Women with autism are slipping through the cracks because health professionals are failing to pick up on the symptoms and the condition is being misdiagnosed.
Around 40,000 New Zealanders suffer from autism and many go undiagnosed, University of Otago psychiatrist Dr David Bathgate said in a recent presentation to fellow specialists.
He said historically autism was often recognised in men and it was assumed the condition was uncommon in women.
"But what more research is showing is that women tend to develop social skills earlier and therefore the signs are missed because women are better at hiding it," Bathgate said.
For Auckland mother-of-two Rachael Keach this was her life.
The 38-year-old discovered she had autism only after both of her sons' were diagnosed. She believes her husband also presents the condition.
But for more than three decades she battled with the unknown.
"Growing up I struggled with the social things. I didn't understand people and couldn't fit in. People would make a joke and I didn't get it so I'd get hurt.
"I tended to copy a lot, I started subconsciously copying accents to fit in and do what was socially required of me," Keach said.
Then, at the age of 15 Keach was diagnosed with severe depression, anxiety and boarder-line personality disorder. But not autism.
"I was getting more and more stressed because I didn't know what was wrong with me and eventually I had a break-down."
Keach, a straight-A student all the way through school, dropped out and shut herself off.
"The social pressure got too much, exams got too much and I was severely depressed."
She said anti-depressants helped but throughout her life she struggled to make sense of it all.
Fast-forward 22 years, Keach found herself furiously researching the symptoms after both her sons' were diagnosed. That's when she realised she had autism.
"I've learnt a lot just by reading and I accepted that things I do or things I say is because I have autism."
Refusing to let her sons go through what she did, Keach reminds them there's nothing wrong with them, autism was just a different way of thinking.
Bathgate said Keach's experience was not uncommon.
"There is an urgent need for more training of psychiatrists on the diagnosis and management of Autism Spectrum Disorder and the mental illnesses that complicate the condition.
"There is also an overall lack of mental health service provision for autistic adults."
He said a new training program was needed for psychiatrists, so they can accurately diagnose and manage Autism Spectrum Disorder.
"There is still a large gap between recommendations for best mental health care in autism and the reality of over-stretched clinical service providers.
"The gaps need to be addressed," Bathgate said.