Too Smart, Too Polite, Too Screwed

The Invisible Epidemic of Undiagnosed Autistic Women

“None of them were wrong—anxiety, depression, insomnia, female…they just weren’t complete. Like diagnosing a house as drafty while ignoring the fact that the living room is on fire.”

Chaotic Goodisms

Let’s begin with a scene, shall we. A girl bright, rule following, prematurely fluent in adult discomfort sits in a second-grade classroom blinking at the overhead lights like they’ve personally betrayed her. She is not disruptive. She does not bark, bite, or behave like the boys who get shunted into "behavioral support." No one is collecting acronyms on her behalf. No one is observing her from the back of the room with a clipboard and a tight-lipped expression of bureaucratic concern. No, this one is “doing just fine.” She reads three grades above level. She apologizes when she coughs. She has already internalized that her own needs are inconvenient and possibly fictional.

She is me. Or you. Or ten thousand of us, post-masking, post-burnout, post-crisis, post-wellness-influencer-exorcism, staring into the abyss of adult life wondering how we’ve survived this long without anyone noticing the house is on fire. The house being our nervous systems. The fire being society.

Diagnosis, in this context, is less a form of clarity and more like opening a drawer marked “Miscellaneous Screaming” and discovering every single childhood memory filed under Misunderstood or Medicinally Gaslit.

We are not difficult to diagnose. We are difficult to believe.

The autistic female, biologically or socio-culturally shaped, typically arrives at adulthood by way of weaponized agreeableness. She does not stim publicly. She does not complain unless someone tells her it’s safe to, and even then, she defaults to offering snacks and over-apologizing for the weather.

Clinical literature, for the most part, imagines autism as a slightly antisocial twelve-year-old white boy who loves trains and struggles with eye contact. You know the one. The diagnostic criteria still smell like a boys’ locker room full of unexamined bias and unwashed hoodies.

Meanwhile, the girls? They memorize the rules. They become the rules. They get praised for quiet compliance while slowly accumulating emotional concussions from all the masking. Their sensory issues get reframed as “high maintenance.” Their meltdowns are dismissed as hormones. Their rigidity is called perfectionism. Their pattern recognition is repackaged as intuition, which everyone loves until it starts making them uncomfortable.

Eventually, they collapse. But collapse politely.

There is a moment in every late-diagnosed autistic woman’s life that feels like the psychological equivalent of finding a secret trapdoor beneath her own personality. You tug on a thread that looks like chronic fatigue or perpetual social confusion or this vague, humming sensation that you are faking your entire existence in order to be palatable. You follow the thread, and down you go.

I followed mine around age thirty-four. It was tangled up in phrases like “you’re just too sensitive” and “you’re so smart, why are you so anxious?” and “you just need more structure,” which is hilarious because structure is the thing I’ve both craved and rebelled against like it’s a Calvinist god with inconsistent Wi-Fi.

I was diagnosed with ADHD at ten, anxiety somewhere in my twenties, PTSD and MDD by thirty-three. I’d already collected labels like anxiety, depression, insomnia, adrenal fatigue, and the ever-popular catch-all: female. None of them were incorrect. They just weren’t sufficient. Like diagnosing a house as “slightly drafty” while ignoring the fact that the living room is actively engulfed in flames and the smoke alarm’s been quietly weeping in the corner for years.

The performance of wellness among neurodivergent women is something that deserves its own dissertation, or at least a limited run HBO series. We get so good at self-monitoring that we can actively dissociate while also choosing the polite salad, smiling at the server, and giving directions to a place we can no longer emotionally reach. We are praised for our self-awareness while being punished for our actual needs.

And let’s be honest. Most of us didn’t go undiagnosed because we were “high functioning.” We went undiagnosed because we were high performing emotional labor robots who learned early that authenticity is only acceptable when it’s attractive.

Co-occurring ADHD doesn’t help. It just adds flair. You’re not just overwhelmed. You’re overwhelmed in five different directions with thirty tabs open and no memory of why you entered this room. You’re not just overstimulated. You’re overstimulated while also over obligated and under-caffeinated, navigating the sensory hellscape of adulthood with a nervous system that wants to live in a soundproof cave but also needs Target to stay emotionally regulated.

Most mental health professionals still miss it. They see the coping mechanisms and assume competency. They see the vocabulary and assume resilience. They see the eye contact and assume comfort. They don’t see the pre-rehearsed scripting, the hours of mental preparation, the sobbing after social events, the exhaustion of pretending to be coherent in spaces that feel like psychic sandpaper.

The invisibility is not accidental. It’s structural.

What we need urgently, actually, in the way one might need oxygen or non-fluorescent lighting is a collective relearning of what autism looks like in girls. Not what the outdated textbooks say. Not what some dusty male pediatrician decided based on a sample size of five disruptive third graders and his own discomfort with emotion. I mean what it actually feels like inside a girl who’s never had the luxury of being obvious.

Because it doesn’t look like flapping or silence or a fascination with train schedules. It looks like perfectionism so punishing it becomes a personality. It looks like apologizing before asking a question. It looks like chronic exhaustion from constantly decoding social cues that everyone else seems to absorb through osmosis. It looks like being praised for how “mature” you are while quietly developing an ulcer from the pressure of being likable.

It looks like disappearing yourself by degrees. Smiling through sensory hell. Becoming a human spreadsheet of everyone else’s expectations.

The problem isn’t that autistic girls don’t show signs. It’s that we’ve been conditioned not to see them unless they arrive with discomfort we can’t ignore. And autistic girls especially the high achieving, overly articulate, emotionally clairvoyant kind are experts at not making anyone uncomfortable but themselves.

So, we reward the camouflage. We pathologize the fallout.

And then we call it a mystery.