speriamo che questi studi proseguano.

I received from the Publisher a complimentary digital advanced review copy of the book in exchange for a honest review.

[Maggie Carr · Rating 4 out of 5]

"Autism's Lost Girls and Women have Long been overlooked, unrecognized, underdiagnosed, and left off the spectrum." This book explains how it happened and is a call to action to correct it, by a Cognitive Neuroscientist that says she was part of the problem and how she intents to improve research in the future. This book actually had me thinking about adults in my life and wondering if their tendencies are also attributed to undiagnosed autism instead of the cornucopia of labels they've been given.

[Molly]

an interesting book looking at what autism is (based on diagnostic criteria and also biological brain differences) & how it looks in women and why they have been historically missed. there's discussion whether sex differences in the brain are relevant and what's due to gender vs sex. she also often brings up the importance of listening to autistic people themselves.

[Joanne Wadsworth · Rating 3 out of 5]

Interesting and good discussion of loads of relevant studies - as I listened to this I don’t think I retained as much info as I could have!!

[Louise Hall · Rating 4 out of 5]

I requested The Lost Girls of Autism from my library because I’m in my third year of waiting for a formal diagnosis of autism.

As one of the Lost Girls, it shed so much light on my experiences from early childhood up until now. I recognised myself clearly in the first-person accounts of being female and autistic. It also makes sense as to why it took so long for myself and other women like me to discover we’re autistic given the historical male focus in research and diagnostic tools.

The brain-imaging data was fascinating but as a non-scientist, I did find it tricky to follow in places.

[Aubrey Bass · Rating 3 out of 5]

I'll save you the read and say that to every question you've ever had about girls with autism, the answer is camouflage-ing. Turns out (with no surprise to any woman) that girls are more adept at blending in socially than boys and therefore go undiagnosed. Also, anyone who's read info on the lack of research on girls shouldn't be surprised to hear there is also.... little to no research on girls with autism. I didn't feel like I learned anything mind-blowing about this topic, more like "we don't know much, but here's our meager research and best hypothesis."

The things I learned from this book were actually more about autism in general and that somehow Asperger syndrome is no longer a diagnosis. I'm not sure how that escaped my notice, but that was the most shocking news I received. I do feel like I have a better awareness of autism now, but this novel talked in circles and could have been heavily condensed.

[Sharon · Rating 5 out of 5]

An incredible book - as a late-diagnosed autistic woman, I felt understood.
It's shocking how there was a Russian woman scientist, way back in the 1920s, who observed that there were almost as many autistic girls, as boys, and that autism had different characteristics in girls. But this appears to have been ignored by Kanner, a German scientist, who put forward that autism only really affected boys, even though there is evidence that he, also, observed it in girls, too. This has meant about 80 years of research into the male-type autism with very little understanding of how autism affects females differently, and development of testing which actually misses a lot of female autists.
Researchers now know that there are two types of social behaviour in autism. There's the Kanner group of autistic individuals, with the traditional pattern of social withdrawal and aloofness and a lack of interest in social interaction (more often represented by autistic males). Then there's the autistic Chameleons, who make highly proactive attempts to mask their autistic behaviour, driven by an intense desire for social interaction (more often female).
Studies of the brain have also shown that the usual feedback system which helps people to fit in socially, by giving them a negative feeling when they make a social error, is amplified in autistic Chameleon's brains. So not only do autistic females struggle to understand social rules, and make more mistakes, but their brains give them stronger negative feedback every time this happens, only increasing their already high anxiety.

[Gina Sconyers · Rating 2 out of 5]

Thank you to NetGalley and the publishers for an advanced copy.

As a mother with an autistic daughter I had very high hopes that this book would give me some insight, guidance and give me ideas on how to be a better advocate for my daughter. Unfortunately that was not the case and I was unable to finish the book. I got about halfway through before giving up. It seemed to just be repeating and reproving that there was not enough research in female autism. That is a fact that is very understood to me and probably to anyone dealing with female autism. Nobody needed to prove that so many times within a book. I was hoping for new groundbreaking research. Maybe that is near the end of the book? Who knows? I couldn’t suffer through to get there.

[Vikki · Rating 3 out of 5]

Interesting, but very dry and academic.

3.5 stars

[Sarah Augustin · Rating 2 out of 5]

She calls out the harmful impact Baren-Cohen has had yet is blind to her own harmful language.

Problem?
Miswiring?
Gone wrong??

This language is outdated and pathologising. What impact do you think this has on autistic readers?

Autism is not a problem to be solved. Autism is a neurotype not a defect. My brain is different, not broken or inferior.

[Katie · Rating 3 out of 5]

Important message, bit repetitive writing.

[Fiona · Rating 5 out of 5]

If you have any interest in why so many women are being diagnosed with autism in middle age, this book is a hard hitting, at times quite emotional read.

[winnie · Rating 5 out of 5]

shout out Gina Rippon :]

i really liked this as literature overview on some of the research on ASD + the history of the diagnosis. the emphasis on neurobiological studies makes sense, considering Gina Rippon's background. i think some of the negative reviews were expecting the book to be focused on biographical/personal accounts of autistic women, but i'm very happy with the more academic lens! i haven't been able to get into a lot of other recommended ~autism books~ because they lean much more self-help or memoir. it would be interesting to read more in-depth analysis of how gendered socialization contributes to this particular phenotype, and especially about gender nonconformity and autism (i think the ways in which autistic women are gender nonconforming sheds light on gender norms in general) buuut that in-depth analysis deserves its own book (hiiii cordelia fine). when it is brought up though, its brought up in an insightful way!

my biggest criticism is how ADHD largely goes unmentioned. it'd be interesting to discuss how AuDHD masking is its own sub-archetype. but i still enjoyed this a lot!

[Natalie Coyne · Rating 4 out of 5]

This book was great and very informative. I was, for some reason, under the impression that the author was, herself, a late-diagnosed Autistic woman, so I was caught off-guard when I read "neurotypicals such as myself" in the conclusion, but honestly I think I would give her more props for writing this as a neurotypical researcher.

Some other reviews almost scared me off of reading this (talking about how overly scientific it is, not a clear point, etc.), but I am glad that I read it. I didn't personally find that to be too much of an issue for me, though I understand how it can be for some people. But I will admit that some of the stuff in the actual chapters about neuroscience/biology flew right over my head, as I was definitely more interested in the chapters about topics related to the history of research, psychological impacts, sociological issues, and so on. That is what brought it down from 5 stars to 4 stars. But I wouldn't necessarily say this is a book to avoid, as it was still, largely, easy to read.