Boys and men are at least three times more likely to receive an autism diagnosis than their female counterparts. A new study published in PLOS One found that one of the core reasons leading to such structural inequalities is due to a poor understanding and recognition of female autistic traits and healthcare workers’ implicit bias that makes them associate males with autistic traits.
“Female stereotyped behaviors, in many ways, stand in stark contrast to typically recognized autistic traits. The language used to describe autism spectrum condition is littered with certain gender expectations,” the researchers explained. “For instance, the general view that women display more heightened emotional expressions, alongside greater motivation to communicate for social reasons than men, directly contrasts characteristics associated with autism.”
‘Such biases may contribute to the systematic constraints that prevent girls from obtaining recognition for their autism spectrum condition from their parents, educators, and peers at the same rate as their male counterparts. A reluctance to view a female as autistic likely has a detrimental effect on wellbeing. Improved understanding and more positive perceptions from peers are essential outcomes of a recognized diagnosis,” they added.
Women tend to get an autism diagnosis much later in life compared to their male counterparts. And in most cases, women are at an increased risk of remaining undiagnosed — which can severely affect their mental health and well-being.
In fact, studies have found that recognizing an individual as autistic is crucial for building double empathy between an autistic person and the neurotypical majority. The double empathy problem arises when people with vastly different life experiences struggle to empathize with each other following a few interactions. But if an autistic person is diagnosed, that can enable them to understand what makes them different from neurotypicals and then work towards building mutual understanding.
“A public-facing autistic identity allows neurotypicals to recognize that an autistic person possesses a neurodivergent perspective equally deserving of understanding and respect. Failure to acknowledge and validate neurodivergent views is known as the double empathy problem, which may be compounded in autistic females. Specifically, as the stereotypes associated with females may be particularly at odds with perceptions of autism, there runs the risk of a heightened misunderstanding of neurodivergence in females,” the researchers explained in their study.
“Qualitative research has revealed how healthcare providers consistently dismissed autistic female clients’ accounts of their autistic traits as more indicative of conditions such as depression, as these are none to have higher female ratios. Autistic participants have also discussed how their experiences of gender dysphoria were minimized or explained away by their autistic status,” they wrote. “These accounts show how stereotypes of neurodivergence and gender can reduce double empathy and inhibit the acceptance of autistic people who may not fit the typical male-autistic presentation.”
It is widely believed that autistic social differences stem from being unable to take another person’s perspective into consideration and not being as interested in socializing as their neurotypical peers. But women are known to be better at taking different perspectives into account and even being more socially motivated than males.
“Interestingly, research has not found a female advantage in social tasks. For instance, autistic females appear to have similar difficulties reading emotions in their eyes as autistic males, despite an advantage on the same task in neurotypical females compared to males. To minimize differences in ways that match society’s expectations, autistic individuals often camouflage their traits by attempting to emulate the social interaction style of what is deemed as neurotypical to fit in more with their peers,” the authors explained.
“Motivation for camouflaging and masking social difficulties is increased by social pressures and expectations experienced by females. For instance, women with autism ‘pretend to be normal’ by copying others’ speech patterns and body language as a reaction to the societal messages they receive, which tell them as females they should be more sociable than males,” they added. “There is a worrying association between camouflaging, autistic traits, and diminished mental health, alongside stress associated with autism being ‘found out’. These additional gendered pressures are of pragmatic concern.”
The best solution to address these problems is ensuring that women have better access to an autism diagnosis. And that means it is imperative for healthcare workers to equally identify autistic traits among girls to make early diagnoses a reality. That provides a reason and better understanding for girls and women who express atypical behaviors.
Autistic adults tend to face vicarious discrimination within society. Studies have highlighted that people form a far more negative or unfavorable first impression of autistic people than neurotypicals. The general population also displays significant negative attitudes towards autistic people .
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