Are Girls with Autism Being Overlooked?

While she was growing up, Fiona Pettit O’Leary sensed that she was not the same as her peers. She explains that living her day-to-day life was exhausting because “there was an ever-present feeling of disconnection.” Along the way, she experienced anxiety, depression, anorexia, and suicidality—making an attempt on her life at age 18. It wasn’t until she was married with kids on the spectrum, however, that she began looking into autism more. Only then did the light click on: she had Asperger’s. A formal diagnosis confirmed this.

Lonely sad woman deep in thoughts. Portrait of a thinking woman

Many women on the milder end of the spectrum recount similar experiences. It could, of course, be due to the fact that autism awareness only took off recently, leaving a number of less-affected adults undiagnosed. But autism has always been seen as a male disorder; the gender ratio is approximately 4:1. This leads to an important question:

Is autism truly as male-dominated as we’ve thought, or have girls with autism been slipping through the cracks?

Mounting evidence has led scientists to believe the latter is most likely the case. And if that’s true, there have been a lot of girls who have passed through the system, missing out on support they need just as desperately as the boys do.

What We’re Learning About Girls With Autism

Historically speaking, the fact that fewer girls are diagnosed with autism has been a conundrum for researchers. Were girls simply less prone to it for some reason? Or were doctors missing them altogether because their disorder looked different than boy autism?

We’re still not 100 percent certain what the answer is. But recent research has begun to shine a light on the mystery.

When it comes to the more severe end of the spectrum, autism in boys and girls appears relatively similar. But when you move toward the milder end with Asperger’s and Pervasive Developmental Disorder, things start getting a little more complicated.

Namely, girls are better at “hiding” their autism symptoms. Socialization does not come naturally to these girls—just like it doesn’t in boys with the same disorder. But girls will watch their peers and imitate their behavior. They may make eye contact and overall be more social than boys.

girl peeking around door

In addition, girls on the spectrum, on average…

  • Engage in fewer repetitive behaviors
  • Have interests that are more “socially acceptable.” While their degree of fascination matches that of boys with autism, their fixations tend to be on things like celebrities or cute animals—interests that are less likely to raise suspicions that they are “different.”
  • Play differently. Unlike boys with autism, girls are more likely to engage in imaginative play, but they do so differently than neurotypical girls. For example, they may play with dolls but spend their time arranging situations and scenarios rather than actually acting them out.
  • Tend to be less violent and better behaved.

Make no mistake: just because girls are better able to adapt doesn’t necessarily mean they’re better off. They often describe social situations as exhausting because they must put on a front.

In addition, on a societal level, girls’ interactions are often different and more complicated than boys’—especially once adolescence hits. They’re steeped heavily in communication, social scenes, and fitting in—things girls on the spectrum tend to struggle with. These girls may desperately want close relationships yet struggle to form them due to these difficulties. As a result, they often feel isolated.

Is all this why they experience depression more often than neurotypical girls and guys on the spectrum?

Differences in Diagnoses

As it is right now, boys with autism are diagnosed an average of four or five months earlier than girls, depending on the severity of the disorder.

This is because we know way more about boy autism than girl autism. As a result, we’ve created our diagnostic tests to reflect the characteristics of boys with autism. Girls with autism are more likely to pass through life without anyone recognizing they have a disorder.

Therapist listening to her patient

The Problem with This

Many people with autism, especially adults, describe an autism diagnosis as a relief. All their lives, they’ve felt different but never knew why, and an autism diagnosis provides illumination. When girls go undiagnosed, they do not get this relief.

More significantly, they don’t get the support they need. Girls may go through a plethora of diagnoses and treatments, but nothing seems to work because their primary disorder is not being addressed. Which means they’re not getting the help they need.

The Point of All This

While some researchers are still pretty sure autism is largely a male disorder, they also believe we’ve been missing the girls who also have it. That’s a good start. And the fact that we’ve identified some of the differences between boys and girls on the spectrum is great, too.

But we’re not done yet. Scientific research on girls needs to continue, developing a way to better identify and treat their autism.

Because there are far too many overlooked girls out there. And they need our help.

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