Much like Attention Deficit Disorder with or without Hyperactivity (ADHD), autistic girls and women are under-diagnosed. Better able to hide their social difficulties, they tend to fly under the radar more easily. Not to mention the fact that Autism Spectrum Disorder (ASD) has historically been framed as a male disorder… Here’s why.
Less obvious signs of autism in women
It is commonly observed that autistic people, whether men or women, copy other people’s social codes to fit in better. But a recent study published in the journal «Autism» revealed that autistic women were more likely to mask their social difficulties than autistic men.
« In its most complex form, [social camouflaging] involves adopting a persona. For women in particular, this can mean watching other women who seem popular, and copying their body language or clothing », explained Dr Will Mandy, co-author of the study[1].
« We find that the autistic traits of many girls aren’t noticed or recognised in the same way as the autistic traits of boys at school. And that’s because the same mould is used to diagnose boys and girls, even though their autism often doesn’t rest on the same criteria », said Hannah Hayward, a researcher in female autism at King’s College London.1
The pitfalls of gendered medicine
According to the ICD-10 (the WHO’s International Classification of Diseases), the sex ratio shows that 3 to 4 autistic men are diagnosed for every one autistic woman. But « it’s important to remember that prevalence rates and diagnosis rates are two different things », points out Muriel, a senior lecturer specialising in the history of women, gender and medicine at Lyon 1 University[2].
Clinically, the way autism functions and presents is identical regardless of a person’s sex. « However, it can show up differently in women and men, notably because of social conditioning, each person’s unique identity and their stage of life », explains Magali, co-founder of an association for autistic people advocating for responsible and innovative self-determination.2
Historically, it should be noted that ASD was framed as a male disorder: the first studies on the subject, in 1943-1944, concerned almost exclusively boys. It wasn’t until the 2000s that research on autistic women began to appear.
These studies call on doctors to be more attentive and to better diagnose autism in women, ideally as early as possible. If in doubt, parents are encouraged to make an appointment and get an initial assessment with a speech and language therapist, which can then be complemented by other specialists (psychologists, paediatric neurologists, etc.).
[1] Sources: https://www.santemagazine.fr/actualites/actualites-sante/autisme-pourquoi-les-femmes-sont-sous-diagnostiquees-426931
[2] Sources: https://centre-imind.fr/femmes-autistes/
