GENDER DISPARITIES AND AUTISM
Most individuals who have been diagnosed with autism are male. In fact, it is diagnosed at a rate of 3 to 4 times more often in males (Loomes et al, 2017). However, what appears to be a definitive ratio is much more complex than at first glance. Much of the research regarding Autism Spectrum Disorder (ASD) has centered on males (Giambattista et al, 2021). As such, all of the tools we use to diagnose and support autistic kids and adults are based on a male standard. Additionally, assessment of females is “restricted to areas where they are most similar to males.” (Giambattista et al, 2021). In the process, females with ASD often remain undiagnosed, unidentified, and unsupported, particularly those with symptoms that are not immediately obvious.
There are many reasons that females are underdiagnosed, one of which is gendered socialization. In order to understand this phenomenon, it is important to note that the criteria for an autism diagnosis include social skill and communication impairment. Girls are socialized to be less aggressive and more mindful of the emotions of their peers, and therefore, autistic girls tend to have more vibrant social lives than autistic boys overall. Even when autistic girls are more introspective or quiet, they are thought to simply be exhibiting characteristics of femininity rather than of ASD. They might also be experiencing problems with socializing or communicating, but perhaps not in ways that are apparent. There are subtle but important differences in the manifestations of autism between females and males that are not always caught by standard screening tools (Giambattista et al, 2021).
What does this mean for you as a parent?
If you have a female child who tends to be quieter, be mindful of how she discusses her social interactions. Keep in mind that the traditional screening tools for autism are designed for male children. Although your child may not be exhibiting characteristics of what you traditionally perceive as autism, it may be helpful to seek a professional opinion, particularly if she reports having some difficulties at school socially. Try to keep your own biases in check.
Giambattista, C., Ventura, P., Trerotoli, P., Margari, F., & Margari, L. (2021). Sex differences in Autism Spectrum Disorder: Focus on high functioning children and adolescents. Frontiers in Psychiatry, 12, 1-13.
Loomes, R., Hull, L., & Mandy, W.P.L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 466-474