The author demonstrates a strong commitment to thorough research, thoughtfully acknowledging both her past mistakes and those of others. However, I found the writing style less engaging, Overall, this book was a mixed experience for me. I learned a bit from this book, but the first one-third of the book failed to engage me or include much information I found noteworthy.

Thanks to NetGalley and the Basic Books publisher for giving me an opportunity to read this book. If they didn't, I probably wouldn't have realized what I did.

If you are a woman and interested in all things autism, either because of having someone close affected or simply out of curiosity, this book will be right up your alley. I belonged to this second category, however, I didn't realize that soon I'll find unconsciously my own person being targeted. That is why it took me so long to write this review - the book literally shook me to the core.

The book is divided in two parts. The first part, Hiding in the plain sight, analyses the history and definitions of autism, male spotlight and lost girls because of camouflaging and too often undetected (female) autism. The second part, Brains behind it all, tries to explain the symptoms and characteristics of autism, and most prominent aspects of women living autistic.

The book raises awareness to the fact that women were omitted from many a research, because it shockingly simply never occurred to those scientists, that women may also have a form of autism, albeit differently manifested. The book explains well why biology differs so much in men and women in that aspect; the main culprit is now thought to be the way men and women evolved through the centuries of having different survival roles from the cavemen to the modern societies. Women had the so-called role of being family keepers and the guardians of the hearth, and as such they had to socialize more with the other people in the group. Males on the other hand used to be family providers and protectors, and more often than not needed to lean on their own wits only. Survival for women meant necessity to be open to the dialogue with the others, while for men apparently it didn't; hence, the autism presents itself way differently in men and women.

Although awkward, women can be social and hide their autism behind various coping mechanisms. The book uses terms such as camouflaging and chameleon brains, which at first glance may seem flattering, but often lead to many disorders and self-harm to the autistic women, because these mechanisms are so hard to maintain, and without help, many women on the more extreme side of the spectrum tend to break sooner or later. That part of the book will be definitely of some help to the women still looking for themselves, as it may offer some answers and ease some of the dismay they feel.

I wasn't aware I belong to the same group. In my country there is no way I'll ever get that diagnosis; here it goes only to boys and men on the extremes of the autistic spectrum, and that's it. Women are simply NOT the part of the equation. And this book showed me how wrong that it is - only now in my 40s! - because I always thought that the way I behave and do things is normal, and that I am just quirky and aloof, and that's why I have so small group of friends I have so hard time to maintain relationships with. The blessing of my quirkiness is that I found the work environment in which it fits perfectly and where I am accepted, even when I blunder and do some social faux-pas.

The only criticism I have is not with the book, but with how ill the autism spectrum is defined. I have a very hard time accepting that diagnosis, even after doing many online tests (no other way here where I live) reconfirming the same. If I can live comfortably the way I am and on my own terms, this definition of autism makes things so much worse for those who do not manage to live so well as I do, so how can I compare with them? I am weird, but am I really that weird, why would I need any help? What I am trying to say, rather than making that spectrum wider, it should be made more specific. Hence my confusion and anger, of what use would it be to stick the autistic label to me when I do not need it, now or ever? I rather think that clinicians should really have a focus on the specific groups rather than going too large in scale, because there will definitely be ones using the system, both doctors and patients. Identification of women on the spectrum should be only one part of the research, the problem solving should be the other. Eating disorders, self-harm and suicidal thoughts aren't issues to be taken lightly, but not all autists have them, and scientists should figure out how to differ between those who successfully navigate their lives despite the diagnosis and those who do not.

I greatly appreciate how the author acknowledged her own biases (amongst other scientists) when it comes to intersectionality in research; it means a lot for someone in the field to recognize how their own perspectives affect raw data, and it's nice to see history being rewritten when it comes to autism in women in girls.

For too long, it was presumed that autism is autism; now we know there is a spectrum and that it affects people in all different ways. I appreciate that the more science-y elements were simplified for the layman like myself without the subject matter being trivialized.

Thanks to NetGalley and the publisher for a digital copy of this book in exchange for my honest opinion.

Off the Spectrum: Why the Science of Autism Has Failed Women and Girls is an exhaustive, well-researched book by cognitive neuroscientist Gina Rippon. She performed brain imaging on thousands of patients and realized that autism is frequently overlooked in females because it presents differently. There is much discussion of gender differences and how females with autism have significantly different behaviors than their male counterparts. The book is divided into several sections, which serve as an excellent reference for anyone who is interested in this subject.

At times the subject matter gets too deep/technical for most readers, such as parents. I would recommend that this author write a simpler and more concise version for parents and teachers of girls who might have autism. Off the Spectrum is very informative and will be a valuable reference to many families and clinicians.

I received an Advance Review Copy (ARC) from NetGalley and Basic Books for free, and I am leaving this review voluntarily.

I wanted to read this as my youngest sibling was diagnosed in her late 20's and I thought this would give me some insight to that as we've discussed many times how females are dismissed so much more than males.
This book appears to be well research and really laid out how females when young either adapt as to go along with the "norm" or are just over looked. My sibling and I were able to discuss at length a lot of the things that the author pointed out that I had never realized. There were so many things discussed like how autistics might identify as something other than what they were born and that was an interesting insight. Also how people treat kids (males vs females) differently and we just don't realize it. Additionally the texture of clothes, food, fabric can set kids off and we try to get them to get over it rather than removing it. I think the more that is shared about this and how we can correct it in the future will make a big difference in how females are examined and diagnosed.

Thanks to NetGalley and the publisher for the arc.

I devoured this book and had the pleasure of receiving both the print and audio ARCs of this publication so both reviews are included:

"Off the Spectrum" is a critical piece of literature that is missing the Autism world--Autism is widely known as a "boy thing" and much of the assessment tools are normed on boys/males as are so many of the interventions. Girls/Females go undiagnosed for many years, decades or throughout their entire lives. Neuroscientist Gina Rippon tackles this important topic head on in this book. This book is a work of nonfiction and is a heavy read if you are not familiar with the topic. I recommend sitting down with the printed version and your highlighters/pens as there is a wealth of information. I am immersed in this world so the audio version was a good fit for me too as an excellent validation to what I've experienced, both as a parent and a practitioner. *I received a complimentary print and audio ARC from the author/publishing company via NetGalley in exchange for an honest review. All thoughts & opinions are my own.

An overdue look at how science continues to fail women. It is appalling how many “known facts” about autism are false because women and girls have not been considered.

Happy Autism Acceptance Month! ♾️ I was thrilled to receive an ARC of Off the Spectrum. As a clinician specializing in working with autistic girls and AFAB individuals, I’m always seeking up-to-date resources to better support my clients. This book provides a thorough exploration of autism’s history and the ways AFAB individuals have often been overlooked—whether through early socialization, the prioritization of male experiences, or the phenomenon of camouflaging and masking. Despite having done extensive research on autism myself, I still learned a great deal from this book. At times, the text was quite data-heavy, so I made sure to tackle those chapters when my brain was fully awake (and caffeinated!). I also appreciated the author’s inclusion of firsthand testimonies, which brought the research to life and underscored key points. I highly recommend Off the Spectrum to any mental health professional working with this population. It offers valuable insights that can help clinicians better understand their AFAB clients, advocate for more inclusive diagnostic criteria, and amplify the voices of actually autistic individuals.

- Thank you to NetGalley, the publisher, and the author for providing me with an advanced copy of this book in exchange for my honest review! -

While very informative, I felt like I was reading more of a peer review in a scientific journal, than an actual book. Many things were repeated and drawn out. For the non-scientific or non-medical person reading this, it is a bit dry and difficult to push through all of the info-dumping. As a mother of 2 children on the spectrum (both a boy and a girl), I was excited to read this, since both of my children were not diagnosed until 16 and 13, respectively. They were both missed and told they had other disorders. I was hoping to read some insights as to why girls are looked over, but instead read a lot of scientific fluff that at times, had me falling asleep reading. I guess I was expecting more of a personal account, not a scientific account that leaves out the actual audience this is intended for.

Gina Rippon’s Off the Spectrum is an urgently needed examination of how autism research has historically failed women and girls. As a neuroscientist, Rippon meticulously dismantles the long-held assumption that autism is a predominantly "male" condition, exposing the dangerous consequences of biased research and diagnostic criteria. Her argument is compelling: generations of scientists focused so narrowly on male presentations of autism that they created a self-perpetuating cycle of exclusion, leaving countless autistic women undiagnosed, misunderstood, and without support. Rippon explains complex concepts—like camouflaging (where autistic girls mimic social behaviors to "fit in") and how intense interests may manifest differently in girls—without oversimplifying them. The book urges clinicians, researchers, and society to recognize the diverse ways autism presents across genders.

That said, some readers may find the scientific sections dense, and while Rippon acknowledges the limitations of a binary "male vs. female" framework, a deeper exploration of nonbinary and trans autistic experiences would have strengthened her argument further. Still, "Off the Spectrum" is an essential read for parents, clinicians, and autistic women themselves. It’s validating, eye-opening, and, most importantly, a step toward correcting a harmful oversight in autism science.

Thank you to the publishers and NetGalley for the opportunity to review a temporary digital ARC in exchange for an unbiased review.

Off The Spectrum is a meticulously researched book. Ultimately, it was not for me, despite its merits.

I wasn’t familiar with Gina Rippon’s work before this book, so I did some searching. In 2020 work, Gender and Our Brains, “Rippon urges us to move beyond a binary view of the brain and to see instead this complex organ as highly individualized, profoundly adaptable and full of unbounded potential.”

It’s unfortunate, then, that Off The Spectrum seems to riff on the idea of “female autism” vs. “male autism.” I found this off-putting and it was difficult for me to get into the book as a result.

Off The Spectrum is well-written and, again, thoroughly researched. I think Rippon is a passionate scientist doing good work. In the end, I believe it comes down to personal preference, and I just don’t tend to enjoy reading allistic scientists' work on autism.

This book has great insights on gender and autism. The research is solid, but the writing can be slow and repetitive at times. I learned a lot, but it wasn’t the most engaging read.

Thanks Netgalley for allowing me to read the ARC!

Off the Spectrum is an engaging and respectful exploration of autism in women, blending scientific research with relatable anecdotes. The book is well-organized, making complex topics easier to understand, and the author approaches the subject with care and nuance. The mix of personal stories and research keeps it engaging, though some sections can feel a bit dense.

Despite that, it’s a valuable and well-written read for anyone looking to deepen their understanding of autism, especially as it presents in women.

This book shared a lot insight about gender and the autism spectrum. I actually had my family take one of the tests about reading expressions. There was some repetitiveness, but I really enjoyed it.

This was fascinating, especially the research on how autism may present differently in AFAB people and how the threshold AFAB people must meet to be taken seriously by clinicians is higher than autistic boys and men. I came to this book with the perspective of a transgender man who was diagnosed with autism in my twenties and appreciated the thought Rippon put into addressing trans/non-binary autistic issues and in general treating it with respect. This seems like a good book for clinicians to read to help eliminate bias in their evaluation process.

Off the Spectrum by Gina Rippon is the ideal book for anyone to read, those with children male or female diagnosed with Autism (ASD), people maybe a carrier for ASD or late diagnosis or Adult diagnosis of ASD. The book gives insight of what ASD is, diagnosis and how it’s different for male and females. I’m a very late diagnosis for ASD and other issues surrounding ASD. After reading the first few chapters I realized on how different I was growing up. I recommend the book to anyone.

Good read for anyone but especially if you know or love a female with autism. Very enlightening about how symptoms are overlooked so often in girls vs. boys.

Well-written, and informative. I’m kind of embarrassed to say I never heard of Grunya Sukhareva before this. Thank you to NetGalley and the publisher for the eARC.

Off the Spectrum by Gina Rippon is a fascinating and eye-opening read. It challenges so many misconceptions about autism and provides a fresh perspective on what it really means to be on the spectrum. I really appreciated how the author breaks down complex science in a way that’s easy to follow and engaging. The book is full of facts and personal stories that make you think, and I love how it encourages readers to rethink stereotypes. I think our library patrons will love it too—it’s an enlightening, thought-provoking book that offers valuable insights, and I can see it sparking a lot of great discussions.

As an autistic female (I say female as I’m nonbinary), this book was mind blowing and will stick with me for a long time.