Autism Spectrum Disorder (ASD) is a complex neurobiological disorder that ranges in severity and is chiefly recognized by difficulties in social interaction and verbal communication, alongside repetitive or restrictive behavior patterns. Because ASD is so complex and the range and severity of symptoms exists on such a wide spectrum, many people, diagnosticians included, still struggle to understand the various ways in which it can present.
Stereotypes have dominated the popular narrative, causing people to abandon nuance in favor of believing that all autistic individuals must perfectly align with the image of them portrayed in the media. Unfortunately, that image is very limited and promotes the incorrect idea that only a certain type of person can have autism, and that person is almost always male.
The idea that ASD is a male disorder is a widely held belief despite insignificant data to back it up. As a result, women with autism are often overlooked and undiagnosed relative to their male counterparts. This causes many women on the spectrum to experience feelings of alienation and distress, which can lead to anxiety, depression, and low self-esteem. They are unable to receive the support they need because they aren’t even aware that they’re allowed to ask for it.
Because autism is about 4.2 times more prevalent in boys than girls, many researchers choose to only include boys in their studies. This means that while there is significant data on how autism presents in boys, there is shockingly little on how it might present differently in girls. Even the diagnostic criteria for the disorder are based almost entirely on observations of boys. As a result of the glaring gender bias, parents, teachers, and clinicians are less inclined to consider ASD as a possible explanation for why girls under their care may struggle with social interaction and sensory issues.
On average, girls with autism are identified much later than their male counterparts, with many of them not receiving a diagnosis until adulthood. There are several possible reasons for this. Because girls are under more societal pressure to meet gender expectations they are usually better at masking their struggles. They tend to be more socially adept, learning how to “pass” by observing and mimicking others
This can make it difficult for clinicians to notice symptoms of autism even when they’re looking for them. It isn’t uncommon for women on the spectrum to be repeatedly misdiagnosed. ASD is linked to a number of other conditions such as ADHD, OCD, anxiety, depression, learning disabilities, sensory processing disorder, and eating disorders to name a few. Failure to acknowledge that these conditions do not exist on their own and are an expression of autism hinders treatment.
This is especially dangerous considering that women with ASD have a higher risk of attempting suicide compared to their male counterparts. After years of struggling to keep up with the fast-moving neurotypical world, many of them are left feeling burnt out. When they reach out to clinicians for help and are met with misdiagnoses and treatments that do more harm than good, it’s easy to see how it can quickly become frustrating. That frustration is often directed inward, causing these women to believe that they are “unfixable,” leaving them to be overcome by feelings of hopelessness.
But there is nothing about these women that needs to be fixed. It is the system that needs repairing, not them. The unethical biases that allow women and girls with ASD to be overlooked and underdiagnosed must be done away with. The harm it has caused is immeasurable.