Autism in Women and Girls
In recent years the number of women and girls1 diagnosed with Autism Spectrum Disorder (ASD) has increased (Autism Research Institute, 2023; Hendricks, 2015). Interestingly the increase is not just seen in younger women but in women in their adult years. The experience for a women with ASD can be quite different than that for men. Let us explore why the rates of women on the autism spectrum are increasing, what the presentation of ASD looks like in women and girls, challenges that women with ASD face, and what resources are available to those with ASD.
Image of a woman looking away from the viewer.
Rates of Diagnosis
Historically it was believed that the rate of autism diagnosis in men to women was four to one. Thus for every four men diagnosed with autism one woman would be diagnosed. More recent research is indicating that the ratio is more likely three to one (Autism Research Institute, 2023). Why this sudden change? Partially it has been due to a better understanding of the diagnostic criteria for Autism, and public awareness of ASD.
In the past the observable behaviors used to diagnose Autism were those that were observed in men but not necessarily in women. More recently research has started to note that women might present differently than men and this adjustment in the understanding of the presentation is now capturing more women with the disorder (Autism Research Institute, 2023). Moreover, women who were not diagnosed as children are now seeking out evaluation and diagnosis on their own as a way to better understand themselves. As awareness and understanding increase more people are seeking evaluation and thus being diagnosed. It is not that there is a new rise in ASD in women and girls, just that we are finally capturing a portion of the population that has been historically ignored.
Presentation in Women
Historically the observable symptoms of Autism were predominantly derived from observing boys diagnosed with Autism. The underlying assumption being that there would be no difference in how the symptoms would present between boys and girls. This however does not appear to be accurate. As men and women are socialized differently in our culture the presentation of symptoms can often be different.
For example for boys with Autism are often singled out by their peers for their ridged thinking and special interests. In the United States girls are taught to be pro-social and to be inclusive in their play and thus in the early grades it might not be noted by teachers or other adults that there are any challenges. Many women diagnosed with Autism do note that they had social difficulties but they are often not observed until later into elementary school, or even middle school (Hendrickx, 2015). It seems while girls can be more accepting of someone who does not follow social norms in earlier grades, where as boys are often singled out and thus their differences are easier to notice. The tolerance that women with ASD enjoy in their early school years seems to erode towards middle school years, and many women with ASD will note how their friends ‘turned’ on them during middle and high school.
One of the key indicators of Autism Spectrum Disorder is engagement with special interests. Historically special interests related to ASD have been thought to be trains, space, and other math or science related topics. Women and girls with ASD have special interests but these can often take the form of celebrities, bands, animals, shows, or fantasy series (Hendrickx, 2015). While many neurotypical women and girls might share such interests the level of knowledge and time given to the special interest for those on the autism spectrum will be notably more intense. As the special interests of women and girls did not fit what was noted in the diagnostic criteria this added to professionals not considering ASD as a diagnosis.
Challenges
Bullying is an all too common experience for those with ASD. Many adult women on the Autism spectrum will note a history of being bullied, or excluded during their childhood (Hendrickx, 2015). As many women and girls with ASD are not diagnosed the social difficulties they experience are often just viewed as kids being kids. Many adult women who have been diagnosed with ASD will look back on their social struggles and can see how they are directly tied to being on the autism spectrum.
One of the primary difficulties that women and girls with ASD can report is continued social difficulties. There are subtle social cues that women and girls on the Autism spectrum tend to miss and this can cause them challenges with their neurotypical peers. Subtext in communication seem to be particular challenge for those with ASD. There is a cultural expiation that women and girls will be more proficient at picking up subtle cues in conversations, and thus while women might be no better or worse their their male ASD peers they can face harsher social consequences.
Women and girls with ASD tend to find solace in their special interests (Attwood, 2007). They will engage in fandoms and will have extensive almost encyclopedic knowledge of their favorite subjects. This could range from a favorite book series or TV show to their favorite band. When getting to discuss their special interests they tend to fit in better socially. As women and girls tend to self-select into such groups their challenges can often be overlooked because they seem to fit in, but should the topic shift away from something they are familiar with challenges will again be seen.
Resources
As more women and girls are being diagnosed with ASD resources are increasing. More providers are learning about the unique challenges that women face and how to help them navigate these challenges. For many women finding support groups online can be incredibly powerful. Reading books on being a women on the spectrum can also be very helpful.
Talk with your family and discuss what being on the Autism spectrum means to you and your experience. Discuss what challenges you have, and how you can best address these issues. If your friends and family ask how to help have a few things that you can have them do that you know will be helpful.
Therapy with a provider who understands Autism, and specifically Autism in women can be greatly helpful. Therapy will not change who you are, more it will help you find ways to successfully navigate your life with the resources you have. For tips on finding the right therapist see our previous blog post here. For more information on Autism in Women the following books are recommended:
Women and Girls with Autism Spectrum Disorder by Sarah Hendrickx
The Spectrum Girls Survival Guide by Siena Castellon
References:
Attwood, T. (2007). The complete guide to Asperger’s Syndrome. Jessica Kingsley Publishers.
Autism Research Institute. (2023, March 9). Women in autism. Autism Research Institute. Retrieved August 7, 2023, from https://autism.org/women-in-autism/
Hendrickx, S. (2015). Women and Girls with Autism Spectrum Disorder: Understanding Life Experiences from Early Childhood to Old Age. Jessica Kingsley Publishers.
When the term women and girls is used this term is inclusive of those assigned female at birth identifying as non-binary, and transwomen. ↩︎
