Autism spectrum disorder is a condition that affects the way people behave, socialize, and communicate with others. This disorder is commonly referred to simply as autism. It used to be broken down into subtypes, such as Asperger’s syndrome, but it’s now treated as a condition with a wide-ranging spectrum of symptoms and severity.
But can autism symptoms and their severity differ between the sexes? Among children, autism is about four times more common in boys than it is in girls. However, a 2013 study involving almost 2,500 children with autism suggests that it often goes undiagnosed in girls. This could explain why autism appears to be more common in boys.
Why does autism often go undiagnosed in girls? Is autism in women really different from autism in men? Read on to learn potential answers to these questions and others about autism in women.
Autism symptoms usually appear in early childhood, before the age of 2. For example, infants may not make eye contact. In some cases, they might show indifference toward their parents. Around age 2, they may start to show signs of aggression, fail to respond to their name, or start taking steps backward in their language development.
Still, autism is a spectrum disorder, and not all children with autism display these symptoms. Generally, though, autism symptoms tend to involve problems with social interactions and behavioral patterns.
Social communication and interaction symptoms
Children and adults with autism often have difficulty connecting with others.
This can result in a range of symptoms, such as:
- inability to look at or listen to people
- no response to their name
- resistance to touching
- a preference for being alone
- inappropriate or no facial gestures
- inability to start a conversation or keep one going
- excessive talk about a favorite subject with no regard for the reactions of others
- speech problems or unusual speech patterns
- inability to express emotions or recognize them in others
- trouble recognizing simple social cues
- difficulty following simple directions
- inability to predict someone’s response or reaction
- inappropriate social interactions
- inability to recognize nonverbal forms of communication
Behavioral pattern symptoms
People with autism often have repetitive behavior patterns that are hard to break.
Some of these patterns include:
- performing repetitive movements, such as rocking back and forth
- developing routines or rituals that can’t be disrupted
- self-harming, including biting and head-banging
- repeating words and phrases
- becoming extremely fascinated with a particular subject matter, fact, or detail
- experiencing sensations of light and sound more or less powerfully than others
- fixating on particular objects or activities
- having particular food preferences or aversions to food textures
The symptoms of autism in women aren’t very different from those in men. However, researchers believe that women and girls are more likely to camouflage or hide their symptoms. This is particularly common among females at the high-functioning end of the autism spectrum.
Common forms of camouflaging include:
- forcing yourself to make eye contact during conversations
- preparing jokes or phrases ahead of time to use in conversation
- mimicking the social behavior of others
- imitating expressions and gestures
While both males and females with autism can camouflage their symptoms, it appears to be more common in women and girls. This could explain why they’re less likely to be diagnosed with autism.
It’s important to note that studies looking at differences between autism in women and men have been very small or flawed. Experts still don’t have any definitive information about these differences, including whether they’re real or just a result of camouflaging.
Still, one of the largest studies done on the subject suggests that, compared to men, women with autism have:
- more social difficulties and trouble interacting
- less of an ability to adapt
- less of a tendency to become hyper-focused on a subject or activity
- more emotional problems
- more cognitive and language problems
- more problem behaviors, such as acting out and becoming aggressive
Many more large, long-term studies are needed to draw any firm conclusions about autism in women.
Experts aren’t sure what causes autism. Given the wide range of symptoms and severity, autism is likely caused by several factors, including genetics and environmental factors.
While there’s no evidence that the exact cause of autism is different between the sexes, some experts suggest that boys are at a higher risk of developing it. For example, investigators involved in the larger study mentioned above believe that girls might be born with genetic protective factors that reduce their risk of autism.
There’s also an emerging theory called the extreme male brain theory. It’s based on the idea that fetal exposure to high levels of male hormones in the uterus might affect brain development.
As a result, a child’s mind might focus more on understanding and categorizing objects, traits that are generally associated with the male brain. This is in contrast to empathizing and socializing, which are more often associated with female brains.
The differences between male and female brains aren’t this simple and concrete, giving this theory some major limitations. Still, it’s a start toward understanding how autism develops and why it appears more in boys than girls.
There is no medical test that can diagnose autism. It can be a difficult process that often requires visiting several types of doctors. If you believe your child could be on the autism spectrum, make an appointment with their doctor. Depending on your child’s symptoms, their doctor may refer them to a child psychologist or pediatric neurologist.
If you suspect that you may have undiagnosed autism, start by talking to your primary care doctor. A psychologist can also help you evaluate your symptoms and rule out other potential causes. Learn more about the process of working with a doctor to get an autism diagnosis.
Autism can be very hard to diagnose in adults. You may need to visit a few doctors before you find one who understands your symptoms and concerns. If possible, try to ask close family members about any potential signs or symptoms you might have displayed as a child. This can help to give your doctor a better idea of your childhood development.
Throughout the process, remember that you are your most important advocate. If you feel your doctor isn’t taking your concerns seriously, speak up or get a second opinion. Seeking a second opinion is common, and you shouldn’t feel uncomfortable doing so.
While there’s no cure for autism, medications can help to manage certain related symptoms or disorders that may co-occur. But medication is only one aspect of autism treatment. There are many types of physical, occupational, and talk therapies that can help you better interact with the world around you and manage your symptoms.
Given that women tend to be better at masking their symptoms, being a woman with autism can feel particularly isolating. For many women, it’s an emotional process that involves revisiting childhood behavior and social problems.
Consider reaching out to other women living with autism. The Autistic Women and Nonbinary Network is a nonprofit organization dedicated to supporting women and gender-nonconforming people with autism. Even if you’re not ready to interact with someone, you can find blog posts, first-person stories, and doctor recommendations online.
- Thinking in Pictures. This is the firsthand account of Temple Grandin, PhD, one of the most well-known women with autism. She offers her perspective as both an accomplished scientist and woman living with autism.
- Women and Girls with Autism Spectrum Disorder. This collection of research articles and personal stories offers multiple perspectives on how women and girls with autism navigate the world around them.
- I Am AspienWoman. This award-winning book explores how women uniquely experience autism across different ages. It also discusses the ways in which autism may be more of a beneficial way of thinking than a condition that needs aggressive treatment.
Looking for more book recommendations? See our list of other essential books for adults with autism or parents of children with autism.
Autism appears to be more common in boys than girls, and researchers are starting to better understand the differences in how boys and girls experience autism. While this is promising for future generations, adult women who think they may have autism still face challenges getting a diagnosis and finding treatment.
However, as awareness about autism and its many forms grows, so do the available resources. The internet has also made it easier than ever to connect with others, even for those living with social anxiety, a common symptom of autism.
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