Female Autism: Is it Different and What Should I Look Out For?
What is Autism?
Autism is a life-long condition that affects the way in which a person communicates, relates to other people and makes sense of the world around them. It usually becomes apparent in the first three years of childhood and can impact on a person’s behaviour, learning and social skills for the rest of their life.
Autism is sometimes described as a ‘variation’ in thinking; people with autism simply view things differently to those without the condition, with neither view being ‘right’ or ‘wrong’.
It’s also a spectrum disorder, so-called to reflect the wide range of difficulties that people with autism may experience. For example, some people will experience difficulties in multiple areas and it will have a severe impact on their day-to-day life, whereas others may have a singular difficulty which they find easier to manage.
Although autism affects everyone differently, the characteristics can be divided into three main groups known as the ‘triad of impairments’. These are:
- Difficulty with social communication (verbal and non-verbal language).
- Difficulty with social interaction (social skills).
- Difficulty with social imagination (the ability to understand other people’s thoughts, feelings and actions).
Autism in Girls and Women
Autism is a condition that affects both men and women. However, studies have shown that up to five times as many men are diagnosed with autism than women.
These differences have been dominant in research for many years, beginning with Hans Asperger in 1944 who originally thought that no women or girls at all were affected by the syndrome he described. Similarly, in 2009, a study by Brugha found that of the adults surveyed, 1.8% of the men had an Autistic Spectrum Disorder (ASD) yet only 0.2% of women were affected. According to the National Autistic Society, in 2015 the number of men supported by their adult services exceeded women 3 to 1.
But why is this the case? Does autism really affect more men than women? There’s no straightforward answer and research is continually being done to find out more and to see if there really is a link between gender and autism.
Why are Fewer Women Diagnosed with Autism?
Despite there being no clear-cut reason why women are less likely to be affected by autism than men, the research presents us with a number of ideas that could help us to understand why women with the condition are less likely to be diagnosed:
– Research and surveys are often focussed around the male characteristics of autism. To this date, there is comparatively little research that focusses specifically on autistic women, largely because the condition is seen as more common in boys than girls, and so boys are routinely only included in research projects. The National Autistic Society says that because of the male gender bias, women are less likely to be diagnosed with the condition, even if their symptoms are equally as severe.
– The diagnostic criteria for Asperger Syndrome are based on the characteristic of males. During childhood boys are often more disruptive than girls, meaning that they’re more likely to receive attention. However, this can lead to girls going un-noticed as their behavioural characteristics are seen to be less of a problem that needs investigating.
– Females with autism are better at masking their symptoms. In general, girls are more skilled at fitting in with their peers and those with autism may try to repress their behaviour so that they don’t stand out. Not only does this lead to symptoms not being spotted but it can also cause mental health issues or cause the girl to ‘act out’ and ‘let go’ once they get home.
– The signs and symptoms of autism amongst girls are less severe. A study from the Kennedy Krieger Institute in Baltimore suggested that, whilst for boys the average age of diagnosis is three, the average age for girls is four or older. This has been attributed to girls exhibiting less severe symptoms – perhaps because they’re repressing their behaviour or because it’s socially acceptable for girls to be ‘quiet’.
– The ‘special interests’ of autistic women are more socially acceptable. Autistic boys often develop strong interests in unusual subjects, like the inner workings of machinery, train timetables or dinosaurs. Autistic girls, on the other hand, commonly develop strong interests in things that are more typical of girls their age, such as books, dolls or celebrities. It’s likely that the autistic girl’s interest will be more intensified but it’s much more likely to go un-noticed.
– Females are protected against autism by their genes. In 2000, a study by David H Skuse suggested that the genes for autism are located on the X chromosome. Girls inherit X chromosomes from both their parents yet boys only inherit one from their mothers. It’s thought that the singular chromosome inherited by girls contains an imprinted gene which ‘protects’ them from developing autism. Further research on top of this suggests that it takes more genetic mutations for autism to occur in females compared with males. However, these studies could also be explained by the extent to which autistic females are involved in such research.
How Does Autism Present Itself Differently in Women?
Through an accumulation of research, surveys and assumptions it appears that women are under-diagnosed when it comes to autism. It’s been suggested on numerous occasions that the behavioural characteristics of autistic women vary greatly compared to those of autistic men, but how exactly do they differ?
A 2015 research project into gender and autism suggested that the female autistic profile is only just emerging. In the report, the authors propose that autistic women (compared to their autistic male counterparts) exhibit the following behaviours:
- Increased social imitation skills,
- A desire to interact directly with others,
- A tendency to be shy or passive,
- Better imagination,
- Better linguistic abilities developmentally, and
- Interests that focus on animals or people.
Some of the behaviours exhibited by autistic women are positive, as seen in this list, whilst others are negative like those often displayed by autistic boys, but it’s important that you look out for them all if you are to truly recognise that a girl needs to receive a diagnosis.
Autistic Female Behaviours
Additionally, autistic females may display the following behaviours:
- Autistic females tend to be more aware of the need to socialise. Even if they lack the skills to interact, autistic girls often copy what their peers do and mimic the skills needed for social interaction. Autistic girls often won’t initiate social contact but can quite easily ‘go through the motions’ of how they’re expected to behave.
- Autistic females tend to use their words carefully. Rather than making meaningless comments, autistic girls will use their words with purpose and will not use small talk to initiate communication.
- Autistic females often create an elaborate fantasy world. Much like an autistic boy would develop strong, specialist interests, an autistic girl may develop a vivid imaginary world or take great joy in escaping into fiction.
- Autistic females may have trouble understanding status. It’s common for autistic girls to misunderstand the social hierarchy and be unaware of how to communicate with people of different status. This can also cause girls to become anxious or hostile if they don’t understand why fellow peers are more popular than they are.
- Autistic females are more likely to experience high rates of depression and anxiety. Beginning in their teenage years, there’s evidence to suggest that autistic girls commonly develop mental health issues, including depression, anxiety and eating disorders. Staff at eating disorder clinics in Birmingham recently discovered that 60-70% of the women in their twenties attending the clinic were undiagnosed autistic women.
- Autistic females often have fewer friends. Particularly in their teenage years, autistic girls are often isolated or have fewer friends than other girls in their peer group. This is linked to the difficulty that autistic women experience with communication and interaction.
- Autistic females find teenage life particularly stressful. Whilst any teenager can have trouble coping with their adolescent years, autistic girls are likely to struggle even more as they get to grips with their sexuality, relationships and puberty. These events can be challenging to understand and there’s unfortunately very little guidance out there to help.
Further Guidance on Female Autism:
The following links and online resources may be useful to you in your quest to learn more about autism amongst girls and women:
‘The Lost Girls’ on the Spectrum website is a great read that tells the story of Maya and the struggle she went through to become diagnosed with autism.
Autism in Pink is a documentary film featuring the stories of women around the world who have autism, including the challenges they’ve faced and their achievements.
Autism Women Matter is an organisation that represents autistic women in the UK, aiming to support autistic females and raise awareness of the challenges they face.
The Curly Hair Project is a website set up by Alis, a 26-year-old woman with Asperger Syndrome, which aims to provide support and relatable content to women with an ASD.
Scottish Autism has recently been given funding to develop a new Women and Girls support programme, aimed at addressing key health and wellbeing challenges, as well as providing practical advice on a range of issues.
More from The Hub:
- Neurodiversity and the Autism Rights Movement
- Parenting Changes to Make for Teens with Autism
- Autism Awareness Quiz