“Does it really count?”: Women’s Experiences of Doubt and Impostor Syndrome about an Adult Autism Diagnosis

Increasing numbers of adults, particularly women, are seeking and receiving autism diagnoses. Qualitative research typically depicts diagnosis as a transformative event bringing relief, retrospective sense-making, and settled identity. However, emerging findings note experiences of persistent doubt, perceived fraudulence, and questioning of one’s diagnosis that remain underexplored. This study explored the lived experience of doubt and impostor syndrome following an adult autism diagnosis, with particular attention to what these experiences reveal about how individuals make sense of their autism and the meaning of a diagnosis. Interpretative Phenomenological Analysis (IPA) was employed to facilitate an in-depth understanding of post-diagnostic doubt. Semi-structured interviews were conducted with five autistic women (aged 25-49), diagnosed between seven months and five years prior. Participants were selected through purposive sampling and recruited via online platforms. Analysis identified two group experiential themes. The first, ‘"Does it really count?": defining 'real' autism’, captured participants navigating cultural stereotypes, the disruptive influence of competence and masking, distancing from narratives of trendiness and opportunism, and the at-times destabilising breadth of 'the spectrum'. The second, ‘"Getting the right answer": sense-making under uncertainty’, encompassed a fundamental discomfort with ambiguity, the paradoxical nature of self-knowledge, strategic curation of trustworthy evidence, and varying ways of managing doubt. Diagnosis did not provide closure, instead initiating ongoing, ambiguous interpretive work. Cultural stereotypes and stigmas functioned as powerful arbiters of 'real' autism, producing a double bind of being either 'too autistic' or 'not autistic enough'. Characteristics typical of late-diagnosed women, such as masking one’s autistic traits, appear to sustain rather than resolve doubt. Clinicians should anticipate and normalise post-diagnostic doubt, ensuring individuals feel entitled to support regardless of presentation. Further research should examine prevalence, correlates, and mental health associations of this potentially common yet underrecognised experience.