Autism and Gender

Currently, around three times as many males are diagnosed with autism as females. So what’s different about Autistic women and girls?

Mum with teenage daughter and adult daughter

How is autism different in women/girls?

There isn’t as much research specifically focussed on Autistic women and girls, but in the studies we do have, we can see important differences in the characteristics of autistic boys/men and Autistic girls/women.

For example:

  • Autistic girls and women often camouflage their autism by imitating social skills or suppressing some of their Autistic characteristics.
  • Autistic girls/women can appear to have stronger language and social communication skills.
  • Special interests and atypical play in Autistic girls can differ to autistic boys and be much more subtle.
  • Autistic girls and women are often more likely to talk about their emotions than autistic boys and men, resulting in them being less likely to resort to physically aggressive behaviours – this can lead to them being simply labelled as shy or passive.

“The underdiagnosing of women with ASD contributes to the marginalization of females” (Kearns-Miller, 2003)

The current estimated ratio of Autistic boys/men to Autistic girls/women is 3:1. This ratio has changed over time, but what it tells us is that Autistic women and girls may be underrepresented in diagnosis and prevalence information we have now.

There are many reasons women and girls aren’t getting autism diagnoses at the same rate as men and boys, including:

  • A lack of understanding, particularly among health and education professionals, of how autism can present in Autistic girls and women, compared to Autistic boys and men.
  • Screening and diagnostic tools are designed to identify Autistic traits and characteristics that are more common in boys and men, so they can miss the different characteristics Autistic girls and women present.
  • The concerns of parents of girls are often dismissed, leading to later referral, assessment and diagnosis.

Autistic girls and women often receive a mental health diagnosis instead of an autism diagnosis. This can make it less likely for professionals to consider autism as a potential diagnosis.

It’s important for Autistic girls to have access to timely and accurate diagnosis, because a delayed or missed diagnosis can have a negative impact on their development, as well as their social and community participation.

A late diagnosis might mean that an Autistic girl misses out on funding and access to early intervention services, which have been shown to have a very positive effect on child development.

Many school-age Autistic girls often don’t meet the criteria for learning supports because they may mask their autism, show high level language skills and/or not display disruptive behaviour.

A late diagnosis can also contribute to experiences of poor mental health. Many Autistic girls and women are diagnosed with anxiety, depression, eating disorders and other types of mental health concerns.

Many Autistic women are not diagnosed until their children are diagnosed with autism. Without a diagnosis and the appropriate support, Autistic mothers can experience stigma, social isolation, anxiety and depression.

If they have difficulty understanding relationships and/or the real meaning behind what people say or do, Autistic girls and women may also be at increased risk of bullying, verbal abuse and sexual or physical violence.

For Autistic women and girls to thrive, greater understanding and support is needed across all areas of their lives, including education, healthcare, employment and the NDIS.

We are advocating for improved: 

  • Access to diagnosis, including the development of assessment tools more sensitive to identifying Autistic women and girls 
  • Services and supports that understand and can meet the needs of Autistic women and girls. 

Autistic people are more likely than non-Autistic people to identify as transgender or gender diverse. They are also more likely to experience gender dysphoria, which is the distress a person may experience around their assigned gender, their body, or how their gender is perceived. There isn’t a conclusive reason for this link, because research in this area is still developing. Regardless, Autistic transgender and gender diverse people are a valid and substantial part of the Autistic community.  

Unfortunately, the discussion around the differences between Autistic women and men frequently doesn’t include Autistic transgender and gender diverse people. There is currently not enough research available for us to know how transgender and gender diverse Autistic experiences fit with the experiences of cisgender Autistic women and girls. 

For this reason, this page focuses primarily on the research around cisgender Autistic women and girls compared to cisgender Autistic men and boys, although Autistic transgender and gender diverse people may still identify with some of the information on this page based on their experiences of social expectations of gender. We don’t intend to ignore the experiences of Autistic transgender and gender diverse people through this discussion. Ideally in future there will be more research exploring the experiences of transgender and gender diverse Autistic people – allowing the discussion around gender differences to fully include everybody. 

For more information

To learn more about autism and Autistic girls and women, contact the Amaze Autism Connect advisors on 1300 308 699, email [email protected] or use the webchat on this site. This service is open from 8am–7pm, Monday to Friday (excluding public holidays). 

Autistic girls or women – and their families – may find it beneficial to connect with a peer support group. There are also organisations that specialise in supporting autistic girls and women, such as Yellow Ladybugs

References

ABS (Australian Bureau of Statistics) (2018) Disability, ageing and carers, Australia: Summary of findings, accessed 17 January 2023. https://www.abs.gov.au/statistics/health/disability/disability-ageing-and-carers-australia-summary-findings/2018

ACON (n.d.) Dysphoria, TransHub accessed 17 January 2023. https://www.transhub.org.au/dysphoria

George R, and Stokes MA (2017) ‘Gender identity and sexual orientation in autism spectrum disorder’, Autism, 22(8):970-982, https://doi.org/10.1177/1362361317714587 

Loomes R, Hull L, and William MLP (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, https://doi.org/10.1016/j.jaac.2017.03.013 

Matthews E (2022) ‘Autism in women: What are the sociological costs of an adulthood diagnosis?’, SocArXiv, accessed 17 January 2023, doi:10.31235/osf.io/suyqv 

Milner V, McIntosh H, Colvert E, and Happe F (2019) ‘A qualitative exploration of the female experience of Autism Spectrum Disorder (ASD)’, Journal of Autism and Developmental Disorders, 49:2389-2402, https://doi.org/10.1007/s10803-019-03906-4 

Milner V, Will M, Happe F, and Colvert E (2022) ‘Sex differences in predictors and outcomes of camouflaging: Comparing diagnosed autistic, high autistic trait and low autistic trait young adults’, Autism, 00(0):1-13, https://doi.org/10.1177/13623613221098240 

Warrier V, Greenberg DM, Weir E, Buckingham C, Smith P, Lai M-C, Allison C, and Baron-Cohen S (2020) ‘Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals’, Nature Communications, 11:1-12, https://doi.org/10.1038/s41467-020-17794-1 

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