A Qualitative Exploration of the Experiences of Autistic Adolescent Girls and Their Mental Health Difficulties: A Transdiagnostic Approach

Abstract Purpose Autistic girls have been underrepresented in research, which has traditionally focused on male-dominated samples. As a result, there is limited understanding of the unique mental health difficulties they experience and the challenges they encounter when accessing appropriate services. Adolescence is a significant developmental stage where girls can be more vulnerable due to biological, social, and psychological changes. This transitional period may be when girls present for an autism assessment or begin to experience significant mental health difficulties. Methods This qualitative study explored the mental health difficulties of six autistic adolescent girls attending Child and Adolescent Mental Health Services (CAMHS) in Ireland. Results Following an Interpretative Phenomenological Analysis (IPA), three Group Experiential Themes (GETs) were identified: (1) Understanding the Relationship between Autism and Mental Health in Autistic Adolescent Girls, (2) Navigating Social Environments as an Autistic Adolescent Girl with Mental Health Difficulties, and (3) Disconnect between the Needs of Autistic Girls and their Support. Conclusions These results provide valuable insights into the role of diagnosis in fostering self-understanding among autistic adolescent girls, while also highlighting how the interplay between autism and co-occurring mental health difficulties can complicate identity development during adolescence. The study reveals the unique challenges faced by autistic girls, alongside frustration with services not designed for their needs. Clinical implications include the need for more nuanced diagnostic practices and support systems that recognise the overlapping features of autism and mental health conditions in adolescent girls.