Safeguarding Autistic Girls: Executive Summary
This comprehensive guide examines why Autistic girls face systemic vulnerabilities across education, healthcare, legal systems, and social services. It provides practical safeguarding strategies while identifying the specific exploitation patterns that emerge when Autism remains unrecognized. The central thesis: Autistic girls are “hidden in plain sight”, often undiagnosed and therefore unsupported. Research shows 91% of Autistic adults experienced abuse before diagnosis, yet 73% reported being safer after receiving a diagnosis and appropriate support. The book documents how Autistic girls’ neurological differences—including prosopagnosia (face blindness), social imagination gaps, theory of mind differences, interoception issues, and masking—create predictable safety risks that professionals can mitigate through awareness and specific accommodations.
Core Concepts: Why Autistic Girls Are Hidden and Vulnerable
Neurological Differences Creating Specific Safety Risks
Prosopagnosia (Face Blindness) creates vulnerability when Autistic girls cannot recognize faces out of context. They may be convinced by strangers claiming prior acquaintance or accept rides from people they should remember but don’t. Without awareness, professionals cannot implement protective strategies like name labels at gatherings or sending photos with emails before meetings.
Social Imagination Differences mean Autistic girls struggle to foresee social consequences across multiple perspectives. They may not predict that sharing a crush with peers will reach the intended person, that ignoring a text means someone won’t meet them as planned, or that continuing an unplanned pregnancy will derail future plans. This isn’t recklessness—it’s a neurological difference in the ability to imagine outcomes from multiple viewpoints. The “Consequences Game” (a paper-folding collaborative story exercise) effectively demonstrates how difficult foreseeing consequences is when you only have your own knowledge—a daily reality for Autistic girls navigating multi-person social situations.
Theory of Mind and Double Empathy Problem: Autistic girls often assume others have the same knowledge, feelings, wants, and agendas as they do. They may assume someone loves them because they love that person, someone won’t hurt them because they wouldn’t hurt others, or that trusted adults already know about abuse happening to them. The Double Empathy Problem reveals that communication breakdowns result from mutual misunderstanding between Autistic and non-Autistic people, not Autistic deficiency alone. This reframes the problem: professionals must work bidirectionally, not expect Autistic girls to adapt unilaterally.
Interoception Issues: Some Autistic girls don’t recognize when they’re in pain, hungry, thirsty, or need the toilet. Interoception varies widely—some have hyposensitivity (delayed pain recognition even with serious illness like appendicitis), while others are hypersensitive to minor sensations (clothing labels, plucked eyebrows). Without awareness and routine support, interoception differences mask serious illnesses, create health emergencies, and lead to late-stage disease diagnosis. This directly contributes to Autistic life expectancy being only 58 years (39.5 years for those with learning disabilities), with leading causes including epilepsy and suicide.
Masking (Camouflaging): Autistic girls observe others, mimic them, and suppress their authentic selves to appear less Autistic and survive socially. While this helps them blend in, it exhausts them, delays diagnosis, prevents professionals from seeing actual support needs, and erodes self-identity and mental health. Masking peaks during secondary school years—precisely when vulnerability to exploitation is highest. Using a theater metaphor: imagine being dragged on stage mid-performance with no script, forced to improvise, getting reactions wrong, disappointing actors—now do this every day for years in all social contexts.
The “mild Autism” label is dangerous because it means non-Autistic people experience the girl mildly while she implodes into emptiness, depression, confusion, and constant self-approval-seeking from others. Masking is linked to poor mental health, self-harm, and suicide in Autistic girls. Critically, if an Autistic girl only unmasks and shows authenticity at home, parents are succeeding—she feels safe there. School or clinical settings where she maintains masks are the problem, not parenting.
The Diagnostic Pathway: Nine Systemic Gates and Gatekeepers
Diagnosis is positioned as a human right but functions as a privilege. Multiple systemic barriers prevent Autistic girls from receiving timely diagnosis, directly impacting their safety:
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Postcode Lottery: UK regions have vastly different waiting times. The national average is approximately two years; some areas have much longer waits.
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Diagnostic Tools Variation: Different clinicians use different tools (DISCO, ADOS, ADI-R), and not all are equally effective at identifying Autistic girls. The DISCO tool is specifically recommended as most effective for hard-to-reach girls because it uses dimensional assessment across all life domains and developmental history.
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Stereotypes of Autism: Media portrayal typically shows Autistic males interested in trains and mathematics. Girls not fitting this narrow profile face additional barriers to recognition.
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Masking and Eye Contact: Autistic girls’ expert masking makes them appear neurotypical in clinical settings. Many develop strategies to manage eye contact discomfort (removing glasses, wearing sunglasses, blinking excessively) which should be recognized as “lack of eye contact.”
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Hyper-Empathy Misunderstanding: 99% of Autistic girls the author has worked with are hyper-empathetic, yet stereotypes suggesting Autistic people lack empathy lead to missed diagnoses.
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Diagnostic Overshadowing: When girls have other disabilities (blindness, deafness, mobility issues), their Autistic traits are overshadowed and they either receive diagnosis as adults or not at all.
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Race and Cultural Beliefs: Autism has been wrongly perceived as a “male and pale” condition. A 2016 survey found 85% of ethnic minority Autistic women felt unrepresented in Autism media; 50% viewed Autism as a “white condition.”
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Care System Catch-22: Most vulnerable girls struggle most to gain diagnosis. Their Autistic traits are explained away as resulting from abuse, neglect, or trauma rather than recognized as Autism itself.
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Socio-Economic Status: If NHS services lack trained clinicians, private diagnosis costs money. Socio-economic background determines access to fair diagnosis opportunity.
Impact of Delayed Diagnosis: Research shows 91% of Autistic adults experienced abuse before diagnosis. However, crucially, 73% of Autistic adults reported being safer after diagnosis and support. A 2017 informal survey of 65 Autistic adults revealed: 67% had no school support; 89% had mental health issues they attribute to late/no diagnosis; 89% left education without qualifications reflecting actual abilities; 13% became young parents due to lack of inclusive sex education; 81% relied on benefits at some point.
Misdiagnosis: The Autism Lens vs. The Mental Health Lens
Autistic girls are frequently misdiagnosed with mental health conditions before Autism diagnosis, with serious and lasting consequences:
Mood Disorders and Bipolar Disorder: Emotional processing delay means Autistic girls process and display emotional reactions 6-12 months after events occur. A girl experiencing sadness about an event from six months ago, while current events are happy, appears to have unstable mood. This is not bipolar—it’s delayed emotional processing. This misdiagnosis leads to inappropriate psychiatric medications with serious side effects and creates damaging mental health records that follow girls into adulthood.
Dissociative Identity Disorder (DID): Autistic girls’ masking—taking on personas, accents, and alter egos to fit in—gets misdiagnosed as DID. Key differences: Autistic masking can begin early without trauma link; Autistic people are aware they’re masking (they’re doing it deliberately). DID originates from trauma and sufferers often aren’t aware of identity switching.
Borderline Personality Disorder (BPD): BPD traits like emotional instability, impulsive self-harm, and unstable relationships can reflect Autistic experiences instead. Self-harm may be sensory-seeking, pain-blocking, or establishing certainty rather than expressing suicidal ideation. “Unstable relationships” with constant texting might reflect hyper-focus on individuals or being love-bombed by abusers at relationship start.
Educational System Failures
The educational system systematically fails Autistic girls through sensory inaccessibility, lack of teacher understanding, and blame of families rather than systemic failure, directly contributing to school refusal, bullying, self-harm, eating disorders, and early entry into exploitation or care.
Pre-School and Early School Challenges: Sunday night panic attacks triggered by TV cues signaling school return; sleep disruption from worry; sensory issues around clothing (itchy labels, tightness, fabric conditioner changes); inability to choose socks or uniforms.
The “Heavy Backpack” Sign: Autistic secondary students noticeably carry overly heavy backpacks—often containing every school book for every lesson all week. This reflects difficulty with executive function, fear of losing items, anxiety about forgetting and receiving punishment, or sensory comfort from weight.
School Transport Vulnerabilities: Walking alone risks getting lost or encountering strangers. School buses/taxis raise critical questions: Are other students kind or bullying? Is the driver DBS-checked? Many Autistic girls won’t wear visible ear defenders due to social stigma but desperately need discreet earphones and music to manage sensory overload on transport.
Sensory Inaccessibility as Physical Pain: Schools lag behind other buildings (airports, offices, gyms) in accessibility planning. Echoing walls amplifying whispers, screeching chairs, squeaking announcements, thousands of small sharp-blue-tinted energy-saving lights, overpowering smells—these cause physical pain comparable to barriers faced by wheelchair users. Yet unlike wheelchair accessibility, sensory needs are often dismissed as preferences or oversensitivity.
Teacher Attitudes and Lack of Training: Teachers without Autism training misunderstand Autistic girls’ needs. Case examples: A 6-year-old was made to wear a dunce’s cap-style green hat labeled “I will be polite” for 6 hours daily as punishment. A 13-year-old was hit on the head by a teacher for not making eye contact while listening intently, despite the teacher knowing she was Autistic.
The “Problem at Home” Blame: When Autistic girls are subdued and compliant at school but explode with frustration at home, parents are blamed for “problems at home.” This is backwards logic. Girls only unmask when they feel safe—if safe at home, frustrations emerge there. If not feeling safe at school, they cannot unmask there, meaning the school itself is the problem.
Two Life Trajectories: Diagnosed/Supported vs. Undiagnosed/Unsupported
Diagnosed, Supported Autistic Girl:
- Preschool: Sensory breaks reduce anxiety and pain; less fear of separation; pride in Autism, no need to hide
- Primary school: Teachers trained; scheduled bathroom breaks prevent accidents; specific classroom requests reduce confusion; supported play time; reasonable adjustments for trips and tests
- Secondary school: No need for masking due to feeling valued; school refusal rare; bullying rare; trusted friend group; empowered sex education; less likely eating disorders, self-harm, shutdowns
- Young adulthood: College/university attendance with support; fear of failure addressed; toxic relationships identified earlier; loyal friendships
- Mid-adulthood: Aware of pregnancy risks due to interoception issues; confident parenting; potential for full-time work and financial independence; health professionals aware of Autism
Undiagnosed, Unsupported Autistic Girl:
- Preschool: Sensory overwhelm misunderstood; high anxiety about separation; masking begins
- Primary school: Fear of school continues; toilet accidents or infections; misunderstands teacher requests; feels unsafe in playground; exhaustion; falls behind academically
- Secondary school: Masking peaks; school refusal, bullying, assaults; isolation; sexual vulnerabilities; eating disorders, self-harm; GCSE difficulties; higher teen pregnancy risk
- Young adulthood: Extreme fear of failure and late course quitting; vulnerable in relationships; likely mental health issues (genuine or misdiagnosed); inability to leave toxic relationships
- Mid-adulthood: May not recognize pregnancy; misunderstood parenting style; struggles with school social aspects; unable to work full-time; health issues go undiagnosed/misattributed; lost childhood friendships; abusive relationships
Exploitation Vulnerabilities
Autistic girls require specialized sex education because they may not understand others’ agendas due to social imagination differences. They often assume their own knowledge is universal and may not report abuse promptly, leaving them vulnerable for prolonged periods.
Survey data: 82% of Autistic adults reported that Autism makes it harder to report abuse in a timely way, and 78% felt Autism “treatments” like Applied Behavior Analysis (ABA) increase vulnerability to abuse.
Four Hurdles Before Abuse Gets Reported:
- Recognizing what’s happening is wrong and wanting it to stop
- Understanding loved ones don’t automatically know what’s happening
- Knowing how to communicate what happened
- Believing sharing will result in advantageous consequence (stopping the abuse)
Mate Crime (befriending specifically to exploit) includes: paying for social outings but never reciprocating; demanding money back repeatedly; only visiting on payday; becoming the “boyfriend” after she gets her driving license so she provides free transport. Autistic girls often appear as the “common denominator” in multiple negative situations with different groups—they’re blamed as troublemakers, but they’re actually vulnerable and exploited. They’re literally wearing an invisible “I’m a mug” sticker visible to everyone but themselves.
Online Grooming: Predators use grooming tactics: requesting “sexting” or inappropriate photos (often as first step), offering gifts or money. The person may not be who they claim—they could be much older, or a middleman using a younger appearance.
Teen Pregnancy, Domestic Violence, Eating Disorders
Teen Pregnancy: Many Autistic teen pregnancies are intentional, not accidental. Reasons include: craving unconditional love, wanting to escape childhood confusion/bullying, using pregnancy as a protective factor. Some Autistic girls don’t realize they’re pregnant until late pregnancy or birth due to impaired interoception.
Domestic Violence: Autistic women experience domestic violence differently and it often lasts longer due to difficulty with change, blurred lines between care and control, and vulnerability to gaslighting. Types include physical abuse, rape and sexual abuse within relationships, financial abuse (withholding financial information, controlling access to money), and coercive control (pattern of assault, threat, humiliation, intimidation, and abuse used to harm/punish/frighten).
Eating Disorders: For Autistic girls, food restrictions often start with sensory issues (predictable foods vs. unpredictable). But the maintenance factor is frequently control. In an unpredictable, overwhelming world, restricting food becomes the one area where an Autistic girl has absolute agency and predictable results. Hospital treatment fails because it removes even this control—more restrictions, more demands, less autonomy. Recovery requires more control elsewhere: gaming scores, sports achievements, photography followers—numerical, measurable successes that redirect the control-seeking function.
Burnout, Shutdown, and Catatonia
Meltdowns vs. Shutdowns: Meltdowns are visible explosions (misread as tantrums in children, aggression in adults). Shutdowns are silent implosions—far more common but less understood. Both hurt physically and emotionally.
Shutdown Experience: Imagine worst migraine × 10. Head feels like “brain is mince in a hot pan”; eyes feel swollen; every sensory input is affected. Body loses spatial awareness; person retreats to safety (bed, chair, quiet room). Sounds become torture. It’s terrifying—feels never-ending, like “drowning silently” with no outward cry for help.
Burnout Warning Signs: Increased time alone; heightened sound/light sensitivity; clothes suddenly intolerable (sensory on steroids); controlled/restricted eating; increased silence.
Catatonia: Severe consequence of prolonged burnout/shutdown. Person becomes unable to move—eyes open, aware, but physically paralyzed. Feels like stroke symptoms but is Autistic shutdown-related. Requires professional medical support.
Practical Strategies & Techniques
The Four Ts: Core Communication and Accessibility Strategies
Timekeeping: Arrive 30 minutes early for appointments or communicate delays immediately. For Autistic individuals who struggle with transition and change, knowing you’ll be there when you say creates emotional stability.
Text Communication: Written instructions prevent misinterpretation. Use explicit language (avoid ambiguous phrases like “next Wednesday”—specify “May 15th, 2022 at 20:30 hours”). Structure emails with short sentences, bullet points, and clear calls to action.
Terminology: Use identity-first language (“Autistic girl”) rather than person-first (“girl with Autism”). Never say Autistic people “suffer from” or are “touched by” Autism—these frame neurodivergence as tragedy. Avoid medical model language (“symptoms,” “disorder”).
Telling Tales: In one-on-one support, use narrative techniques to initiate conversations about sensitive topics. Rather than direct questions, discuss TV shows, books, or news events with similar themes to what the young person is experiencing.
The Four Rs: Professional Collaboration
Relationship: Maintain professional relationships with other agencies and professionals to create continuity of care, fill support gaps, and see the bigger picture of an Autistic girl’s life.
Research: Investigate organizations before partnering. Use social media to gather community feedback. Understand your organization’s reputation within the Autistic community.
Recommend: Share genuine recommendations for effective, well-tested, reasonably-priced support services.
Remember: Many Autistic girls reach professionals without prior diagnosis. Those in eating disorder clinics, local authority care, school exclusion, suicide attempts, self-harm, young offender programs, or homeless services may be undiagnosed Autistic. A diagnosis is a privilege, not a requirement for accessibility needs.
Technology and Code Word Safeguarding Strategies
The Uncle Kev Trick: If followed while alone, the girl should wave at the nearest house, run toward it, and shout “Uncle Kev” (or a different name to maintain secrecy). This makes flight appear joyful rather than fearful, potentially deterring the follower.
The Emoji/Codeword Password: Establish a secret emoji or word the girl can text to a trusted adult when uncomfortable in social situations. The adult immediately calls with an excuse to extract her (“homework not done,” “Nan visiting”). This allows her to leave without appearing to “grass” friends.
Google Earth Pre-Navigation: Use Google Earth Street View to visually pre-familiarize with new routes, reducing anxiety about unpredictable environments.
Smartphone Access: Allows texting/calling trusted adults and using maps/GPS for navigation and independence. Critical safeguarding tool.
Education and Employment Strategies
Interest-Based Learning: Autistic girls’ “special interests” should be reframed as “expertise.” These interests are not obsessions to discourage but powerful motivators for learning.
Processing, Not Slowness: Autistic students aren’t slow; they’re processing more information simultaneously. This depth is an asset, not a deficit.
Flexible Schooling: Offer hybrid models: attend school Monday for materials, learn online Tuesday-Thursday, return Friday to submit work and socialize. This prevents burnout-driven exclusion while maintaining access to qualifications and peers. Mental health must precede grades.
Employment Equity: Autistic applicants typically have knowledge exceeding confidence. Interviews reward confidence over competence. Guaranteed Application Feedback Scheme (GAFS) should expand to provide feedback to all disabled applicants at application stage.
Healthcare and Legal System Support
Interoception Support: Healthcare providers must understand interoceptive differences, implement routine health screenings, teach Autistic girls to check internal sensations regularly, and not dismiss pain reports as hypochondria.
Cervical Cancer Screening: Only 19-31% of disabled women access smear tests vs. 73% of general population. Local authorities’ home education teams should alert families when vaccines are due.
Police and Legal System: 100% of surveyed Autistic adults felt vulnerable to false confessions under police questioning. 74% reported no access to fair trials. Mandatory Autism training for all legal professionals is essential.
Key Takeaways
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Autistic girls are hidden in plain sight, making them most vulnerable when their Autism is unknown: Without diagnosis and understanding of specific Autism traits, professionals cannot implement protective strategies.
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The diagnostic pathway contains nine systemic barriers that disproportionately exclude Autistic girls: Postcode lottery, diagnostic tool variations, stereotypes, masking, misunderstanding of empathy, overshadowing, racial/cultural factors, care system placement, and socio-economic status all prevent girls from receiving timely diagnosis.
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Autistic girls are systematically misdiagnosed with mental health conditions instead of Autism: Autism traits (delayed emotional processing, masking, sensory pain, self-harm) mimic mental health conditions when viewed through a non-Autism lens.
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Educational systems fail Autistic girls through sensory inaccessibility, teacher lack of training, and blame of families: Girls feel unsafe and exhausted; professionals misinterpret their behavior as problems at home rather than school problems.
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Early diagnosis and support creates dramatically different life trajectories: Supported girls avoid bullying and exploitation, maintain peer relationships, access education with accommodations, achieve financial independence.
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Autistic girls’ social imagination gaps create exploitation vulnerability: They struggle to read hidden agendas, may take colloquialisms literally, and assume everyone else knows what they know.
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ABA and compliance-based therapies increase abuse risk: Teaching children to comply consistently with adults removes their ability to say “no” and recognize when compliance is unsafe.
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Masking for approval erodes self-identity and mental health: Autistic girls who appear “fine” in school/clinical settings but shut down at home are succeeding at feeling safe at home—the professional environments are the problem.
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Teen pregnancy is often intentional, not accidental: Using reborn dolls and visualizing five-year plans showing how motherhood derails goals have 100% success rates for prevention.
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Autistic girls are repeatedly victimized because they’re easily targeted, not because they’re troublemakers: If an Autistic girl appears as the “common denominator” in multiple negative situations, she’s the scapegoat, not the perpetrator.
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Burnout and shutdown are serious medical/psychological events requiring lifestyle changes: An Autistic girl retreating to her room, becoming hypersensitive, and going silent is in crisis, not being lazy.
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Practical technology and code words save lives without shaming: The “Uncle Kev trick,” emoji codewords, and Google Earth pre-navigation provide Autistic girls tools to extract themselves from danger.
Counterintuitive Insights & Nuanced Perspectives
The “mild Autism” Misconception
Reality: “Mild Autism” means non-Autistic people experience the girl mildly while she implodes into emptiness, depression, confusion, and constant self-approval-seeking from others. A girl successfully masking in public appears “mildly Autistic” while experiencing complete erasure of self-identity, exhaustion, and internal crisis.
Emotional Processing Delay ≠ Mood Disorder
Many Autistic girls process emotions 6-12 months after events occur. A girl sad about an event from six months ago while happy about current events isn’t unstable—she’s experiencing delayed emotional processing on a predictable timeline. This is so common among Autistic girls that it should be a diagnostic marker.
Literal Interpretation As Communication Difference, Not Deficiency
Context-free literal interpretation is how Autistic brains process language neurologically. When told “don’t jump in the deep end or talk to strangers,” an Autistic child may understand this as conditional: “if you jump in the deep end, you must talk to strangers.”
Interoception Differences Create Healthcare Crises
Many Autistic girls have delayed or absent pain recognition for serious illness while being hypersensitive to minor sensations. An Autistic girl arriving at the hospital with appendicitis joking and laughing isn’t malingering—she’s experiencing genuine delayed pain recognition.
Hyper-Empathy, Not Empathy Deficit
99% of Autistic girls in the author’s experience are hyper-empathetic, “fixers of the world,” deeply concerned with justice and suffering. Diagnostic tools designed for Autistic men misrepresent Autistic girls’ empathy as deficit.
Theory of Mind Differences Enable Abuse Through Misunderstanding
Autistic girls with theory of mind differences assume loved ones automatically know what’s happening to them. An Autistic child experiencing abuse may assume her parents already know and don’t care (abuser’s lie) or may not report because she assumes the adult already knows.
Self-harm As Sensory Regulation, Not Suicidality
Self-harm in Autistic girls often serves regulatory functions: establishing sensation/certainty in overwhelming situations, managing pain through competing sensations, or seeking proprioceptive input.
Eating Disorders As Control-Seeking
Autistic eating disorders often begin with sensory preferences (predictable foods creating certainty), but the maintenance factor is frequently control. Hospital treatment fails because it removes even this control—more restrictions, more demands, less autonomy.
Change Is Unbearably Difficult; This Isn’t Laziness
Change feels neurologically unbearable for many Autistic people. An Autistic woman in an abusive relationship may stay not because she loves the abuser but because leaving—moving, new routine, new environment—feels worse than staying.
Critical Warnings & Important Notes
When Diagnostic Barriers Become Safeguarding Failures
The diagnostic pathway’s nine barriers don’t just delay identification—they create situations where the most vulnerable girls remain completely unsupported and unprotected. Research shows 91% of Autistic adults experienced abuse before diagnosis.
ABA Is Conversion Therapy for Autism
The author unequivocally states that ABA (Applied Behavior Analysis) with compliance-teaching is equivalent to conversion therapy for LGBTQ+ communities. It teaches Autistic children to suppress their authentic selves and comply consistently with adults—removing their ability to say “no” when needed.
Misdiagnosis As Mental Illness Leaves Girls on Damaging Medication
Autistic girls misdiagnosed with bipolar disorder, BPD, or DID are often placed on psychiatric medications with serious side effects while their actual needs go unmet. These psychiatric labels follow girls into adulthood, damaging their credibility in legal proceedings.
Interoception Differences Create Healthcare Crises
Autistic girls’ delayed or absent pain recognition leads to late-stage disease diagnosis. Average Autistic life expectancy is 58 years (39.5 for those with learning disabilities); leading causes are epilepsy and suicide.
Police and Legal Systems Fail Autistic People Systematically
100% of surveyed Autistic adults felt vulnerable to false confessions under police questioning. 74% reported no access to fair trials. Court intermediaries often lack Autism training, leading to catastrophic misinterpretations.
Child Marriage Is a Disability Issue
The legal allowance of marriage at 16 with parental consent is a disability issue. Autistic people at 16 lack executive function to understand marriage as a binding lifetime contract affecting personal freedoms, finances, and child custody.
Financial Abuse Persists Years Post-Separation
Paperless financial systems allow perpetrators to use victims’ addresses for fraudulent loans years after separation. The DVLA cannot prevent address misuse until perpetrators’ next renewal (typically 10 years later).
Shutdown Is Not Laziness; It’s Medical Crisis
When an Autistic girl retreats to her room, becomes hypersensitive, stops communicating, and seems “stuck,” she’s experiencing shutdown—a neurological state comparable to laptop overheating. Forcing demands escalates the crisis toward catatonia (complete paralysis).