Manchester United goalkeeper Safia Middleton-Patel made her autism diagnosis public in September 2023 via Instagram, but her journey to that point had been challenging.

Speaking to She’s A Baller, Safia recalled how she felt she had been dropped and singled out by former clubs because of her diagnosis, with one coach accusing her of “faking autism” which led to unease with her teammates.

At another club, the 20-year-old felt she had been dropped because it was easier to release her than try to understand the way she works.

“It just made me question everything, every conversation I’ve ever had with them and what I did wrong for being me, as if I didn’t feel like an outsider enough,” Middleton-Patel said.

“At the time, I was highly ‘masking’ (hiding certain behaviours) and I wasn’t very good at that to start with because I was clearly not fitting in. But I look back at it now, and it’s me at the end of the day. It’s who I am, so if they don’t like it, I’ll move on.”

Autism is a neurological and developmental condition that exists on a spectrum and affects how people communicate, interact, learn and behave. It presents differently for everyone but can impact social interaction, create heightened anxiety and cause difficulty understanding how others think and feel.

While it is estimated there are 700,000 people living with autism in the UK, it remains highly stigmatised in society and in sport more specifically, leading to a lack of understanding of how to support autistic athletes.

“It’s a very taboo subject, and there needs to be more visibility. I just never want anyone to feel as alone in the world,” says Safia.

“It’s a subject that clubs shy away from because they don’t know how to deal with it.”

Safia, who was born to an Indian father and Welsh mother, received her first call up to the Wales international team in 2023 for the Women’s World Cup qualifiers against Greece and Slovenia. 

But she didn’t get a formal diagnosis until she was 18 and she explained the difficulty in always feeling different from her peers. 

“At secondary school, I struggled to socialise and I felt I was always following this social script,” she recalls.

“After football games, I’d be drained because all the prep and the day took so much energy out of me. I just thought, ‘Does everyone feel like this?’”

The realisation, then, was gradual but Safia was spurred into seeking a diagnosis at a time she should have been celebrating personal triumphs. In the same week she had made her Championship debut with Coventry United and she then went on to make her senior Wales debut.

“For many people, that would have been the best week of their life, but for me, it was the worst.”

“I couldn’t deal with the emotions of the week. I had a massive breakdown, and I remember sitting on the end of my bed saying to my mum, ‘I need help. I don’t think I can do this much longer.’

In many ways, obtaining that diagnosis was a triumph. It can provide clarity and access to help, but it takes courage to seek out a formal diagnosis, especially for women and girls, where it can often be missed or misdiagnosed.

“I felt a lot of sadness and grief for the life I could have had if I wasn’t autistic. I remember questioning all the friendships that I’d built and who I was.”

Since then, Safia has been able to recognise her own symptoms and implement adaptations that mean she can fully realise her potential on the pitch.

But football, like many professions, retains norms that present barriers for many autistic people.

Having had five different loan spells during her time with United, Safia is all too aware that change remains an integral expectation of all footballers.

“It’s something that horrifies me, I am so scared of change,” she says. “Going to Watford last year I was settled in perfectly with the club, but I would go home, and I would just cry and cry and cry because I hated how I felt.

“I couldn’t control anything because I didn’t have my set routine. Even driving on the roads, I would have routines where I can take a drink at certain traffic lights or on certain roads I can turn the music up louder.

“I look back at it now and think that loss of routine is so detrimental to my health.”

Yet football has provided Safia with a rare space to be comfortably challenged.

“Football has provided that sense of routine and structure in my life that I need, but it’s also pushing me out of my comfort zone,” she says.

“One of the main roles for me is communicating and, at times, I need to give feedback in a way that sometimes I don’t even know how to do myself by changing the tone of voice.

“If I’m on a pitch and someone has changed their tone of voice [I have to learn] not take it to heart because I think into it too much.

“Being put in this high-pressure sporting environment can be so challenging if things go wrong. It’s something in football more people need to understand.”

Thankfully, at United, the Wales international has found a community where support is always forthcoming.

“I’m so grateful for our goalkeeping coach [Ian Willcock] because he’s embraced me with open arms. He’s got to know me on a person-first level and made me feel valued as an individual,” she says.

In the ‘Lego Club’, with Jess Simpson, Leah Galton and Rachel Williams, she has also found a group who have her back “no matter what”.

It is an environment that has allowed Safia to be herself and become the backup goalkeeper to Phallon Tullis-Joyce. Safia made her debut with United last week.

“Getting to train day in day out with Phal is inspiring. It’s really exciting to keep pushing her on. Personally, I’m ready to take my opportunity when it comes, and I just want to fulfil my potential.”

Looking back on it all, Safia emphasises that it does get better because sometimes it’s the little triumphs that can make you smile the most.

“One day, it can feel like everything’s crashing down on you, and the next day, I’m loving life because I’ve just found a Lego figure in a cupboard that I didn’t know I had,” she laughs.