'She masked, she masked, she masked': Unseen autism and its toll on young girls

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Set us as preferred Ruby Hobbs-Leffler felt things with an intensity that even a smart little girl with a big vocabulary couldn’t put into words.Life was an onslaught of bright lights, loud noises, intolerable textures and tastes.Feelings bubbled up uncontrollably: inconsolable howls in infancy, classroom meltdowns in childhood, rages in adolescence.Most children did not understand her.

Neither did many adults.She was articulate and insightful in so many ways — why wouldn’t she just behave? No one seemed to understand the world was sometimes too much for Ruby.

What she absorbed instead, her mother, Jessica Leffler, said, was that she was too much: too dramatic, difficult, strange.Her diagnosis with autism at age 14 was, to Ruby, a relief.There were reasons for the way she perceived things, words for the sensory experiences that set her apart from peers.Leffler was angry.

Why did Ruby have to go so many years without the support she needed? Why did none of the professionals the family asked for help identify her needs? Why did she spend the formative years of her life being treated by teachers and peers like a failure, instead of a person navigating a world designed for a different way of thinking?And today, after Ruby’s 2024 death from suicide at age 15, she wants to know: Why are so many autistic girls with gifts and challenges like Ruby being overlooked?Autistic children are significantly more likely than their neurotypical peers to have co-occurring mental health conditions like depression and anxiety, and to think about and die by suicide.For girls, however, there is an additional complicating layer.Autistic girls without co-occurring intellectual disabilities tend to be diagnosed significantly later than their male counterparts, often not until adolescence or later.As a result, they miss out on early interventi...