Evidence is emerging that women with Autism Spectrum Disorder (ASD) think and act differently than men with ASD. The difference is so pronounced that some experts are proposing a type of Autism Spectrum Disorder unique to women, referring to this distinct condition as the Female Autism Phenotype.
Although reference is made to autism, the participants in studies of this condition are generally women with higher functioning autism, more commonly known as ASD. Thus, wherever they fall on the autism spectrum, from classic autism to ASD, it appears that women are distinctly different from men, with important repercussions.
The gender differences in Autism Spectrum Disorder (ASD) can be grouped into three main spheres:
- Women with ASD tend to seek social engagement and have a greater capacity for traditional friendships than men with ASD.
- Women are vulnerable to “internalizing” their problems, that is, keeping them private and hidden from others, focusing their problems inwards and subsequently experiencing them in the form of anxiety, depression and/or eating disorders. Men with ASD, on the other hand, typically “externalize” their problems, directing them towards the external environment and acting them out, typically in the form of hyperactivity, impulsivity and inappropriate conduct.
- Women engage in fewer repetitive behaviors, interests, and activities than their male counterparts. They obsess less about favorite topics and are less insistent on repeating the same routines over and over.
Furthermore, there are indications that women with Autism Spectrum Disorder are particularly adept at “camouflaging” their social difficulties. From an early age, they prioritize fitting in to a greater degree than men. By observing others and mimicking what is normal, they work to learn, adopt and use “neurotypical” social skills, in effect masking their true nature in order to appear normal.
An important consequence of these characteristics is that women are at greater risk of having undetected Autism Spectrum Disorder than are men. By internalizing their problems and appearing sad, lonely or withdrawn rather than disruptive or troublesome, they fall below the radar of family, friends, and professionals. Because of their social motivation and better non-verbal communication, they are often diagnosed with mood or stress-related disorders, rather than Autism. This is compounded by a frequent bias among professionals that women can’t have Autism Spectrum Disorder. As a result, women require more severe symptoms and a greater number of symptoms to meet the criteria for an ASD diagnosis.
The costs of this bias and the resulting misdiagnoses are considerable. Rather than receiving care for Autism Spectrum Disorder, women are often stuck with the residuals of their internalizing tendencies, that is, anxiety, depression and general distress. Without a proper diagnosis, they have a more difficult time accessing the resources and support that would help them manage their challenges. They miss out on engaging with the adult ASD community. More damaging, perhaps, they are often mischaracterized as lazy, incapable, and inadequate.
The challenges of being a woman with Autism Spectrum Disorder are not insignificant. Many are burdened by their repeated efforts to conceal their symptoms. They are confused about their true identity. Prioritizing fitting into “normal” society often results in being manipulated and mistreated by others, as well as ignored and marginalized.
The challenges of having Autism Spectrum Disorder in today’s society are magnified for women who have to contend with societal expectations that are odds with the specific characteristics of ASD. Traditional female roles such as taking care of others, submitting to authority, being sensitive, gentle, and empathic are often incompatible with how these women wish to live their lives. Taking care to ensure they receive proper consideration, including an accurate diagnosis, is of utmost importance, to them, and to all of us.