Holly Madison on Autism and Female Stardom

Gina-Marie Lobaito

Pop Culture Correspondent

Holly Madison is a New York Times bestselling author, and has had her own burlesque show in Vegas—but she’s most likely known for being a Playboy Bunny, and Hugh Hefner’s girlfriend, from 2001 to 2008. In 2023, Holly Madison went public with her diagnosis of autism at the age of 42. Immediately, the TV-personality was immensely supported on the internet, with more women feeling free to share their experiences with the disorder. I was lucky enough to interview Holly on everything that diagnosis meant to her. As an autistic woman, I am honored to have had this talk with her. This conversation has been edited for length and clarity.

Holly Madison pictured by Denise Truscello.

You would be considered as having a late diagnosis. Did your formative years in the public eye make you want to push further for a diagnosis? 

HOLLY: Yes, I wanted a diagnosis because I felt in order to speak about it publicly, I needed to get as many answers as possible first.

Looking back on The Girls Next Door, during your rewatch for your podcast, do you see any inherently autistic traits that you displayed? 

I definitely see autistic traits displayed. For example, in the episode where Bridget gets a new car, I’m excited for her but I don’t look it. I look very flat and get caught zoning out, so it gets turned into a gag where I’m “not impressed” with her car.

In the mansion, did you find yourself masking around the other girls since there was almost a “mold” as to what you had to put yourself out there as?

I think I tried masking harder when I first moved to LA but I thought it was all part of what I needed to do to “make it” in the world.

Do you think that your autism made it harder to form relationships in your life, whether they be platonic or romantic?

Being autistic definitely made it harder for me to form all kinds of relationships. Especially romantic [relationships], even to this day. Even other people I’ve been involved with, that I suspect are also on the spectrum, have a hard time feeling connected to me. Oftentimes, I will feel connected to someone, but they feel they can’t “get through to me” or aren’t “getting anything” from me, so they give up entirely. This can be very isolating.

What was the hardest thing about having a late diagnosis?

I think the hardest thing about being late diagnosed is the public bullying I got from other, older women who I lived with at the mansion. I think if I would have been able to articulate what was going on with me, perhaps some of that could have been avoided, but maybe not. They may have bullied me specifically for being autistic. Who knows?

As a woman, did you find it difficult to get a diagnosis for ASD?

I did find it difficult to find a doctor who does adult diagnoses, regardless of gender. I asked other doctors and even had to google-search for local doctors. It took about two years of casual searching for me to find someone to even visit. Considering the fact that I split my time between two large cities, and have the financial privilege of being able to see any doctor I want, it surprised me. So when people say they struggle to find the right doctor to get an adult diagnosis, believe them!

Do you have a current hyperfixation? 

I’ve had many hyperfixations in my life. I think the latest one is health and fitness.

How does it feel to have so much support around your diagnosis online? 

It feels amazing to have so much support online, and to be able to see so many people on my “for you” page who are talking about their experiences and have gone through a lot of the same things I have. I’m really grateful to TikTok for that.

What’s one thing that you wish your neurotypical fans or followers knew about Autism? 

One thing I wish people knew about autism is that it’s a spectrum and everyone’s experience is different. My executive function is pretty high, so there’s a lot of people out there on the spectrum who struggle with it more than I do. I try to address that any time I talk about it publicly, but even so, people whose family members are struggling sometimes get mad at me. I can really only speak on my experience.

What’s some advice you would give to girls on the spectrum who are reading this article?

My one piece of advice would be to be patient with yourself; don’t feel alone if a formal diagnosis is not something accessible to you at this time. It’s expensive, time consuming and not widely available. Don’t feel bad about making appropriate adjustments in your life to aid your function. Again, it’s a spectrum and everyone’s experience is so different.

— You can find Holly Madison on Instagram (@hollymadison) and on Tiktok (@hollyjeanmadison). Her podcast, Girls Next Level, is available anywhere you get your podcasts.