Women and Late ADHD & Autism Diagnoses
I’ve been having so many conversations lately with women (and AFAB folks in general) who are just now being diagnosed with ADHD or autism, sometimes in their late 20s, 30s, 40s, 50s, or later. And while it can feel validating to finally have language for your experiences, it can also stir up a mix of emotions: relief, grief, anger, confusion, even hope.
Why So Many Women Were Overlooked for ADHD and Autism Diagnoses
For a long time, ADHD and autism research focused almost exclusively on boys. The diagnostic criteria were developed based on studies of hyperactive, outwardly impulsive school-aged boys… not quiet, perfectionistic, or internalized presentations that we are seeing more commonly in girls and women.
So when girls showed up differently… Maybe it looked like
zoning out
overachieving
working long hours
large emotions
or people-pleasing
Challenges were often dismissed as “just being sensitive” or misdiagnosed as anxiety, depression, or borderline personality disorder.
And to be fair, those emotions were real, but they were often symptoms of living in a world that didn’t recognize or support how our brains worked. As a result, many undiagnosed folks did meet criteria for a mood or anxiety disorder. And maybe they sought support.
But even after years of therapy and medication targeting anxiety or depressive symptoms, the same challenges often persisted:
overwhelm, executive dysfunction, difficulty focusing, and exhaustion from constant masking. This can be incredibly frustrating: feeling like you’ve “done ALL the right things” and yet something still isn’t clicking. That’s often when people start wondering if there’s more to the picture.
Women (and many nonbinary folks) often learn early on that their value comes from being organized, reliable, kind, and easy to be around. They work extra hard to meet those expectations, which can hide underlying executive functioning struggles. What gets praised as “high-functioning” or “driven” is sometimes just burnout in disguise.
As Dr. Thomas Brown writes, ADHD isn’t a lack of intelligence or motivation, it’s a difference in how the brain manages and prioritizes information
& when that difference goes unnoticed, people learn to push themselves harder instead of getting support.
Masking and Women: the cost of “Looking fine”
Masking is one of those terms that comes up a lot in neurodivergent spaces, and for good reason. It’s essentially a survival skill: the unconscious (or sometimes very conscious) effort to blend in, to act “normal,” to minimize the parts of yourself that might be judged.
Masking can look like:
Forcing or monitoring eye contact when it’s uncomfortable
Memorizing social “scripts” to navigate conversations
Taking on more work to prove you’re capable
Downplaying sensory sensitivities (“I’m just picky”)
Hiding emotional overwhelm until you’re alone
Monitoring how much or how little you are talking
Over time, this takes a real toll; mentally, physically, and emotionally.
Many late-diagnosed women describe hitting a wall in adulthood: burnout, exhaustion, anxiety, or even physical health issues that stem from chronic stress.
Dr. Devon Price, in his book Unmasking Autism, talks about how masking is often about survival, and how unmasking, while freeing, can also feel terrifying. It’s not just about showing your “true self”, it’s about re-learning who that even is after years of adapting to fit in.
The Rise in Adult Diagnoses
In the past decade, more adults have started recognizing themselves in ADHD and autism content online. TikTok, podcasts, and blogs have made neurodivergence visible in ways that clinical systems never did. People are realizing: “Oh… that’s me.”
Clinicians have been catching up too. We’re starting to see a shift toward neurodiversity-affirming assessment and care… meaning we’re not trying to pathologize difference, but to understand how neurodivergent brains impact daily life, relationships, and mental health. More practitioners are beginning to recognize that ADHD and autism can look very different from the textbook examples many of us grew up with. Assessments are becoming more nuanced, taking into account gender, culture, trauma, and the effects of long-term masking. This is especially important when using standardized tools, which can sometimes miss lived experiences that don’t fit neatly into diagnostic checkboxes or consider masking.
At our clinic, many adults come in after years (sometimes decades) of feeling as though they are different, or struggling a lot, but never get clear answers. Some were previously diagnosed with anxiety or depression (which can absolutely coexist with ADHD or autism) and
others were told they “just needed better routines.”
Accessing assessments:
If you’ve been learning about neurodivergence and are starting to see yourself in these experiences, you might be wondering whether to pursue a formal assessment, and what that might actually look like.
Readiness for an assessment can mean a few things. For some people, it’s about feeling emotionally prepared to revisit past experiences through a new lens. For others, it’s about reaching a point where you want clarity, not necessarily a “label,” but a clearer path forward to understand how to better support yourself.
If that sounds familiar, you might want to check out our blog post on navigating adult ADHD and autism diagnoses in Canada. It breaks down the different providers who offer assessments, varying costs and wait times, and overall what to expect. If you want to start with speaking with your family physician, we also have a guide here on talking to your doctor about suspected ADHD.
Why a Late Diagnosis Can Bring Big Feelings
Getting a late diagnosis often stirs up a lot … grief for the years spent misunderstood, anger at being overlooked, and even relief that it finally makes sense. And all of that is completely normal.
Many people start replaying old memories with new context. It can be heavy to realize how much you were masking or missed out on just to survive.
That grief deserves space.. a real, messy space. You don’t have to rush to feel “grateful” or “empowered” right away.
But alongside these challenges, after a diagnosis, we start to see A LOT of progress with our clients. Many of our clients describe a sense of relief and clarity once they finally have a framework to explain how their brains work.Of course, it’s still messy, even after a diagnosis, moments of self-doubt and self-invalidation are there. This is where support becomes crucial. Understanding your brain is one thing, but figuring out how to live well with it is another. That’s where occupational therapy can help.
Building Support That Actually Works for You
Occupational therapy (OT) for adults with ADHD and autism focuses on practical, compassionate support — not “fixing” who you are, but understanding what actually works for your brain.
That might mean learning sustainable systems for daily tasks, rethinking productivity in ways that honour your energy, or working through the impacts of burnout and masking.
A lot of traditional strategies for organization, focus, or emotional regulation assume a neurotypical baseline, which can make clients feel like they’re “supposed to work” but never quite do. Neurodiversity-affirming OT flips that on its head: instead of forcing yourself into systems that don’t fit, we co-create approaches that do.
Many clients describe this shift as a kind of unlearning, letting go of rigid expectations about what “should” work and instead noticing what actually feels doable. It’s often less about adding more structure or effort, and more about giving yourself permission to build systems around your real energy, attention, and sensory needs. Progress becomes less about perfection and more about ease, sustainability, and self-understanding.
If you’re curious about neurodiversity-affirming occupational therapy for adults in Canada, our team offers support for ADHD, autism, anxiety, and burnout. We’d love to connect and help you explore what living authentically might look like, one sustainable step at a time. :)
You can learn more on our services page, or book a consultation call with a member of our team.
-Lisa :)
