It’s no longer an official diagnosis, but when it was, Asperger’s tended to be diagnosed less among females than males. This led to many women with Asperger’s masking or disguising their symptoms, which could complicate long-term prognosis and treatment. 

What Is Asperger Syndrome?

Asperger syndrome, or Asperger’s, is a neurodevelopmental disorder where people experience challenges in nonverbal communication and social interaction. Many also have restricted interests and repetitive patterns of behavior when stressed or scared. 

Asperger syndrome is a form of autism spectrum disorder (ASD) but is different from other presentations of autism. This is because people with Asperger’s have a relatively unimpaired level of language and cognitive ability. 

Like autism, the causes of Asperger syndrome are not fully understood. Geneticists currently believe that people inherit the condition, but they have not identified the genes that might be responsible for this. Similar to autism, the development of Asperger’s might involve environmental factors. 

In 2013, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Volume 5, removed the separate diagnosis of Asperger syndrome and folded it into the diagnoses for autism and pervasive developmental disorder not otherwise specified. However, the International Classification of Diseases continues to list Asperger’s as a distinct subtype of autism spectrum disorder. 

Asperger’s & Gender

Past research has shown that while an Asperger’s diagnosis for boys can start as early as age 2, it might take a girl with Asperger’s up to 18 years to be properly diagnosed. One reason behind this is because of gender roles that often reinforce the idea that girls should be quiet, withdrawn, shy, and neat. These characteristics overlap with many of the common presentations of Asperger syndrome. 

This has led to a phenomenon known as “masking,” which is where a person with Asperger’s hides their symptoms, passing themselves off as a neurotypical person (that is, a person without any form of ASD). This can entail faking eye contact during conversations; mimicking smiles, gestures, and other expressions; scripting conversations and rehearsing answers to questions; hiding stimming (self-stimulating comfort behaviors); and enduring sensory discomfort. 

People with Asperger syndrome are typically able to mask to a better degree than those with other forms of ASD due to a higher intellectual ability. They do so to avoid bullying or other stigmas, and because they can tell that something important hinges on them being perceived as a neurotypical individual. 

Masking is an incredibly difficult and challenging experience for those with Asperger’s, and it takes a significant toll on their mental and emotional health. The Journal of Autism and Developmental Disorders wrote that women who masked to appear neurotypical reported feeling drained and depressed by the constant effort; in some cases, this has led to suicidal ideation.

Girls & Asperger’s

Boys and girls are both capable of masking, but research has found that girls tend to mask more than boys because many girls are socialized to be quieter and more reserved, and take up less space than boys. When a boy presents with symptoms consistent with those of Asperger’s, it is more noticeable. 

Many girls are not diagnosed with Asperger’s until they are in their late teens, by which point they have likely had to mask for many years to cover up for (unseen and unacknowledged) neurodevelopmental challenges. Girls who grow up with Asperger’s become very good at developing coping mechanisms to overcome the social setbacks of being on the spectrum, ironically making it harder for parents and teachers to note that something is wrong. 

This also affects diagnosis rates for women who have the condition, which has led some researchers to ask, “Where are the girls?” Even as the degree of recognition of autism spectrum disorders has drastically increased since the 2000s, there is a gaping gender gap regarding women being diagnosed with forms of the disorder that are on the milder end of the spectrum, such as Asperger syndrome. 

Treating Asperger’s Across Gender

Providing treatment for Asperger syndrome includes several pharmaceutical and therapeutic options. These options may differ based on a person’s gender. For example, Psychology Today explains that women who have autism are more likely to have anxiety and depression, largely due to the effort of masking. 

For this reason, offering treatment to women with Asperger’s might require a specialized focus. So many women with Asperger’s syndrome have become so good at masking that they might struggle with the social aspects of therapy, such as fully opening up to a therapist. This can make it challenging for the therapist to know how they can best help their client. 

For a woman with Asperger’s syndrome, therapy needs to cover all the parts of their life affected by the disorder. This might entail a woman’s partner being a part of her therapy or working with her therapist to create a strategy to help her express her needs to her partner. These are dynamics that tend not to exist with men with Asperger’s.

Asperger’s & Gender Dysphoria

Another gender dynamic in the rates of diagnosis of Asperger syndrome is that young people with gender dysphoria have been found to have an elevated rate of Asperger’s. Gender dysphoria describes a state of distress in a person who feels they are a different gender from the one with which they were born. 

A study by the LGBT Health journal reported on “growing evidence supporting increased prevalence of autism spectrum disorder in gender dysphoric children.” As recently as 2020, another study in the Nature Communications journal noted that people who do not identify with their assigned sex at birth are as much as six times more likely to be on the autism spectrum compared to cisgender people (those who identify with their assigned sex at birth). 

Other research had previously established that people with autism are more likely to be gender diverse compared to neurotypical people.

In terms of treatment, researchers called for clinicians, doctors, and educators to become more familiar with gender identity and dysphoria, and to be aware of the effects of minority stress — the challenges that come from being part of a marginalized group — on mental health. Being both gender diverse and having Asperger syndrome can intensify such stress as people might have to mask on two different levels: one to cover up their autism and the other to cover up their authentic gender identity. 


Asperger Syndrome: History, Diagnosis and DSM-5 Changes. (December 2014). Psychiatry Advisor.

Autism — It’s Different In Girls. (March 2016). Scientific American

The Role of Gender in the Perception of Autism Symptom Severity and Future Behavioral Development. (March 2019). Molecular Autism

My Daughter’s Autism Diagnosis at 23 Shows How Easily Girls Can Mask the Warning Signs. (January 2019). ABC News.

The Experiences of Late-Diagnosed Women With Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. (2016). Journal of Autism and Developmental Disorders

Gender Differences in Self-reported Camouflaging in Autistic and Non-Autistic Adults. (February 2020). Autism

The Gender Gap in Asperger Syndrome: Where Are the Girls? (March 2008). Education Resources Information Center. 

What Do Women With Autism Need From Therapy? (November 2020). Psychology Today

Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic. (October 2016). LGBT Health.

Elevated Rates of Autism, Other Neurodevelopmental and Psychiatric Diagnoses, and Autistic Traits in Transgender and Gender-Diverse Individuals. (August 2020). Nature Communications

Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals. (November 2018).  Journal of the American Academy of Child and Adolescent Psychiatry.

Brief Report: Gender Identity Differences in Autistic Adults: Associations with Perceptual and Socio-cognitive Profiles. (December 2018). Journal of Autism and Developmental Disorders