Common Challenges At School

Internalising & Hidden Anxieties

Autistic girls often internalise or 'mask' their difficulties (e.g., sensory, social, communication) resulting in symptoms of anxiety and depression.11

Studies have shown that anxiety is higher in autistic females than in autistic males.12


One of the common experiences of internalised autism seen in many girls and gender diverse people is the ability to mask. Masking is when an autistic person, either consciously or subconsciously, supresses or hides their natural autistic behaviours and responses 3 . Masking can include forcing or faking eye contact, mimicking the behaviours, body language, or interests of others, hiding their discomfort over sensory stimuli, supressing stress and anxiety reactions, or trying not to shut down.

Masking is often done in order to fit in and make connections, while attempting to hide differences. As a result of masking, autistic girls and gender diverse people often appear more socially capable, less disruptive and display less obvious autistic presentations when compared to autistic individuals who display more external autistic traits. However, masking can be extremely exhausting, can result in a loss of identity, and is a contributing factor to mental health challenges in many autistic girls and gender diverse young people.

Masking, and the internalised autistic experience help explain why many autistic girls and gender diverse young people continue to fly under the radar and are undiagnosed and unsupported at greater rates than their autistic male peers.

Ebony Birch Hanger is a Teacher, Neurodevelopmental Therapist, Education Consultant and Music Specialist. In this video she shares her own journey and strategies on how to identify and support girls who are experiencing anxiety.

Views from...


It's really important to understand her individual triggers and signs of anxiety. It may not be obvious at first, but you almost need to be a good detective to find the clues and see what's going on under the surface.


Anxiety can impact learning, and can be seen in subtle presentations e.g., nail biting, twirling of hair, flicking of nails. Ongoing and untreated anxiety can result in significant issues such as school refusal and more serious longer term mental health consequences.

Autistic Female

My anxiety is silent. You wouldn't even notice a change on the outside. But when I get stressed I stop managing to do even simple tasks. I am often misunderstood as being lazy but in reality I am just overwhelmed. I wear the mask well.

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11(Head, A., McGillivray, J. & Stokes, M. (2014). Cox, I., McGillivray, J.A., Manjiviona, J., Paterson, D.T. & Stokes, M.A. (2017). Cox, I., McGillivray, J., Manjiviona, J., Bulhak-Paterson, D.T. & Stokes, M.A. (2017).) 12(Attwood 2007; Kopp 2010; Kopp, Kelly &Gillberg 2010; Kreiser& White 2013; Solomon et al. 2012)