Gender Differences in Neurodiversity Diagnoses

Ahead of International Women’s Day on 8th March, it seemed fitting to talk about one of the biggest topics in Neurodiversity: varying rates of diagnoses between genders.

Surely the stats are what they are?

With ratios for many neurodivergent conditions showing greater prevalence in males than females, that would be an easy conclusion to come to; the idea that the data is reflective of reality. But we have to look at the wider context. Male:female dyslexia ratios have decreased from 9:2 in 1970 to 3:2 in 1998. The estimate of gender ratio in autism ranges from 1.3:1 to 16:1. The story is similar for other neurodivergent conditions.

Better understanding of Neurodiversity

As academics have started to question gender ratios in neurodivergent conditions, more research has been commissioned on this topic, like this piece showing that gender variation in dyscalculia diagnoses actually depends which diagnostic criteria are used. Research is showing more equal distribution between the genders, and this is turn is helping us to understand that our diagnostic criteria – and subsequently our interpretations of the diagnostic criteria – are gender biased. This piece from the Dyspraxia Foundation says that primary school teachers of dyspraxic girls were less aware of their symptoms than teachers of dyspraxic boys, and it’s easy to see why:

Boy tapping his foot = annoying

Girl tapping her foot = send her to ballet class

Boy lines up his cars = non-imaginative play

Girl lines up dolls = fashion show

Boy knows detailed train times = “Special Interest”

Girl knows Take That’s international tour schedule = Superfan

In addition to these inherent differences in how we view similar behaviours, girls seem to be better at what is called “masking”. Masking means putting extra effort in to make it look like you’re not struggling. It can involve mimicking friends or repeating lines from films or TV shows to hide the fact that your brain just can’t think of what to say next in a conversation. It could be asking someone to read something for you with a made up excuse so they don’t realise you’re dyslexic. Or saying “No, here’s fine” when your friend picks the table in a draughty spot in a restaurant. Under the speaker system. And a fluorescent light.

What impact does this have?

Missed diagnosis and misdiagnosis can have a devastating effect on girls and women. Imagine going to the doctor with a broken arm and the doctor saying “Yes, there’s definitely something wrong with your arm, let’s give you steroids to increase your muscle mass and see how we go.” This is happening to women who are being medicated for conditions they don’t have because the clinicians don’t recognise their presentation of a neurodivergent condition.

For even more women, Neurodiversity has an impact on mental well-being. Yes, our brains might have a minority wiring, but we feel isolated and “different”. When we don’t have a rationale for that difference and we can’t see it mirrored in the people around us that can really take it’s toll. This piece in The Times is from a lady in her 70s asking if it’s too late to get an autism diagnosis. Why get a diagnosis in that stage of your life? Because it’s confirmation that actually, you’re not weird or lazy or a failure, you’re just autistic, and there are other people out there just like you.

Next Steps

What to do if you think you are neurodivergent

Some people might signpost to a psychologist in this scenario, but I advocate for connecting with other neurodivergent people as a first step.

Why? Because a visit to a psychologist could result in a lengthy or expensive diagnosis process, and this isn’t about having a piece of paper in your hand at the end of the day. Neurodiversity isn’t something to frame and put on the wall. It’s about working out what works for you.

Self-diagnosis is valid among the neurodiverse community, so meet other neurodivergent people (online is a great place to start), and see if what they’re saying resonates with you. You will likely pick up some tactics for making your life a little easier too.

What to do if you think your child is neurodivergent

Again, it is worth connecting with other parents of neurodivergent children and also with neurodivergent adults, but you might also want to look at diagnostic criteria – adjusted for girls if you are looking for your daughter. There will likely be some signs to look out for that you weren’t necessarily expecting, such as:

For dyslexia: perfectionism, inconsistency and/or hyper-organisation

For ADHD: anxiety, low self esteem, day dreaming

For autism: anxiety, shyness, black and white thinking

If you think a friend is neurodivergent

Someone once said to me, “No one needs unsolicited feedback.” And while I do agree – the realisation you are neurodivergent can be life shattering and tear down the identity you have been building your whole life – I do understand that you want to help.

My suggestion is to start by helping with the things that appear to pose a challenge. For example, picking a table in a cafe away from the counter if your friend struggles with too much going on around them. Or introducing them to someone if they have no one else to talk to at a party. Calculating how to split the bill if they struggle with numbers. Sending a link in advance to the restaurant’s online menu if they are dyslexic or struggle with too much choice.

These sorts of accommodations will be far more valuable to your friend and will really have a positive impact for them.

Most importantly, keep reading about Neurodiversity because the more we understand ourselves the more we realise that there are other people out there just like us.


Intersectionalities with Neurodiversity

Neurodiversity can be a tricky topic sometimes. We can’t see it, so it is easy to forget when addressing diversity in our organisations. And we only know our own experience of the world, so different lived experiences can be difficult to understand.

But the biggest difficulty is that we can’t view different diversities in silos. If we are talking gender diversity, we are also talking racial equality and Neurodiversity, for example. We can’t address these differences in isolation if we really want to make a difference.


Did you know that for every female diagnosed autistic, 4 males are diagnosed? For ADHD, the ratio is 1:3

It is believed that prevalence is similar in both genders, and that women and girls are better at camouflaging or masking.

This means that when we look at gender diversity in the workplace, for instance, if we don’t consider Neurodiversity in parallel, we risk decreasing the pool of women we are trying to support by 20% (based on 1 in 5 being Neurodivergent), which in turn will impact our success rate.


This short piece from the Open University articulates, far more clearly than I could, some of the issues around varied diagnostic rates between races.

To take one of their points as an example, in some Asian cultures it is considered rude to give eye contact to an adult or someone in authority, and children are discouraged from doing so. And yet lack of eye contact is often considered one of the markers of autism. Unsurprisingly, diagnoses of autism among Asian people in the UK are half that of people classed as white British.

This is another group of people where Neurodiversity can be under recognised, and potentially impact our hiring, retention and job satisfaction.

Mental Health

Ok, you’ve seen where this is going…

This article from Psychology Today pulls together a number of sources, explaining that 3 in 10 children with ADHD also suffer from anxiety, and children with dyspraxia have been show to have higher levels of anxiety than their peers as young as 3-4 years old.

There is also research showing that the risk of suicide in individuals with “mild”* autism is 10 times higher than in the general population. It also found that autistic women are more likely than autistic men to commit suicide, despite suicide being more common in males in general.

The interesting thing here is that we know that conventional mental well-being practices do not work for neurodivergent people. Suggesting someone with ADHD take a meditation or yoga class is like telling a fish to take a long walk. Some might be able to do it, but it’s not the solution for everyone. DBT has been shown to be more effective than CBT for neurodivergent people, for example.

We need to extend our mental well-being offerings to ensure that everyone can benefit.


Possibly a result of being more likely to challenge social “norms”, it has been found that 70% of autistic people identify as non-heterosexual:

In fact, the intersection between autism and LGBT identities has its own Wikipedia entry.


We know that there are higher rates of Neurodiversity diasgnoses in children, and high rates of research on children. But those children grow into adults, and those adults grow old. And yet there is very little research on the impact of Neurodiversity as we age.

This study found that only 0.4% of autism research focussed on older adults. But how does Neurodiversity impact the menopause, with its hormonal changes, sensory issues and emotional impact? What about the significant life change of moving from work to retirement and its impact on our routines, which in many cases keep us grounded? What about the emotional and executive function challenges of juggling work, children and grandchildren?

What can we do to make sure neurominorities are adequately represented?

There are two key things we need to keep in mind to ensure not only that we are driving inclusion for neurodiverse people, but also that we are maximising the impact of other diversity initiatives:

1. We need to treat everyone as an individual. Each person we engage with has a distinct “diversity profile”: everyone has a gender, a race, a sexual orientation, an age, etc. and we must treat each person as a whole rather than as a sum of those parts.

2. We must ensure that Neurodiversity is a strategic priority on our people agendas across organisations. This will help to drive other diversity metrics, plus creating the psychological safety for individuals to feel comfortable to disclose will increase the accuracy of any Neurodiversity metrics in place. Because until there is psychological safety, those metrics will measure rates of disclosure rather than true rates of diversity.


*This article uses the term “mild autism”, which has been repeated verbatim here, but we do not subscribe to this idea. It can be harmful to describe autism as “mild” because it plays down the challenges that the person has.

Choosing A Career

Now is the time when a lot of students will be starting to think about higher education choices, which ties in nicely with a realisation I had this week.

A few years ago I was at a conference where a mother who was sat next to her visibly terrified teenage daughter asked what jobs might be suitable for the daughter, given that she is autistic. I had almost forgotten about this, until I happened to be Googling something this week and noticed a related search: “best jobs for neurodivergent”. Immediately the Mum and daughter sprang to mind and I realised this isn’t an uncommon question.

The responses the Mum received that day were particularly focussed on creativity, working alone and self-employment. So out of interest, I clicked on the related search and found an equally limited range of suggestions geared around structure and maths: accountancy, IT and engineering.

But I don’t think it’s that simple…

As someone neurodivergent who has been working continuously since the age of 19 in a broad range of jobs, I want to offer 5 tips for forging a successful career if you are neurodivergent.

1. Forget the neurodivergent stereotypes

Sure, our diagnoses are helpful for understanding ourselves and identifying like-minded people, but they are just a framework and we shouldn’t limit ourselves because of them.

Why couldn’t you be, say, an outgoing and personable TV presenter if you’re autistic? Melanie Sykes has a very successful presenting career and was previously a model. And Anne Hegarty is well known from The Chase and did a stint on I’m A Celeb. Accounting, coding and engineering are not the only career paths available.

Equally if you have ADHD, a lot of famous role models tend to be actors or athletes. But let’s face it, how many budding actors or athletes are going to be successful if we channel everyone with ADHD to those two careers? The same is true for other neurodivergences. Absolutely go for it if it’s your passion, but don’t feel pressured if the stereotype roles aren’t your bag.

This is also a great article on the bias against neurodivergent people in leadership positions, and well worth a read.

There are a number of corporate programs out there to attract and retain neurodivergent talent, but again these tend to be in the financial and technology sectors. By all means, check them out and apply for their programs if IT or finance are your thing, but you don’t have to limit yourself to companies with dedicated programs like these. The stereotypes are just that, and your options really are endless.

2. It’s ok to change your mind

I knew about one month into my law degree that that was not the career for me. I thought I’d be able to apply myself to interesting intellectual challenges. Then I realised you are limited to the cases your clients bring. Another petty theft, anyone? Not for me, thanks.

So, I started working in the entertainment industry, and after 10 years I switched industry again and took a very different job in the financial sector. In fact, I’ve never done the same job twice. And that’s ok. There is no such thing as a career ladder anymore – do whatever piques your interest and pays the bills.

I’ve also never done a “typical” job – you know, the ones you learn about in school like doctor, teacher, lawyer, historian… There are loads of jobs out there that you don’t know exist – in compliance, governance, fundraising, audit, HR, diversity & inclusion and many, many more. You only really start to find out about these jobs once you’re in the workplace, and then the world is your oyster.

3. Think about your personal preferences

I don’t mean medicine over history, or sports over music. Think more broadly:

Do you feel energised by being outside? Then maybe consider landscape gardening or nature conservation?

Do you need to do physical exercise every day else you go stir crazy? How about farming or personal training?

Does the idea of having to think on your feet fill you with excitement? Perhaps barrister or fire fighter is right for you?

Would you benefit from flexible hours (consultant?), shift work (healthcare?) or do you need routine (teaching?)?

Do you find strong smells offputting? Perhaps avoid farming, medicine or packing coffee (take that one from me!)

The answers to these sorts of questions will help to give a view of the type of job you might enjoy – and as a result, succeed at. This tends to be a cycle – we enjoy things we are good at, and we are good at things we enjoy.

Once you have an idea of the aspects that are important to you, you can start to build a picture of what you do and don’t want from a job.

4. Hone those customer service skills

For many of us, social anxiety or reading social cues from neurotypicals can be a challenge. I am a firm advocate of recent research showing that autistic people are not “deficient” in communication skills, and equally I’m aware that other Neurotypes can have social challenges too – ADHD, dyspraxia, etc. can come with their own social challenges. So my take on this is that social anxiety spans the neurodiverse categories and is something that neurotypicals should understand and accommodate.

There is an army of people fighting for recognition and change in this regard (see my early blog on the Double Empathy Problem) but the reality is that change does not happen overnight, and you will likely be working with neurotypicals – or even other neurodivergent people – where good communication will require give and take on both sides.

On top of that, any job requires you to do the tasks that your boss (or client if you are self-employed) is paying you to do. This means you just can’t escape the fact that you are going to have to engage and communicate with other people in your day-to-day job.

If this is really something that you struggle with, it should be a key factor for you to consider when thinking about your working preferences. And again, try to think outside the box – it is possible, for example, to work for a company with thousands of employees, but to be part of a small team where you only liaise with a handful of people on a regular basis. Or perhaps a role that is largely scripted might be appealing?

If you can, I recommend everyone taking a customer service role early in your career. This will help you to forge your work persona (everyone has one of these, neurodivergent or not) in an environment where you can practise defining social scripts for yourself and honing teamwork skills. Let’s face it, a raft of people you’ll only ever talk to once are the best people to practice scripting with, because you’ll never see them again so it doesn’t matter if some conversations go better than others. Best of all, these sorts of (often part-time and/or temporary) roles can provide scenarios to answer interview questions for future jobs like “tell me about a time you overcame a challenge” or “how do you perform under pressure?”

And customer service doesn’t have to mean working with lots of people… you might be able to take a job at a veterinary centre, stables or rehoming shelter if you like working with animals, or in a library or independent bookshop if you’re the literary sort. Anything that will build your confidence to communicate will help set you up for success.

5. It is easier to get a job if you already have a job

I know, this is inherently unfair, more so for us neurodivergent folks who can struggle with executive function and spoons. This article from Forbes gives a couple of reasons why this is the case, and what to do if you’re not in education or employment and are looking for a job.

The reason I call this out is that I know how hard it is to save the spoons for work when you’re in education. While I did my GCSEs and A Levels I was exhausted. Mentally and physically exhausted. I probably wasn’t getting enough sleep, but was undiagnosed at the time so didn’t realise I was neurodivergent and more tired than my friends.

When I finished my A Levels I was told by my parents that I wasn’t going to be allowed to sit at home all day for the three months between finishing my exams and starting university. I was expected to go out and work.

So that’s what I did. I signed up with a local temping agency, and after a call at 8am one morning asking if I could be up the road for a cleaning shift at 10am (which I accepted, even though the short notice was a massive challenge for me), I received a week at the coffee packing factory (and came home stinking of the stuff!) and then a much happier 6 weeks printing off invoices for an estate agent.

This experience helped me to land a part-time job while I was at university, where there is much greater flexibility in terms of when you get your study hours in and when you can work, eat and sleep. The experience I gained in that part-time job then helped me to get my first full-time job. Any work experience you can get is going to help you in forging your own successful career.

Advice for neurodivergent career planners

So, what’s the overall message from these 5 tips? In short, you don’t need a career plan at the age of 18 – give things a go, study subjects you enjoy, build up your work experience, and use those experiences to figure out what you do and don’t want to do as your next step. Unless you want to go into a specific career, any course you enjoy will stand you in good stead. This advice is just as relevant for neurotypicals as it is for us neurodivergents, and the added extra for us is: don’t let the stereotypes limit your choices; think about your personal preferences when looking for a good job match and don’t worry if your career path twists and turns.

Good luck, and most of all have fun! You can do this!!


What does Neurodiversity Look Like?

I’m sorry – I’m teasing you with the title of this one, and you’re getting three different answers to this question!

And for that reason, let’s jump straight in:

Answer 1

You can’t tell whether someone is neurodivergent just by looking at them

Never a good idea to tell someone they “don’t look autistic” or that they “cover it well”. You might get very short shrift. These preconceptions are based on an outdated stereotype.

Did you know?

A lot of stereotypes of autistic people are based on individuals who are autistic but also have other diagnoses. For example, Kim Peek – who inspired Raymond Babbitt in Rainman – wasn’t only autistic. He had learning difficulties and possibly also a condition called FG Syndrome. Yet the film suggests that all of Babbitt’s traits are down to autism. Why let the truth ruin a good story, eh?

Answer 2

One person’s neurodivergent traits might not be the same as another’s

If you’ve met one neurodivergent person, you’ve met one neurodivergent person. Our challenges, strengths, coping mechanisms, sensory sensitivities all vary from person to person, even when we share a diagnosis. This means that just because one neurodivergent friend didn’t need a particular accommodation, that doesn’t mean that other neurodivergent friends won’t. So take the time to understand what makes your friends and family tick.

Answer 3

Some real world examples of what Neurodiversity “looks” like

When reading this list please ask yourself: If I had the opportunity to talk to this person, would it matter to me that I might need to accommodate their foibles? Because giving your neurodivergent friends time, space and understanding can be a huge help in social situations.

Richard Branson

Virgin Tycoon Richard Branson knew he was dyslexic from school age, saying “I was seen as the dumbest person in school”. You can read more from Richard Branson here: Dyslexia helped me to become successful

Simone Biles

Multi Olympic gold medal winner Simone Biles had to speak publicly about her ADHD when hackers revealed that she takes a commonly prescribed ADHD medication. See a 3 minute discussion of the topic on Good Morning America here.

Cara Delevigne

Model, actress and author Cara spoke candidly about her dyspraxia in this interview with Vogue. She has since written a book to help teenagers navigate their mental health.

David Beckham

Footballer and Spice-husband Beckham has been talking openly about both anxiety and OCD for over 10 years.

Billie Eilish

In 2020 singer-songwriter Billie Eilish joined the likes of Shirley Bassey, Adele and Paul McCartney in recording the theme tune for the latest James Bond film. You can hear her talking about Tourette’s with Ellen Degeneres here (2 minute video). She touches on two very important topics: not being defined by our neurotype, and masking (which we’ll talk about in a later blog).

Anthony Hopkins

In this 2017 interview Oscar winner Sir Anthony Hopkins talked about his autism diagnosis (referred to here as “Aspergers”) and said, “I don’t go to parties, I don’t have many friends… But I do like people.” The paradox of autism in a nutshell!