This book was not for me. I got about 50% before I put it down. It was like reading a medical journal which is fine if that is your cup of tea but not what I was expecting.

I really enjoyed this latest book by Professor Gina Rippon. It offers fascinating insights into the neuro-scientific approach to studying autism and sheds light on how AFAB people are often overlooked, under- and misdiagnosed. The narration was wonderful, easy to follow, even when it got technical.

That said, I have a few gripes (in order of occurance in the book):

1. She says that "autistics found their voice" in recent years. Nope. Largely thanks to the internet, autistic folks are able to connect and speak without being silenced or talked over. There are more resources available to understand one's experience and put it into words.

2. The outcry over Asperger's Syndrome being replaced with Autism-Spectrum-Disorder is not just a question of identity, or rather it is, but one rooted in what is commonly referred to as "Aspie supremacy". In a world where ableism runs rampant, many people diagnosed with Asperger's used the term as a way to distance themselves from other autistics, often those with higher support needs and/or learning disabilities. This plays a significant role in the outcry Rippon mentions.

3. the constant appropriation of the word "tribe"

4. She only mentions the DSM, never ICD, though many autistics get diagnosed using the latter.

5. I hope that, had she spent a single second googling the implications of puzzle/jigsaw analogies in relation to autism (spoiler: Autism Speaks is the worst!!), she would've opted for different wording.

6. I feel like she didn't actually mention how harmful camouflaging and masking is to autistic people, the advantages of unmasking, etc. I also found her examples very limited and stereotypical (such as literally writing out social scripts to rehearse), when in reality, most autistics, especially AFAB, don't know they're masking or camouflaging. That's the part of the issue! She presumes that masking and camouflaging are always conscious and identifiable.

7. The gender section... existed. She should've left it out, IMO.

8. Ableism never comes out. Not once, not even when talking about stigma. I found that so disappointing.

Thank you to Netgalley for an audibook ARC in exchange for an honest review!

This book includes some really good and insightful info. I am, however, disappointed that the intersection of race and Autism was not examined -- though I do understand through their disclaimer that the data is just not there. I still feel there must have been some way in which this could have discussed or acknowledged in a way that is still impactful without relying on anecdotal evidence too much.

I am very frustrated that the author spent the entire first chapter overexplaining the nuances of language and word choices and the sensitivity read before publishing, yet immediately uses the term "find their tribe" and continues to use "tribe" throughout the book. They easily could have used the more appropriate term "community" or the like. [Tell me this book was written by Brits without telling me.]

(4.5/5, rounded up)

This is what I've wanted from comparable titles and then some!

From the sounds of it, I'm Gina's prime audience. Neurospicy (note I don't have an ASC diagnosis. tbh I'm not certain someone <i>diagnosed</i> would get much more than validation out of this), late 20's, figuring out as we go what a mess healthcare is. Especially mental healthcare, & especially for women. Autism is yet another area science *cough* men *cough* and the field of medicine have failed us.

The info isn't consistently presented in layman's terms (Gina's way is ideal, IMO) so this may not be as accessible to those without at least a bit of background knowledge. But for me, it was exactly what I'd hoped. The stats aspect, while much too narrow for obvious reasons, further enlightened the utter crap that is AFAB vs AMAB studies and the conclusions made from them. It's wild that this big of a hole has been dug for us by past the failures of people we'll never meet.

I'd highly recommend this to anyone close to someone w on the ASC spectrum, who works w someone on the ASC spectrum, wondering if they may also be a mis- or missed diagnosis or are just hoping to learn more on the subject.

Side note: I was SO glad the background 0f Asperger (the person) was mentioned, because he sucks. Big time. Hard pass on Nazis & eugenics.

Catherine Bailey did a great job w the audiobook. Very clearly spoken and with a great, natural rhythm.

Thank you bunches to Gina Rippon, Catherine Bailey, Seal Press, Hachette Audio & NetGalley for the DRC & ALC in exchange for my honest review!

Written by a late in life diagnosed autistic woman, this is part memoir, part sociological study into the gender differences in autism diagnoses. I really appreciated how well the author relied on research studies and their particular attention to gender nonconforming autistic people. Great on audio and a must read for anyone looking to better understand autism. Many thanks to NetGalley and the publisher for an early audio copy in exchange for my honest review!

This is a very insightful book about how women with autism have been overlooked for decades and what are possible reasons to that. One of the most interesting aspects was learning how autism symptoms and the ways people cope with them can vary by gender. Exactly this difference causes a significant challenge in diagnosing autistic girls but is actually a consequence of much broader issue related to gender stereotypes and societal norms.
The book also has a lot of information about autism in general, including its history and key research in the field. Different neuroscience and brain studies, that are covered in the book and that go beyond autism, provide another level of understanding how the brain develops from early childhood through adolescence, and how different social interactions are reflected in brain imaging and forming.
I would definitely recommend this book. It has many examples and personal stories, which makes it very easy to read and understand. At the same time it provides a rich amount of information, addressing many important topics.

I have heard quite a lot about the fact that autism studies tend to be focused around boys and men rather than women and girls. I've discovered this in documentaries, too. including one focusing on women being diagnosed later in life.

I don't have autism myself, but knew and know some women who do, and they were diagnosed when they were very young. I know both men and women with autism.

I find there are good, and bad, points about this book. What I feel I need to say first is that, in many books about autism, there's always the mention of the word "normal" and a lot of comparisons between people who have autism and those who don't.

I do have disabilities. Cerebral Palsy and Hydrocephalus, and I, just like people with autism, have experienced a lot of bullying and misunderstandings. I've always found the concept of "normal" and not offensive. There was too much of a focus on this. Some sentences could have been worded better.

I found the author was difficult to listen to, and that affected my overall enjoyment of the book.

I was wondering how easy to understand the book would be, and it was easier than I thought, for the most part. I did find it overly wordy in some parts, but not nearly as much as many other medical books.

I'm glad that books like this try to bring awareness of autism and show the experiences of it in women and girls.

3 stars

Thanks to Gina Rippon and Audible Audio for my audiobook in exchange for an honest and voluntary review.

⭐⭐⭐ 3 Stars

Off the Spectrum is an important examination of the differences of Autism between Male and Females, differences in experience and the diagnosis (and lack thereof). The information presented within the book is clear, and put together as puzzle pieces that paint a bigger picture of Autism in females. 


When critically analysing a book, it's important to observe the intended audience. For this book, Off the Spectrum, I do not think this is me. The book was written fantastically, fluently, and clearly, however the content is a bit... dry. It resembles more of a psychology textbook in its presentation. Considering the subject matter, I am not surprised, but if projected towards the audience of the typical Psychology-Non-Fiction (which is more self-help targeted) I do not know if it would 'land'. I did struggle to push through this book, and I believe that was made worse by the fact I was listening to the Audiobook.


The narrator of the Audiobook was concise, clear, and had an engaging tone and voice. However with such dry content it can be hard to consume audiobooks - in my experience!


I feel that this is a book that should be read by practitioners, people in positions who see children with Autism (teachers, doctors, psychologists and psychiatrists) to help expand awareness around Autism and ensure that women and girls aren't being skipped over!

Thank you to Hachette Audio and NetGalley for the ARC Audiobook of this title, in exchange for an honest review.

Off The Spectrum is written by cognitive neuroscientist Gina Rippon. Rippon takes a closer look into the commonly held belief that autism is a “male problem”. Through science and research, Rippon shows how the diagnosis of autism has intentionally left out women and girls and provides an exploration into how autism may present in females (in what should shock no one, the criteria in order to be diagnosed as autistic is based off of white males!). Rippon does a great job at making the science and evidence in her book digestible and I truly learned so much. Autistic women really have had to advocate for themselves to change the face of autism to include them- I hope this book continues to help change misconceptions about autism, especially autism in women. 4.5

Thanks to NetGalley for the opportunity to listen to the audiobook Off the Spectrum: Why the Science of Autism Has Failed Women and Girls.

(I read the audiobook)

This book explains how ASD came from a male bias, onto a brain research into sex differences.
What is it like to be you?
Many people with ASD share their experience in books, some recurrent features are:
nerdy, anxiety, hide, inappropriate.

There are barriers of recognition, making the diagnose for women more complex.
Many went through years of tests and false diagnosis, before getting to ASD.

It’s imperative we talk to those women and get their stories.
Only then we’ll gain more comprehension and we’ll be able to reassess our minds.

Thank you to Netgalley for this opportunity.

I really enjoyed all the information in this, especially the history of how girls got left out of the autism diagnostics criteria. It was truly heartbreaking how much of it was rooted in Nazis, but it goes back to the initial autism research being done by a Russian woman, and her work got buried by a couple of men. It's all way too typical, honestly. I've suspected for a few years now about my own neurodivergence. I'm still not certain, but in the past few months my two-year-old son has gotten assessed and shown a lot of signs of autism, which made all the information even more interesting to me--especially seeing how much easier it is to get a diagnosis for a boy with a lot of delays and more obvious signs, and how many resources are available to him because of that. I did feel like toward the end of this book all the neuroscience data got really thick and hard for a layperson like me to follow, but all in all I found it super interesting.

Rippon delves into the history of autism diagnosis and research with a critical eye, exposing how early theories—overwhelmingly developed by and for neurotypical men—skewed our understanding of autism in ways that continue to impact diagnostic practices today. She unpacks the “male brain” myth, critiques the cultural baggage around behavioral norms, and methodically dismantles the binary thinking that has shaped the field.

Where Off the Spectrum really shines is in its exploration of the lived experiences of autistic individuals, particularly those who’ve long been ignored by mainstream diagnostic frameworks—women, girls, and gender-diverse people. Rippon balances scientific rigor with a clear commitment to amplifying marginalized voices, weaving in interviews, personal accounts, and sociocultural analysis. The result is a compelling case for reframing autism not as a deficit to be corrected, but as a variation in human neurology that is too often misunderstood or overlooked. It’s a book that doesn’t just inform—it forces you to reconsider how knowledge is produced, who it includes, and who it leaves out.

4.5/5 ⭐️

I received an ARC copy of the audiobook version of this book thanks to NetGalley, Hachette Audio and Seal Press. This book is SO needed; not just in the Autism community, but each and every person could benefit from listening to or reading this book. The author has a great way of breaking information down to make it relatable and understandable regardless of the background you are coming from. She made a really great point when speaking about Asperger’s and how when they dispelled Asperger’s and lumped it in with Autism Spectrum Disorder it truly left a lot of people feeling without a piece of their identity. I can understand where Autism is a spectrum and Asperger’s has a place on that spectrum, but I can also understand where when it has always been such a stand alone piece of the spectrum, to lump it in can bring up a lot of feelings for people and identity crisis that maybe weren’t there prior, or that people may have finally overcome by being given a diagnosis.
The author also really drove home the fact about females getting overlooked, it’s something that myself as a parent and educator am aware of, but the author made some really valid points that I hadn’t considered until reading them in the book!

I will be purchasing the book when it is published as I do feel like I would love to do a deeper dive into the text.

The narrator also did a great job and was easy to listen to!

Raises important questions Autistic Women and Girls need answered .. yesterday

I listened to the audio book version of Off the Spectrum, which was narrated by Catherine Bailey. The introduction was read by Gina Rippon herself, which was a nice touch and made it feel more genuine. If you struggle to take in a lot of numerical and statistical information verbally, you will definitely want to pick up a paper copy.

As a researcher specialising in neuroscience on the brain (gender differences in AMAB and AFAB brains), as well as an activist, Gina Rippon uses this book to sift through one hundred years' worth of research into Autism in females and the male bias most of this research exhibits. She examines the history of diagnosis, terminology and empirical errors. What little current scientific news there is on AFAB autistic people and brains, she summarises rather shortly. What she does, with the exactitude of a neuroscientist, is lay bare the missing information, the gaps in the research. This book does not answer questions, it finds the gaps and asks the scientific community to do better. A roadmap for the future?

I have to say first and foremost, that as an autistic woman, there was little new in this book. There were many interesting things in there but she did not provide an answer to the question of how women, girls and all AFAB are going to be more able to be included in research and in access to diagnoses. She points at data as to why this has been the case in the past and asks important questions, but she does not demonstrate much in terms of putting these things into practice.

This book deals with a lot of heavy things, including gender binary language, eating disorders, bullying and self harm. If you have issues with these things, you may want to get someone to skim the chapters for you in advance.

In my review, I am trying to use appropriate language for those on the ASC spectrum. One of the big downsides in this book (and for which the author tries to apologise in the introduction) is the binary language. Male and female people with autism, male and female brains. There is a short section on diverse genders in AFAB autistics, but it feels like a cop-out to not use inclusive language throughout with such a significant proportion of AFAB autistic people having diverse gender identities (she even points that out..). Another massive issue is the medical concept Rippon uses almost throughout the entire book. With ASD (disorder) no longer being the preferred term of the community, her consistently using it feels insulting. Identity-first language (autistic people, not people with autism) would have been a big step towards making this book appeal to the community as coming from an ally.
Another entire group missing from her book (and, of course, the research) are POC. The fact that there is little research into AFAB autistic POC cannot mean that there is none, and even if that is the case, Rippon should display thoroughness and call that out, too.

I think the target audience of this book is not the autistic woman (or girl, or family member post-diagnosis) but rather GPs, psychotherapists and the research community. It is a powerful call for more rigour and inclusion of the overlooked half of the population into health research. It is not news to the affected people.

This audiobook was full of detailed information on Autism and how it relates to women. Having several neurodivergent relatives, this book opened my eyes to how girls have been treated differently in diagnoses. Thank you to #NetGalley for this audiobook ARC #OffTheSpectrum.

I found this to be informative and relatable. It felt engaging even with stats and long winded facts. The author definitely is filling in a gap in the publicly accessible Autism information. I think there are some nuances missed as always, and not everyone will be able to relate but I think many women with autism would find this helpful. The narration is also well done. I appreciate the author sharing their knowledge.

Thank you so much to Netgalley and the Publishers, this was an informative read.

4.5 rounded up. This book is highly informative without being overbearing. The audiobook narrator was perfect - she sounded intelligent and highly intelligible. The author touches on many aspects to present her case which makes for a sound, well-rounded argument on the lack of study on women with autism. I do work in the medical field, so I was familiar with some of the science already, but this book gave me new ways to look at it. Highly recommend for those whose work overlaps with individuals with autism, whether they be medical professionals, teachers, advocates, etc. Thanks to NetGalley and Hachette Audio/Seal Press for the advance audiobook!

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.

Thank you to NetGalley, Seal Press and Gina Rippon for providing me with an audiobook ARC in exchange for my honest review!

As an autistic woman, I am always excited to see books covering autism and gender so I was anticipating this release and it did not let me down. I definitely would not recommend this as an introduction to understand autism spectrum disorder as the diagnostic criteria, diagnosis process, etc. is only discussing in relation to how it is exclusionary to AFAB and fem presenting people.

I loved how the author weaved studies and information on the history of autistic women with stories from interviews with actual autistic women, it felt so comforting and validating of my experience. I didn't expect to cry when I listened to this, but it was so powerful to me! I also loved the narrator and how they shifted from a more lecture/factual voice when reading statistics and studies to a more conversational tone when reading from the interviews, it was very easy to follow and remain engaged (even when they just listed numbers for 2 mins straight lol).

While I rate this book highly because of how it related to my experience, I can also see how this book can feel exclusionary to some. I felt the complete lack of intersectionality quite strange as it feels like it would be more effort to not mention certain things like race when talking about barriers to diagnosis, how masking is a safety mechanism, etc.

I also found the use of the term "severe" autism as quite ignorant, similar to older research describing autism with functioning labels. I appreciated the author discussing how she would listen to the community post-publication about how certain terms may be offensive so I am speaking from that point of few when I say that most autistic people do not appreciate terms like mild/severe when referring to autism. Allistic people hear autism spectrum disorder and assume it works as a scale from one end to the other but most autistic people would not see it that way.

Personally, I view it more similar to the colour spectrum wheel. Just like how you can slide in different directions to get different colours, every autistic person slides around the spectrum depending on which situation is presented to them but we are all still colours (autistic). I appreciate how difficult this can be to describe as some autistics are non-verbal, struggle to take care of themselves, etc. while others seem to be able to work full time, raise children, etc. so the terminology that has developed that the community has adopted is support needs. This seems to be easier for allistic people to understand as it is a scale, from low to medium to high support needs.

Besides these criticisms, I enjoyed this book thoroughly and will most likely reread! I think I would have been diagnosed a lot earlier than 23 if the mental health professionals I was in the care of had read this book and would recommend this to any mental health care professional, specialising in autism or not!

I'm from France, and, in term of autism research, we are far behind from other countries' research...
So I learned a lot out of this book, it was very interesting but also unnerving as a woman.
This is another topic where we are left behind, where studies exclude us, where men have the power to say who we are or, in this case are NOT.
It is also women who find the work and research that other women have done on the topic.
So thank you Gina Rippon to be one of those women, it is so important for us.
And lastly, as I said, I'm from France so I'm not a native english-speaker but I hadn't problem understanding the audiobook narrator !

thank you so much netgalley for this amazing book