Neurotypes such as autism and ADHD have historically been conceptualised through a male-centric lens, contributing to the persistent under-recognition of neurodivergence in girls and women. As a result, many females remain unidentified until adolescence or adulthood, often presenting within mental health services with concerns such as anxiety, depression, eating disorders, borderline personality disorder, trauma-related difficulties, and chronic burnout.

This presentation will explore how neurodivergence commonly presents across the female lifespan and why these presentations are frequently overlooked in clinical settings. Particular attention will be given to internalised presentations, masking and camouflaging behaviours, sensory differences, and the social and cultural pressures that shape how neurodivergent girls and women navigate the world. The ways in which many girls compensate socially, internalise distress, and develop perfectionistic coping strategies will also be explored.

The session will examine how neurodivergence may present across key developmental stages, including childhood, adolescence, and adulthood, and how these patterns contribute to delayed identification. The cumulative impact of late recognition, including increased vulnerability to mental health difficulties, identity confusion, trauma, and autistic burnout, will also be discussed.

Drawing on current research and clinical practice, this session will highlight key indicators of neurodivergence in females, common pathways to misdiagnosis within mental health services, and barriers women face in accessing appropriate assessment and support. Practical guidance will be provided to assist professionals in recognising neurodivergent presentations and adopting neurodivergence-affirming approaches within assessment and therapeutic work.

Women frequently enter the mental health system through acute and primary care settings with complex, often under-recognised psychological distress, particularly in relation to personality disorders. These early presentations commonly seen in emergency and community mental health services are characterised by fragmented care, repeated service use, and unmet needs, rendering much of women’s distress invisible within existing systems.
Lismore Medicare Mental Health Centre (LMMHC) implemented the Gold Card Clinic (GCC) as an integrated care pathway to support individuals presenting with symptoms related to Borderline Personality Disorder (BPD). It facilitates structured step-down referrals from Mental-Health-Emergency-Care (MHEC) team and Acute-Care-Services (ACS) team of Local Health District (LHD) to the LMMHC, strengthening continuity of care following crisis presentations. Data also shows other common comorbid diagnoses in this cohort such as ASD/ADHD and Bipolar Affective Disorder. A majority of referrals were female (61.8%), highlighting the gendered nature of service access.
Clients received four manualised brief intervention sessions based on the Project-Air model. Since implementation we have supported 47 women with BPD symptoms. Data demonstrate timely access, with 91.5% receiving an appointment within seven days, supporting improved transition from acute to community care. The majority of clients (55.3.6%, n=26) have successfully completed all four sessions. These clients demonstrated a significant reduction in suicidality and BPD symptoms, measured through Suicidal Ideation Attributes Scale and Borderline Symptoms Checklist 23 respectively. In addition, among female clients, the model reduced emergency department utilisation by 3.3 days per person per year.
These findings highlight several key learnings for improving women’s mental health care pathways. First, early, structured intervention following crisis presentations enables previously unrecognised distress to be identified and addressed. Second, cross-sector collaboration can reduce service gaps, strengthen early intervention, and deliver recovery-oriented, person-centred care. Third, brief, manualised interventions can produce meaningful clinical improvements while reducing reliance on acute care services.