Holly Madison believes her undiagnosed autism landed her at the Playboy Mansion when she was a young and impressionable 21-year-old.
The former Playboy Playmate, 45, received her diagnosis in 2023 after first publicly sharing her suspicions two years prior.
She tells Page Six in an exclusive interview that the news didn’t come as a shock (in fact, she recalls feeling “relief”), as she always knew she had “certain social difficulties and difficulties relating to people.”
However, for the majority of her life, she convinced herself that was because she “grew up in a really, really remote place in Alaska.”
But as she got older, her now-ex-husband, Pasquale Rotella — with whom she shares two kids — approached her mom about struggling to connect with his then-wife.
Her mom informed Rotella that she always felt “something was going on” with her eldest daughter.
So after “a series of seven appointments,” Madison was told she has high-functioning autism spectrum disorder, which refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, according to Autism Speaks.
The “Girls Next Door” star believes that, in part, made her susceptible to “falling in love” with Hugh Hefner, who was more than five decades her senior. For seven years, Madison — and several other busty blondes — lived with the late adult magazine founder, who expected sex around the clock.
“I feel like having the difficulty I did connecting with people for so long made me feel like when I was meeting somebody who was older and more experienced and maybe a little bit better at manipulating people, I thought, ‘Oh, wow, maybe I’m meant to be with an older man. Maybe this is what it is.’ It just felt like love,” she shares.
“It definitely sheds some light on where my feelings were at and my motivations and why I had certain impressions about things.”
Had she “known what [she] was dealing with,” Madison theorizes, “Maybe I would have handled myself a little differently.”
While she doesn’t have “any regrets” about where her life took her, the “Girls Next Level” podcast co-host notes that her autism is an “interesting” and important part of her story.
Later this month, Madison will make her first major public appearance since revealing her diagnosis as the event ambassador for the 2025 Grant a Gift Gala in Las Vegas. The event raises critical funds for children and young adults navigating autism and other neurodevelopmental conditions.
Despite her high-profile past, Madison insists that she is — at her core — a “private” person with a reserved “temperament.”
But when she received her diagnosis, she knew she had a “responsibility” to use her platform to raise awareness, reduce stigma and spotlight the urgent need for expanded services and support.
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