The Lost Girls of Autism.

How Science Failed Autistic Women.

Rippon, G. (2025). The Lost Girls of Autism: How Science Failed Autistic Women [Cover image]. Pan Macmillan.

I recently listened to The Lost Girls of Autism: How Science Failed Autistic Women by Gina Rippon as part of the research for my paper, and I’m still taken aback by how much of it hit home. I didn’t expect to get emotional, but I did. Again and again, I found myself pausing the audiobook, feeling like someone had finally put words to things I’ve experienced for most of my life. Things I had never heard explained before, or had assumed were just faults in the way I functioned. But here they were, described with clarity, backed by research, and most importantly, shared by others.

One of the main threads in the book that stood out to me was masking. It’s the idea that many autistic people, especially girls and women, learn to hide their traits in order to fit in. Sometimes it is conscious, but often it becomes second nature. You mirror others, script conversations in your head, rehearse how to look relaxed or engaged, even when you are completely overwhelmed. What I found striking is how early this starts. Rippon mentions that babies begin to diverge in how they interact with the world from around four months old. Girls are often spoken to using more emotive and socially expressive language, which can lead to earlier development of social mimicry. In autistic girls, this might lead to masking so early that it becomes completely ingrained before they are even able to speak.

This early conditioning might help explain why so many autistic women go undiagnosed. The "gold standard" of autism diagnosis was built around traits commonly seen in boys. These were often external and more obvious to spot, such as repetitive behaviours or delayed speech. But when autism presents differently - more internally, subtly, or through emotional overwhelm - it often goes unrecognised. Diagnostic models have historically filtered out autistic women because they were not built with us in mind. That realisation explained so much.

Looking back, I can see how much of my own life fits within this context. I have always struggled with anxiety, especially in social situations. I hate crowds, airports, and anywhere I feel like I don’t have control. I’ve spent years rehearsing conversations in my head, going over every possible version of small talk just so I wouldn’t freeze when it came to actually speaking. I’ve kept lists of safe talking points in my mind for when social etiquette made them necessary. These might sound like small things, but they take up a huge amount of mental space. They’re exhausting. And all the while, I thought this was just part of being broken or overly sensitive.

I’ve also had periods of depression and OCD, especially in high school and my early twenties. At the time, these were seen as isolated issues. But now, with what I’ve learned, it feels more like a pattern that was never recognised. These were likely symptoms of unrecognised autism, shaped by years of masking and not understanding my own needs. Rippon’s book describes this as a common experience among autistic women and non-binary people, whose mental health challenges are often treated in isolation, rather than as part of a bigger picture.

In recent years, my physical health has also become more complex. I live with fibromyalgia, and for a long time I assumed it was mostly down to my spinal curvature and hypermobility. But I’ve started to wonder if there’s more to it than that. If long-term stress, chronic masking, and the constant effort to "pass" have taken a toll on my nervous system in ways I never fully understood. I know now that the mind and body are not separate, and I can’t help but think that years of living in a state of hypervigilance may have contributed to my pain and fatigue. This isn’t something the medical world talks about enough, but it’s starting to come up more in the lived experiences of autistic people, particularly those who were diagnosed later in life.

The statistics are telling. For decades, the assumed male-to-female autism diagnosis ratio was around 4 to 1. But more recent research suggests it could be closer to 2 to 1, and even that may not fully reflect the reality. There are many autistic people who have been missed entirely, especially those who are good at masking, or who do not fit the outdated and gendered stereotypes that diagnostic criteria are still based on.

The cost of masking is not just exhaustion. It can erode your sense of self. You learn to perform rather than be. You start to question your instincts, your reactions, even your memories. That lack of belonging becomes something you carry in every space you enter. And yet, our need to belong is so deeply rooted. It is not just emotional but physical. There is something instinctive, even animal-like, in our desire to be part of a group, to feel at home in the world. When that connection is missing, it does something to your sense of identity.

These themes of identity, memory, and belonging sit at the heart of my creative work. I’ve often felt drawn to places that seem to echo with something unspoken. Spaces that feel half-remembered, or where I’ve felt both connected and disconnected at once. The tension between visibility and invisibility, between being present and being seen, runs through my artwork. I often explore this through ink landscapes that hold both movement and stillness, reflecting the push and pull between who we are and who we think we need to be.

Rippon’s book left me with more than just a clearer understanding of autism. It gave me a deeper awareness of how much of my life has been shaped by systems that never accounted for people like me. But it also gave me language and context. It offered a new lens for understanding my experiences, and a way to reconnect parts of myself that have long felt fragmented.

Since finishing it, I’ve also started reading Unmasking Autism by Devon Price. That book, too, has felt like a kind of quiet revolution - a guide not just to recognising my patterns, but to beginning the process of unlearning them. I want to try, gently and consciously, to start unmasking. To stop apologising for how I move through the world. To live more authentically, for the version of me that never had the words, and for the version of me that is still to come. It’s not easy, but it feels necessary.

There is a growing shift in research and public understanding of autism. More inclusive models are being developed. Lived experience is being taken seriously. Researchers are beginning to ask different questions - ones that include emotion, sensory experience, and the long-term impact of masking. This shift towards complexity and context feels long overdue, but it is happening.

This book didn’t just inform my research paper. It changed the way I think about myself, my work, and the stories we tell about who belongs and who doesn’t. It reminded me that the disconnect I have often felt isn’t a personal failing. It’s the result of being filtered out of the narrative. Now I’m finding ways to write myself back in - both through language, and through the landscapes I build in ink.