The Invisible Spectrum: Gender Disparities in Autism Diagnosis and the Underrecognition of Autistic Girls and Women

Introduction: Autism Spectrum Disorder (ASD) is a relevant neurodevelopmental condition, whose understanding has historically been centered on the male profile, contributing to the invisibility of girls and women in the diagnostic and support systems. Objectives: This review investigates the factors that contribute to the invisibility of autistic girls and women, highlighting gender disparities in the diagnosis of autism and the clinical and social impacts of social camouflage, especially in cases of late or absent diagnosis. Methods: This integrative literature review (2020–2025), based on studies from PubMed, Scopus and Web of Science databases, investigated gender disparities in the diagnosis of autism, focusing on social camouflage and its clinical impacts. Results: The findings indicate that the real ratio between autistic men and women may be lower than the traditional one (4:1), with estimates between 2–3:1 or even 1:1. Approximately 50% of the studies analyzed reported significant underdiagnosis in girls, with diagnosis often being delayed. Social camouflage strategies, more common in autistic women, hinder clinical identification and are associated with a higher risk of mental disorders. Conclusions: It is concluded that underreporting of autism in women is a public health problem, requiring a review of diagnostic criteria with gender sensitivity, adequate professional training and centrality of female experiences in clinical practices and research.