Understanding Autism in Women: Insights from Dr. Patricia van Wijngaarden- Cremers
When we think of autism, the image that often comes to mind is still shaped by how the condition appears in boys and men. Yet, as psychiatrist and psychotherapist Dr. Patricia van Wijngaarden- Cremers explains, autism in women is both more subtle and more complex. In her work at Dimence Groep’s Department for Developmental Disorders, she has seen how many women go undiagnosed for years, struggling silently behind a façade of adaptation.
“I noticed there are a lot of unnoticed developmental disorders, especially in women,” she says. “Women with autism often copy the behaviour of others. They try to be part of the group, and because they adapt so well, people do not notice it. But that does not mean it is not there.”
The cost of masking
This masking comes at a high cost. Many women only receive a diagnosis in their 40s, after decades of anxiety, burnout, and self-doubt. “They have often been treated for depression or anxiety for many years,” Patricia explains. “But the underlying cause is not recognised. Their self-esteem goes down because they think, I am a weirdo, everyone gets better except me.”
For women with autism, everyday life can be deeply draining. “Social contact costs them a lot of energy,” Patricia says. “They like it, but it also exhausts them. They cannot read others automatically, they have to think about every detail of interaction. Everything they do costs energy.” This invisible exhaustion is one of the clearest signs that something deeper is happening. Unlike temporary fatigue or stress, this is a chronic strain caused by constant adaptation. “When things change suddenly, like a meeting being rescheduled, it can be very hard for them to cope,” Patricia explains. “They need time to recover after each activity. In today’s world, where everything changes so fast, that is very difficult.”
Autistic women also experience stronger hormonal fluctuations that can intensify emotional distress. Conditions like PMDD or PCOS are more common, and hormonal changes during puberty, pregnancy, or menopause can trigger depression or even suicidal thoughts. “When the estrogen drops, it gets more difficult,” Patricia notes. “We see more depression during menopause and postpartum periods. It is very important to always take hormones into account when treating women.”
Learning self-acceptance
Patricia’s advice for women who discover they may be on the spectrum is simple but transformative: listen to yourself. “Stop masking all the time,” she says. “You can do it sometimes, but not always. It is a recipe for suicidal thoughts if you keep doing it. Learn which things cost you energy and take enough time to recover.” She encourages women to focus on their strengths rather than trying to fit into others’ expectations. “Every person has talents. Focus on what you are good at instead of what you cannot do. Acceptance is a big part of recovery.”
In the workplace, women with autism often bring exceptional focus, creativity, and analytical strength. “They are the inventors,” Patricia says. “They think in a different way and see details that others overlook. Society needs people with autism.” However, the modern open office can be overwhelming. “Those shared work gardens are not suitable,” she explains. “People with autism need a quiet space where they can work without too many stimuli. They also need time to recover between tasks and should not be expected to socialize during breaks.” Managers who listen and create structure allow neurodiverse talent to thrive. “Give them the space they need and listen carefully. They will tell you what they need, but you have to listen very well. When we do that, they can function very well and add great value.”
At Silatha, we believe that creating psychologically safe environments starts with listening and understanding the diverse needs of every individual. Our Taboo Topics Training opens up conversations on neurodivergence, perimenopause, and hormonal cycle, helping organizations foster true inclusion.
Book a call with us today to learn how Silatha’s programs can help you strengthen your teams, reduce turnover, and build an inclusive culture where everyone can thrive.
Written by Tudor Marinca