Autism and Girls – Under the radar

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The growing discussions surrounding autism and gender are a positive step toward addressing an important issue: the manifestation of autism in girls and women. While there is now increased awareness that autism often presents differently in females compared to males, this realisation is not entirely new.

Early autism researchers observed these gender differences, but unfortunately, they did not pursue them with the same depth or urgency. The focus largely remained on boys, reinforcing a male-centered understanding of autism. This skewed focus has significantly shaped the diagnostic criteria and assessment methods that are used today, which continue to be more attuned to identifying autism in boys. Furthermore, many of the stereotypes and portrayals of autism are based on male experiences and behaviours, contributing to a misrepresentation of the female experience. Interestingly, autism in girls is often identified later than in boys. While this delay in diagnosis is becoming less common, it highlights a broader issue: girls may not exhibit the same outward signs of autism that boys do, leading to missed or delayed recognition. This raises the question: where does this leave girls and women on the autism spectrum? Are they being properly supported and understood?

Gender Differences in Social Motivation

A key factor that may contribute to the gender disparities in autism diagnosis is social motivation. Research by Sedgewick et al. (2016) highlighted a crucial distinction between autistic boys and girls in terms of their social motivation. The study found that autistic girls showed similar levels of social motivation and friendship quality to non-autistic girls, while boys with autism exhibited lower motivation for social interaction compared to both non-autistic boys and girls. This difference is not merely academic but has practical implications for how autism manifests in girls and boys.

One interpretation of these findings is that girls on the autism spectrum may be more socially motivated than boys, leading them to seek out and engage in more social situations. As a result, girls may develop better social skills through these interactions, even if they do not come naturally. While autistic girls certainly face social and communication challenges, they often learn to camouflage these difficulties by mimicking the behaviours and social cues of those around them in an effort to “fit in.” In other words, they may work hard to disguise their challenges, which can delay diagnosis and increase the burden they face. Importantly, this camouflaging requires tremendous effort. Social skills are not instinctive for autistic individuals in the same way they are for neurotypical individuals, and the strain of consistently performing social behaviours can be exhausting and anxiety-inducing.

A real-life example of the delayed diagnosis of autism in girls can be seen in the story of Emily, a young woman who was diagnosed with autism in her late 20s. Throughout her childhood, Emily exhibited classic signs of autism – difficulty with social interactions, an intense focus on specific topics, and a preference for routine. However, these traits were often overlooked or misinterpreted by her teachers and family as simple shyness or introversion. Emily was described as a “quiet” and “good” girl, someone who was perfectly capable academically but tended to avoid large social gatherings. When she did interact with peers, she gravitated toward younger children, which was seen as a sign of maturity rather than a social preference.

At school, Emily learned to mask her difficulties by mimicking the social behaviors she observed in her peers. She worked hard to fit in, rehearsing conversations and monitoring her body language, but the constant effort left her feeling drained and anxious. Despite her struggles, it wasn’t until her university years that Emily began to recognise patterns in her behaviour that didn’t align with the expectations placed on her. She experienced overwhelming anxiety in social situations and found it challenging to maintain friendships, often feeling isolated and misunderstood.

After much self-reflection and research, Emily sought out an autism assessment. It was then that she received the diagnosis of autism spectrum disorder, which helped her make sense of the social challenges she had faced her whole life. Her late diagnosis, however, was a stark reminder of how gendered expectations and stereotypes about autism had impacted her recognition and support. Emily’s story highlights the tendency to misinterpret autism in girls, often seeing their traits through a lens shaped by male-centric assumptions, and underscores the emotional toll that camouflaging can take on autistic girls and women. Emily’s case also emphasises the importance of early diagnosis and tailored support for women on the autism spectrum, which can provide clarity, validation, and help them better understand their unique challenges. With the right support, Emily has begun to embrace her identity and is now advocating for greater awareness of autism in girls.

The Impact of Gender Stereotyping

In addition to the inherent social motivation and camouflaging tendencies, traditional gender stereotypes can exacerbate the problem of underdiagnosis in girls. Autistic girls may be labeled as “shy” or “quiet,” which can be misinterpreted as a simple personality trait rather than a symptom of an underlying condition. Similarly, if a girl prefers friendships with younger children, she may be viewed as nurturing or caring – a common societal expectation for girls – that does not raise concern. However, if boys exhibit similar behaviours, they may be perceived as socially withdrawn or even “odd,” leading to more scrutiny and, potentially, an earlier diagnosis.

These gendered expectations can obscure the signs of autism in girls, allowing them to fly under the radar for much longer than boys. The problem lies in the tendency to view social difficulties and preferences in girls through a lens shaped by traditional gender roles, which can prevent clinicians, teachers, and even parents from recognising the signs of autism.

The Cost of Camouflaging

While camouflaging may help girls “fit in” in the short term, it comes at a significant emotional and psychological cost. The constant effort to mask one’s true self in social settings can lead to overwhelming anxiety and, over time, can result in mental health issues such as depression, burnout, or eating disorders. Imagine the mental strain of planning and rehearsing every social interaction, constantly monitoring one’s own behaviour to ensure it aligns with social expectations. For some, this relentless effort to maintain a socially acceptable façade can be physically and emotionally exhausting.

Furthermore, the pressure to conform can lead to unhealthy relationships. Girls and women on the autism spectrum may struggle to navigate the complexities of social interactions, potentially forming friendships or relationships that are not beneficial or even manipulative. Social naivety, compounded by the effort to camouflage difficulties, can leave them vulnerable to being taken advantage of, further damaging their self-esteem.

The Importance of Diagnosis

While some girls and women may live fulfilling lives without a formal diagnosis, the lack of recognition of them being on the autism spectrum can be problematic for others. A diagnosis can provide valuable insights into why certain situations cause discomfort, why they experience heightened anxiety, or why they struggle with relationships. It can also provide a sense of validation and self-understanding. For many individuals, a diagnosis can help explain the challenges they have faced, allowing them to stop blaming themselves for things that may have seemed inexplicable before. It provides an opportunity to better understand their own neurological makeup and experiences, and in doing so, helps alleviate feelings of guilt or inadequacy.

Support for Autistic Girls and Women

At I AM Autism, we recognise the importance of providing a safe and supportive environment where individuals, particularly girls and women, can build their social skills and self-awareness. We offer a space where individuals do not have to engage in camouflaging their challenges, where they can be open about their experiences and receive the support they need to thrive. It is essential to create a space where everyone, regardless of gender, feels understood, valued, and capable of developing their social abilities in a way that suits their unique needs.

For more information about our services and how we support individuals on the autism spectrum, please feel free to contact us at enquiries@i-am-autism.org.uk or call us on 0161 866 8483.

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