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Why Does Autism Get Diagnosed Less in Women and Femmes?


Why Does Autism Get Diagnosed Less in Women and Femmes?

These days, many more boys, men, or those who present as male, are diagnosed more often with autism than girls, femmes, women, or those who present as female. 

However, this is not because there are more boys or men that have autism. Instead, autism in girls, women and femmes presents much differently, so doctors often misdiagnose it.

What Happens When Young Girls Don’t Get Diagnosed With Autism?

If young girls with autism don’t get diagnosed, they won’t have access to as much support and may have trouble understanding the difficulties they face in social settings and environments like school. They can also get more exhausted than their neurotypical classmates because it takes more effort to fit in or avoid being bullied. Ultimately, this can cause depression, anxiety, or low self-confidence.

Is There a Gender Bias That Causes Late Diagnoses?

Women and femmes experience inherent gender biases in their everyday lives. This can occur at school, at work, in family dynamics, or in social settings. According to new research, gender bias is being determined as one of the reasons that there are fewer diagnoses in women and femmes with autism. 

The Guardian released a report about a new study that discovered the ratio of women to men with autism was 3:1. However, these results were conducted via active screening instead of referring to clinical and school records. The issue with this is that many women and femmes are not diagnosed – and for those who were, they found out about it later as an adult. Also, since early autism research was solely focused on men and neglected to consider that women and femmes may present their symptoms differently, this contributed to women and femmes being underdiagnosed. Researchers, in fact, only recruited men or male presenting individuals to participate in their research. Luckily, researchers are now starting to study the differences in autism according to other genders, and the results show that autism looks much different in women and femmes. 

Is There a Stigma With Women and Femmes Having Autism?

Unfortunately, there is still a stigma that women and femmes don’t have autism by the general public and even diagnosticians. Some specialists even think that women and femmes with higher testosterone are more likely to be diagnosed with autism due to a concept called the “extreme male brain” theory. 

Popular culture and media representation has also encouraged the stereotype that only boys, young men, or those who present as a male can have autism.

How Does Autism Manifest Differently in Women and Femmes?

According to research scientists, women and femmes have special interests that are different than young men. Young girls with autism or those who present as female may have more mainstream special interests than men. Many people may perceive these as more “normal” or conforming to a neurotypical society. These special interests can also be seen as “girly” and be overlooked.

Young boys or those who present as males with autism tend to be more overt with their behavior and can misbehave more, whereas young girls or those who present as girls with autism show their symptoms more covertly, like being more anxious or depressed.

Repetitive behavior, like hand flapping, is a common sign of autism that many doctors recognize easily. However, young girls with autism may not engage as much in many repetitive behaviors as their boy counterparts and be much quieter about it.

Autistic girls can also be better at socializing, pick up social cues faster, and mimic traits from their friends. In addition, they can also be more effective at controlling their behavior in a public setting. For example, they may have been told early on or coached by parents, family members, or other adults to smile or make eye contact. 

Young girls with autism may also be more interested in making friends as opposed to boys with autism. Since all of these traits can be more subtle, it may be more difficult for a doctor to recognize them right away. In addition, since most autism studies have been about young boys, these traits can seem more obvious and easier to diagnose. 

At What Rates Are Young Girls and Boys Diagnosed With Autism?

When analyzing the rates of young girls diagnosed with autism by comparison to boys, the results are startling. For example, only 8% of young girls with autism are diagnosed before the age of six, whereas 25% of boys with autism are diagnosed before age 6. Also, 50% of boys with autism are diagnosed before the age of 11, while only 20% of girls with autism are diagnosed before this age.

What we can draw from these statistics is that there is a considerable difference in diagnosis for men and women and femmes. Another factor contributing to women and femmes being diagnosed with autism less is that it can be more costly. In many cases, doctors will give an incorrect diagnosis of another disorder or not do enough of an extensive assessment of the patient’s social abilities. As a result, many women and femmes have to find care from the private sector to get a diagnosis, which not everyone can afford to do. Due to this expense, many women and femmes may avoid seeking a diagnosis because they can’t afford it or need to save money. Plus, since many professionals don’t believe that women or femmes have autism or as often as men do, they feel it can be a waste of time and money to find a formal diagnosis.

Why Is Diagnosing Autism Essential?

Diagnosing autism is a must because it gives the person access to the resources they need. Also, women and femmes who have been diagnosed with autism can stop masking their autistic traits and feel better mentally since they can accept their diagnosis. It can explain a lot about how they’ve been feeling and provide relief, further improving their self-esteem, self-worth, and efficiency.

Women and femmes who have autism but do not receive a diagnosis can feel more alone than others and invalidated. Therefore, it is imperative to continue providing education to medical and health professionals so that women and femmes can get diagnosed with autism much earlier. In addition, there needs to be a better way to assess autistic treats in women and femmes and how they may present differently.

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Kaitlen Knowles, Clinical Social Work/Therapist, LCSW (she, her), Rochester, NY

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