Nearly every single woman who comes to us for an autism assessment has already received a medical diagnosis for a mental health condition. Most often it’s anxiety, depression, complex PTSD (C-PTSD), social anxiety, eating disorder, BPD (borderline personality disorder), EUPD (emotionally unstable personality disorder), or bipolar disorder.

And whilst some of these diagnoses may describe parts of their experience—often because they’ve been impacted by environments that don’t understand them—there are many problems with not being understood as autistic first.

Mental Health Diagnoses Can Delay Autism Recognition

One of the biggest issues is that being given a mental health diagnosis often stops curiosity into whether someone might actually be autistic. Many of the women we meet only start to reconsider this later in life—often in their 40s or 50s—when burnout or breakdown forces them to question the original diagnosis. By then, they may have lived decades believing something unhelpful (and often untrue) about themselves.

Treatments Can Be Inappropriate—and Harmful

It’s incredibly painful to hear how often autistic women have been recommended therapies that don’t fit. For example, women misdiagnosed with EUPD being sent to DBT group therapy. For an autistic person, those groups can be deeply traumatic—adding another layer of pain on top of an already difficult journey. Some women we’ve assessed have been prescribed medication that does not suit their sensitive bodies.

Many women have been in psychological therapies that don’t help, because they’re missing a fundamental piece of who they are.

Knowing you are autistic is essential within any therapeutic support. Without that knowledge, therapy is unlikely to be as effective—and in some cases, it can even harm.

When Treatments Don’t Work, Shame Grows

Another painful consequence of misdiagnosis is what happens when the recommended treatments don’t help. Instead of questioning whether the diagnosis is correct, many women turn the blame inward:

• “I’m so bad or broken that even therapy doesn’t work for me.”
• “If the treatments don’t help, it must be my fault.”

This cycle of shame and self-blame is devastating, and it’s one of the reasons why autism assessments are often such highly emotional processes.

Why Autism Assessments Are Emotional

When women finally arrive at an autism assessment, they bring with them years of unhelpful stories told about who they are.

💔 No wonder there’s so much relief in finally being diagnosed as autistic—they realise they are not broken after all.

💔 No wonder there’s grief and anger post-diagnosis, as they begin to process how long they were misunderstood or let down.

This mix of relief, grief, and hope is something we witness often. And it’s exactly why our service is not a quick “in and out” assessment.

Why Our Assessments Are Different

At Autistic Girls, we don’t just assess for autism and ADHD. We carefully screen for other conditions and experiences, so we can rule them in or out with confidence. That way, we can be certain about any diagnosis we give.

This is what an autism and ADHD assessment should be—but sadly, it often isn’t in other services.

Our process goes beyond diagnosis. We support women to:

✨ Let go of unhelpful or incorrect stories

✨ Understand their autistic identity, possibly in the context of other mental health diagnoses.

✨ Begin a new chapter with clarity, compassion, and hope

A Call for Change

I really hope more professionals begin to consider autism before diagnosing mental health conditions in women. It could prevent so much unnecessary trauma. It could spare women decades of shame and confusion. And it could allow them to access support that truly fits who they are. Because when autistic women are finally seen for who they really are, everything changes—for them, their families, and their futures.

If you'd like to explore an autism or AuDHD (autism and ADHD assessment) with us, book a screening call here.