Her name was Grunya Efimovna Sukhareva.
She was born in Kiev in 1891, into a Jewish family. She trained as a psychiatrist. In 1921, she founded a school in Moscow for children whose minds did not fit the world around them. She lived with those children. She watched them for years.
In 1925, she published what she had seen. Six boys. She described children who kept themselves apart from other children from the very beginning of life, who stuck rigidly to a task once started, who could not adapt to anything new, and who returned to the same subject over and over. She called it schizoid psychopathy. She was the first person in history to write a clinical description of autistic traits in children.
She published it in Russian, in a journal called Questions of Pedology and Child Psychoneurology. In 1926, she published it again in German, in the Monatsschrift für Psychiatrie und Neurologie, so that doctors in the West could read it.
This was almost twenty years before anyone in America or Austria wrote a word on the subject.
Then, in 1927, in the same German journal, she did something that nobody else would do for the next ninety-three years.
She published a second paper. On five girls.
What she saw in the girls
Sukhareva wrote that autistic girls looked different from autistic boys.
Their signs were fainter. Their emotions were harder for them to control. Their fixed interests were less obvious, less strange, less easy to spot from across a room.
None of the five girls had an intellectual disability.
She was describing, in 1927, in Moscow, what we now spend fortunes trying to understand. Girls who have the same brain and none of the same signals. Girls who slip past everybody.
That paper, "Die Besonderheiten der schizoiden Psychopathien bei den Mädchen," was not translated into English until 2020. Charlotte Simmonds did it, and published it in the journal European Child and Adolescent Psychiatry.
Ninety-three years.
What the world read instead
In 1943, Leo Kanner, a child psychiatrist at Johns Hopkins in Baltimore, published a paper describing eleven children. Eight boys, three girls.
In 1944, Hans Asperger, a pediatrician in Vienna, described four boys.
Those two papers became the foundation of everything. Medicine is built on them. Then education. Then buildings.
Nobody cited Sukhareva. Not one paper. Kanner and Asperger continued to be credited as the first to describe the condition. In 2015, two Italian researchers, Posar and Visconti, pointed out that what Sukhareva described in 1925 is almost identical to the diagnostic criteria used today, in the DSM-5.
Almost identical. Written eighteen years earlier. By a woman. In Russian.
Meanwhile, the tools that doctors still use to diagnose autism, the ADOS-2 and the ADI-R, were developed and validated mainly on boys. Because of that, they are less sensitive to the way autism shows up in girls.
We built the ruler out of boys. Then we measured girls against it and said they did not qualify.
What did that century cost
Here is what the arithmetic looks like today.
Autism is diagnosed far more often in males. The figure most often quoted is around three boys for every girl. But when researchers screen whole populations instead of waiting for people to be referred, the real ratio comes out closer to 3.25 to one, and models suggest that up to 39% more girls should be diagnosed than currently are.
Women get their diagnosis, on average, five years later than men. At their first assessment, they are less likely to be diagnosed correctly and more likely to be diagnosed with something else entirely.
And there is a reason. It has a name in the research. Camouflaging.
Women score higher on camouflaging than men do. In plain words, women are better at hiding it.
She learns to copy the room. She watches how other people hold their faces, and she holds hers the same way. She rehearses the small talk in the car before she goes in. She laughs a quarter of a second after everyone else, because she is following, not feeling. She keeps her body still while every light and every voice in that building is scraping across her nervous system.
She does this for eight hours. Then she goes home.
And this is where it gets very hard, because this is motherhood
The research says the female autistic profile often only becomes visible in certain moments of transition. Adolescence. University. Motherhood.
Motherhood is where the hiding stops working.
Because hiding costs something. The research is precise about this. Camouflaging helps a woman fit in for the short term. Over the long term, it generates significant cognitive and emotional strain.
Think about what that means in a house at half past five in the afternoon.
She has spent the entire day managing a building that nobody designed for her. Fluorescent lights. Open plan. A hum from the air conditioning that nobody else says they can hear. Every one of those things has been taking a small withdrawal from her, all day, and she has been paying without noticing, because she has been paying since she was six.
She walks in the door. Her daughter runs at her, talking. The kettle. The television. Something is beeping. Somebody needs a form signed.
And there is nothing left.
Not love. There is always love. Energy. There is no energy left, and no patience, and she snaps at a five-year-old over nothing, and then she lies awake at midnight and decides that the problem is that she is a bad mother.
She is not a bad mother. She spent her entire day paying rent for a building.
This is the part that took me twenty years and my own daughter to understand. Because it happened to me.
The line I want to write very carefully
In 2025, a team led by Dr Rachel Moseley at Bournemouth University, working with Simon Baron-Cohen's group at Cambridge, surveyed 1,369 autistic adults about what drives suicidal feelings. The paper is called "A combination of everything," and it appears in the journal Autism in Adulthood.
The survey was designed in consultation with autistic people. That matters because for decades, the questions were written by people who had never been in the room.
Suicide is a leading cause of death for autistic people, and the theories developed on non-autistic populations do not explain it well. One of the themes that came out of the survey was the experience of being abandoned by services. Of waiting years for an assessment with no support in the meantime. Of finally receiving the diagnosis and discovering that it unlocked nothing.
Not having a name for it is not a neutral state. It is not a technicality of paperwork. Commenting on this body of work, Dr Steven Kapp of the University of Portsmouth noted that being undiagnosed is often associated with severe difficulties and even suicidality, and that underdiagnosis should therefore be treated as a serious concern.
So when you see the figure that one in seven people is neurodivergent, understand what that number actually is.
It is a count of the people who made it through a door that was built to keep women out.
Now, let us talk about all of us
I want to be careful here, because this next part is not a story about a minority.
We have built almost everything on an assumption that has never been tested: that there is a standard nervous system, that most people have it, and that anyone who struggles will speak up.
Both halves of that assumption are false.
Look at what the British Standards Institution actually published. In October 2022, the BSI released PAS 6463, "Design for the mind: neurodiversity and the built environment." It is the first standard from a national standards body to address sensory processing differences in buildings. It was written by Jean Hewitt, with contributors including the Royal Institute of British Architects, Transport for London, the BBC, the Department for Education, and the Association for Dementia Studies.
And here is the sentence that ought to be pinned above every architect's desk.
The standard says that neurodiversity describes the variation across the whole population, and that its guidance is about all of us.
Not a condition. Not a diagnosis. A description of everybody.
Read who the standard says is affected. People are assessed as neurodivergent. People with a brain injury. People with a neurodegenerative condition, such as dementia or Parkinson's. And many others who have never been assessed at all, who are still negatively affected by the sensory impact of buildings.
Then it goes further, and this is the part I find genuinely important.
Sensory sensitivity is not fixed. It moves. Across a life, it can change after a brain injury, after trauma, after a stroke, after illness, after a change in mental wellness, or with age. The standard names long Covid specifically, because so many people came out of that illness with an altered sense of smell, a nervous system that responds to noise differently, a body that reads a room in a way it never did before.
Trauma does it too. Reactions to trauma can produce hypersensitivity and difficulty with sensory processing.
Sit with that.
Every single person reading this is one illness, one accident, one grief, one decade away from becoming more sensitive than they are today.
You are not designing for a category of other people. You are designing for yourself later.
And this is what I have said in one form or another for twenty years, in every design I have ever handed over. It is not about what the drawing looks like. It is about how a body feels when it is inside it.
So what does that mean, moving forward
It means we have the entire logic backwards.
We currently design for a nervous system that notices very little, and then bolt on adjustments for anyone who notices more.
Turn it around. Design for the nervous system that notices everything and watches what happens.
An American university library bought sound proofed study pods for its neurodivergent students. The neurotypical students used them constantly. Nobody had complained. They simply worked better once it was fixed. The library is now planning to buy more.
This is not a happy accident. It is the mechanism, and it repeats.
Look at the student research. A 2026 study from the University of Manchester surveyed 159 neurodivergent and neurotypical students about the spaces they study in. The striking finding is not how different they are. It is how alike. Both groups named quiet cubicles and individual study rooms as the most effective places to concentrate. Both strongly preferred natural light and windows. Both wanted study to be kept separate from social life.
Then the intensity. Three-quarters of neurodivergent students said noise disrupted their focus, against just under three-fifths of neurotypical students. 81% of neurodivergent students wanted a choice of environments, against 60%. 77% wanted low stimulation settings, against 55%. 49% wanted somewhere to rest, against 29%.
Same needs. Different volume.
The neurodivergent nervous system is not a special case. It is an instrument. It reports the truth about a building earlier and more clearly than anyone else can. It tells you what is wrong before the rest of us have noticed that we are tired.
Design for it, and the whole building improves. Sound is treated as a material and not an afterthought. The overhead fluorescent is gone. Light: warm, dimmable, controlled by the person sitting under it, not by a facilities request form. A choice of places to work rather than one correct place. Somewhere to rest without having to justify it. There is never a single accessible corner down the corridor, because a separate place for different people is not inclusion; it is a waiting area.
Everyone gets a better day. Most of them will never know why.
That is the whole argument. When we design for the most sensitive nervous system, nobody loses.
Back to Grunya
She was not a lone eccentric. She became one of the most important child psychiatrists of the Soviet era. She published for six decades. She renamed the condition autistic psychopathy in 1959, moving closer to the word we use now. She died in Moscow in 1981, at ninety.
She did not know that in the West her name had been spelled Ssucharewa in the German journal, a stray transliteration from the Cyrillic, or that the small distortion helped her disappear.
She did not know that her paper on girls would sit untranslated on a shelf for ninety-three years while women born in 1950 and 1970 and 1990 walked into doctors' offices and were told they were anxious, or difficult, or too sensitive, or fine.
She did not know that in 2020, a translator named Charlotte Simmonds, autistic herself, would sit down with that 1927 paper and finally bring the five girls into English.
Grunya Sukhareva saw them. She wrote them down. She published in two languages so that we would not miss it.
We missed it anyway.
I do not think we can be relaxed about that. Every generation is convinced that the thing it cannot see is not there. Right now, there are women sitting in offices and lecture halls and kitchens, holding themselves very still, doing an enormous amount of invisible work simply to stay in a place that was designed as though they do not exist.
They will not tell you. They have had a lifetime of practice at not telling you.
So it has to be built into what we hand them.
Sukhareva ran a school where the children lived. She did not write about them from behind a desk. She watched what happened to a child in a place over the years, and then she told the truth about it in two languages, and waited.
Ninety-three years.
Let us not make the women alive today wait that long.
If you have felt this in your own body, in your own home, you are not too sensitive, and you are not too late. You are the instrument. Let me help you build the space that finally fits you, and lifts everyone in it. Apply below, and I will read it myself.