Autism and Women
Does Autism present differently in women?
The first thing to say is that Autistic traits present differently in every individual. There is no single trait that is present in every Autistic person. There are traits that are shared by many Autistic people, but even then, they will present and combine with other traits in a way unique to that person. It is also worth remembering that the scientific understanding of Autism is still in the early stages of development and historically healthcare has had and continues to have a gender bias.
Autistic traits may differ in women and girls in comparison to other Autistic people. One study published in Scientific American found differences in the brain activity of Autistic boys and girls in relation to socialising. They state that Autistic girls’ brain activity in these situations is similar to allistic boys (boys who are not Autistic). In other words, Autistic girls may be different from allistic girls, but similar to allistic boys in this respect.
However, there are also differences in how Autistic traits are perceived by society and healthcare professionals in girls and boys. A girl who prefers to play by herself rather than with others is less likely to be seen as “unusual” than a boy who prefers to play alone. Similarly, Autistic girls may have stereotypically girly interests like dolls, makeup, and art. When Autistic boys have a stereotypically boyish interest (e.g. cars, trains), they are seen as more “unusual”. This gender bias makes it less likely for women and girls to be diagnosed.
Masking and Autistic women
Another key factor in the underdiagnosis of Autism in women and girls is masking. Masking refers to the act of hiding or suppressing aspects of oneself to fit in with neurotypical expectations. It may involve suppressing soothing behaviours like stimming or intense interests, mimicking the behaviour of others (particularly of neurotypical people), and developing complex social scripts. Masking can be conscious or subconscious. Sometimes, Autistic people will mask when they do not feel safe or comfortable to be their true selves due to fear or previous bad experiences of judgement, bullying, or ableism. Masking is a problem as it is exhausting and can have major negative impacts on mental health. Everyone should be free and accepted as they truly are, not forced to pretend to be somebody else.
Autistic women are more likely to mask than Autistic men. This is because society often teaches women to not be “too much” or “too emotional” and the healthcare industry has historically dismissed women’s health-related issues and pains, pressuring women to fit in and downplay their struggles. Because of this, a woman can (unintentionally) have extensive experience in masking to the point that she does not even realise that she is masking. This is particularly common among those who do not know what masking and Autism are. Masking can result in many mental health issues and a feeling of being lost and not knowing who you are. It also impacts accessing a diagnosis and recognition of Autism.
The diagnosis gender gap
A study by the Centre for Disease Control in the USA found that Autism was four times as common in men than women, and it is interesting to see that this is presented as a fact showing how Autism occurs rather than how frequently it is diagnosed in men and women.
The National Autistic Society in the UK summarises research as showing the ratio of Autistic men to Autistic women of anywhere between 2:1 and 16:1 with 3:1 as the most likely situation.
The diagnosis gender gap is closing, but there is still much more to do.
When are Autistic women diagnosed?
Research by Swansea University has shown the average age of diagnosis for Autistic girls to be between 10 and 12, compared to between 4 and 6 for boys. This huge disparity further illustrates the problems faced by Autistic women and girls in having their neurostatus recognised.
Many more women are also seeking a diagnosis as adults, having had their Autism misdiagnosed or missed altogether when a child. The Independent newspaper reports that 150,000 women took an online test for Autism in 2021 compared with 49,000 in 2020. As awareness grows, this trend is likely to continue.
The journey continues
It was not so long ago that anyone suggesting that a girl or woman may be Autistic would probably have been dismissed out of hand by many medical professionals. Thankfully, that situation has now passed, but we are still a long way from equality in recognising and supporting Autistic women to be their true selves. This is important because, with the right support, Autism can bring huge strengths and benefits, not just problems navigating a world designed by brains that work a different way.
We all have a role to play, and education is key. By being well-informed and sharing that knowledge with others when we can, the lives of people will improve, and more women and girls will get the support they deserve and need.
FAQs
Q: What are repetitive behaviours in Autistic women?
Engaging in repetitive behaviours is an Autistic trait also known as stimming. This can include rocking, spinning, and fidgeting. Other types of repetitive behaviours and movements in Autistic women/that are seen as stereotypically feminine can include twirling your hair around your finger for example.
Q: What are the 3 main traits of autism in women?
There are no Autistic traits specific only to women. However, some Autistic traits that women (and men) may have include:
Sensory sensitivity. This includes over- or under-sensitivity to sounds, lights, touch, tastes, and smells. This is also referred to as hyper- and hyposensitivity.
Difficulties understanding social cues, and maintaining eye contact, and may prefer to play/spend time alone or with other Autistic and/or neurodivergent friends.
Struggling with changes to routine or environment, which can lead to distress or anxiety.
Find out more about Autism and Autistic traits here.
Q: Can women and girls be diagnosed with autism later in life?
Yes, many women and girls receive an Autism diagnosis later in life, often in connection with seeking help for related issues such as anxiety, depression, or other mental health challenges. A late diagnosis can provide a significant sense of relief and understanding of past experiences.
Q: How can support for autistic women and girls be improved?
Support can be improved through increased awareness and understanding of how Autism presents differently in women and girls particularly masking and societal gender bias, training for professionals in health, education, and social care, and providing access to resources and communities that understand their specific needs.
Other Resources and External Links
National Autistic Society (UK) - Offers a wide range of information about Autism, including specific resources on Autism in women and girls.
Autistica - A leading UK charity conducting research into Autism, including studies focused on gender differences and late diagnosis.
Autism in Pink - An initiative that has sought to bring more attention to the specific needs of Autistic women and girls through research and stories.
The Curly Hair Project - Founded by Alis Rowe, an Autistic woman, offering books, workshops, and resources focused on Autism.