How Autism Presents Differently In Women

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects social interaction, communication, and behavior.  Autism is traditionally viewed as a male-dominated condition which makes proper diagnosis for women more difficult. As a result, many women and girls on the spectrum often go unrecognized.  Women with autism tend to have other mental health issues which can make life difficult.   The autism diagnosis helps them understand why life is difficult and how to make things better.  The diagnosis can have a positive impact, helping their confidence and getting them the right help and advice.

Why Do Women Present Autism Differently than Men?

The phenomenon of women with autism presenting differently than men is influenced by a combination of biological, social, and cultural factors.

1. Biological Factors: Some research suggests there may be inherent biological differences in the ways that males and females experience autism. Genetic studies indicate that it might take a greater number of genetic mutations or a more severe genetic mutation for a girl to manifest the symptoms of autism, suggesting that females could be somewhat protected from developing ASD. This concept is known as the “female protective effect.”
2. Socialization and Gender Expectations: Women and girls are often socialized differently than men and boys. They are typically encouraged from an early age to be more social and communicative, and societal expectations might lead them to develop better coping strategies for their social difficulties. This adaptation is often referred to as ‘masking’ or ‘camouflaging,’ where girls with autism mimic behaviors of neurotypical peers to fit in. This might cause their symptoms to be less apparent to others, leading to underdiagnosis or misdiagnosis.
3. Diagnostic Criteria: Diagnostic criteria for autism have historically been based primarily on observations of males. Boys are typically diagnosed with autism much more frequently than girls, leading to a male-biased understanding of the condition. This has resulted in criteria that may overlook or misinterpret how autism presents in females. For example, girls may have more socially acceptable interests or obsessions, and their difficulties in social interactions may present as shyness or quietness.
4. Co-occurring Conditions: Females with autism often have co-occurring conditions such as anxiety, depression, eating disorders, or ADHD that can mask their autism symptoms or complicate the diagnosis process.  They may get only diagnosed with one of those conditions while missing the autism.

Why do Women Have Difficulty Getting Diagnosed with Autism?

The difficulties women often face in obtaining an autism diagnosis can be attributed to a combination of factors such as gender biases in diagnostic criteria, social expectations, and the phenomenon of masking. Let’s delve into these factors more closely.

1. Gender Bias in Diagnostic Criteria: The diagnostic criteria for Autism Spectrum Disorder (ASD) were developed based primarily on observations of boys, leading to a male-centric view of autism. Consequently, the signs of autism in girls and women—especially those who are high-functioning—may not match these traditional diagnostic criteria. They might appear less outwardly obvious or manifest differently, leading to missed or late diagnoses.

2. Masking or Camouflaging: Women with autism often ‘mask’ or ‘camouflage’ their symptoms in order to fit in with their peers. They might learn to imitate neurotypical behavior, suppressing their autistic traits. While this helps them socially, it also makes it harder for healthcare professionals to recognize their symptoms, resulting in underdiagnosis.

3. Social Expectations: Societal norms and expectations can also play a role. Girls are often socialized to be more relational and communicative, which can lead them to develop coping mechanisms that conceal their social difficulties. Additionally, their interests or behaviors may align more closely with societal expectations for their gender, making their symptoms less obvious.

4. Co-occurring Conditions: Females with autism often present with co-occurring conditions such as anxiety, depression, or eating disorders. These conditions might be diagnosed first, overshadowing the underlying autism or complicating the diagnostic process.

5. Lack of Awareness and Understanding: Lastly, there’s a lack of awareness and understanding about how autism presents in women, even among medical and mental health professionals. This lack of knowledge can lead to misdiagnosis or women not being diagnosed at all.

7 Key Signs of Autism in Women

1. Social Interaction Difficulties: Women with ASD may have a hard time navigating social landscapes. While they may seem highly social, they often struggle with understanding unspoken social cues, nuances of conversation, or maintaining friendships. The relationships they form often revolve around shared interests rather than emotional connections.

2. Executive Function Limitations:  In women with autism, executive function problems can manifest in various ways, such as struggling to switch from one task to another, difficulty with time management, trouble organizing thoughts or tasks, and challenges in regulating emotions or behavior. It’s important to note, however, that not everyone with autism will experience difficulties with executive functioning, and the degree to which they are affected can vary greatly from person to person.

3. Obsessive Interests and Hyperfocus: Women with autism often have one or two intense interests they hyperfocus on. While this can be true for both genders, girls and women often gravitate towards socially acceptable interests, such as books, animals, celebrities, or art, making this symptom easy to overlook.

4. Sensory Sensitivity: People with ASD, including women, commonly experience sensory sensitivity or sensory processing disorder. They might be overly sensitive to sounds, smells, tastes, textures, or lights, which can often lead to discomfort or even pain in everyday environments.

5. Issues with Change and Routine: Women with autism often rely heavily on routines and struggle with changes, no matter how minor. A sudden alteration in their plans or environment can lead to extreme stress and anxiety. Their attachment to routine is often misinterpreted as being rigid or stubborn.

6. Emotional Regulation: Emotional regulation can be a challenge for many women with ASD. They may experience intense emotions and struggle to manage them appropriately, which can sometimes be mistaken for mood disorders. On the flip side, they may also struggle to understand or interpret the emotions of others.

7. Physical Coordination Problems: Women with ASD often struggle with physical coordination and may appear clumsy or uncoordinated. This lack of motor coordination can affect their ability to perform tasks requiring fine motor skills and can lead to difficulty in sports or other physical activities.

Counseling Help in the Denver Area

Recognizing autism in women and girls can be challenging due to prevailing stereotypes and the tendency of women to mask their symptoms. It’s essential for society, and particularly for professionals in education and healthcare, to recognize these indicators to ensure earlier diagnosis and the implementation of effective support strategies. Remember that every individual with autism is unique, and these signs may present differently or not at all. A comprehensive understanding of autism in women is crucial to address the gap in diagnosis and support services. The journey towards inclusive understanding continues, promoting a world where every individual, irrespective of their neurotype, can feel understood and accepted.

If you are struggling with autism, know that you are not alone. We’d like to help you with counseling so you can start to feel better and get back to your life.

We invite you to call us at 720-551-4553 for a free 20-minute phone consultation with a therapy specialist.  You can learn more about our Therapy services by clicking this link.