We’ve heard, time and again, that boys are diagnosed autism at higher rates than girls, about four to one, if current stats are accurate. But those stats may not be correct. Girls on the spectrum often hide in plain sight—and they’re quite good at it.
Girls and women with autism are often missed, which means they may go undiagnosed and unsupported. It’s true that girls with autism present differently than boys do, but their tendency to fly under the radar could have more to do with how they respond to their autism. Girls become expert camouflagers.
Camouflaging, or “passing,” refers to the tendency of people with autism to suppress their natural tendencies (like stimming or being bothered by loud noises) in order to fit in with the people around them. Both women and men with autism can and do engage in this behavior, but women do it more often.
A new study, led by Meng-Chuan Lai of the Univeristy of Toronto, set out to find a way to measure how much girls engage in this behavior and how big of a gap there is between natural inclination and actual behavior when someone is camouflaging.
Anecdotal evidence tells us that camouflaging takes a mental and emotional toll. It’s hard work behaving in a way contrary to your true nature, especially when that behavior has to be carefully studied and imitated. Some people on the spectrum report requiring long periods of rest or isolation after engaging in camouflaging behavior.
Professor Lai and his team wanted to find a way to measure camouflaging in hopes that their work would lead to a way to measure the behavior’s impact. Camouflaging may help people on the spectrum get by at work, school, and in relationships, but there’s no clear data on what kind of mental and emotional price they’re paying.
The study measured characteristics of autism in a group of 30 men and 30 women on the spectrum using the Autism Diagnostic Observation Schedule (ADOS), a test clinicians use to determine the presence and degree of autism. Study participants also rated themselves on their autism characteristics using the Autism Quotient (AQ). Finally, the participants underwent the Reading the Mind in the Eyes Test (RMET), which assesses the ability to understand emotion from another person’s eyes.
To measure the level of camouflaging participants were engaging in, researchers combined scores from the AQ and RMET tests as these are less susceptible to being influenced by camouflaging. The ADOS test is more susceptible to being influenced by camouflaging because an outside person rates a subject based on observable behaviors.
Researchers subtracted the ADOS score from the combined AQ and RMET score to score a person’s degree of camouflaging.
The resulting numbers did indeed indicate that women on the spectrum have higher camouflaging scores than men, which likely contributes to their going under-diagnosed or missed altogether.
The study also confirmed that men often camouflage, and some individual men in the study had higher camouflaging scores than some of the women. Overall, women had higher camouflaging scores.
Women in general usually have better emotional perception than men, and social norms and pressures for women may make women on the spectrum more prone to camouflaging. Long-term camouflaging may even increase someone’s ability to perceive emotion and “fit in.” But at what cost?
Even neurotypicals can understand the stress and emotional disconnect of acting in ways other than their inclinations. For people on the autism spectrum, the cost may be higher. Women on the spectrum find camouflaging “exhausting and disorienting,” and it may delay diagnosis, support, and a woman’s ability to understand her own behavior.
In men with autism, higher depression rates correlate with higher camouflaging rates. This research will hopefully lead to a greater understanding of the cost of camouflaging for both men and women across the spectrum.
The next step, Professor Lai says, is to see if the team can find a way to identify camouflaging behavior so that it doesn’t keep someone from getting a diagnosis, or from hearing that they don’t have to try and be someone they’re not.
Katie Taylor started writing in 5th grade and hasn't stopped since. Her favorite place to pen a phrase is in front of her fireplace with a cup of tea, but she's been known to write in parking lots on the backs of old receipts if necessary. She and her husband live cozily in the Pacific Northwest enjoying rainy days and Netflix.