A Saint Louis University study shows that the increase in autism diagnoses in the US post-COVID-19 predominantly affects girls and women, highlighting improved recognition and persistent diagnostic gaps.
A new Saint Louis University study suggests that the recent rise in autism diagnoses in the United States is being driven largely by girls and women, who are being identified at much higher rates than in previous years and, in many cases, years later than boys and men.
The research, published in JAMA Network Open, analysed electronic health records for 171,134 patients across a large Midwestern health system between 2016 and 2024. Led by Erick Messias, chair and professor of psychiatry and behavioural neuroscience at Saint Louis University School of Medicine, it is among the first studies to examine autism diagnosis trends by sex across childhood, adolescence and adulthood within the same health system before and after the COVID-19 pandemic.
According to the study, new autism spectrum disorder diagnoses among males were broadly flat or declined over the period, while diagnoses among females rose sharply after 2020. That pattern was seen across every age group in the study, suggesting that the post-pandemic increase in first-time diagnoses may reflect better recognition of autism in females rather than a broad rise in autism prevalence across the population.
The findings also point to a persistent gap in the age at diagnosis. Girls and women received an autism diagnosis at an average age of 15.7, compared with 12.3 for boys and men. The study also found that Asperger disorder, a diagnosis removed from official manuals in 2013, continued to disappear from medical records as clinicians increasingly used the broader autism spectrum disorder label.
The results fit with a wider body of research showing that autism in girls and women is often missed or recognised late. A separate analysis published in The BMJ argued that autism has long been viewed as a mainly male condition and that current clinical practice still fails to identify many women until adolescence or adulthood, if at all. Other studies have found that females are increasingly being diagnosed later than males, particularly when co-occurring intellectual disability is present, while Swedish research published earlier this year suggested that autism rates may be closer to equal between the sexes than previously thought. Together, the findings reinforce a growing view among researchers that longstanding diagnostic patterns may have underestimated autism in girls and women.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
