Thousands of GIRLS may have undiagnosed autism because they

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"But autism is a boy's disorder"

Do I have to do sexism 101 here now? If you refuse to believe something that is a real thing, how can we have any basis for discussion? Imagine if you had to establish the existence of gravity before discussion how things fall to the ground? Because that's how this response strikes me..

There are real studies that are peer reviewed that have found that when looking at "severe" autism that two boys are diagnosed for every girl who is diagnosed. If you're seeing basically no girls anywhere with this diagnosis, then it's probably not because girls don't have it.

Yes but these peer reviewed studies merely establish that there is a ratio of boys > girls being diagnosed. There is no consensus as to whether the girls are being misdiagnosed or whether they have better coping mechanisms or something else. Even a highschool student can diagnose a female child as autistic who has repetitive and obsessive behaviors, twirls in circles or stacks toys one upon another and in addition is non-verbal.

I think LFA will eventually be shown to often have a different cause (or set of causes) than HFA, and that the higher rates of LFA in males will be because of chromosome specific causes.


As far as "hide the symptoms" goes, I think it's a combination. I am the only daughter in a family that includes at least one Aspie brother. I self-diagnosed with Asperger's in part because:

1) When I was reading about Best Practice interventions with kids with Asperger's, it was EXACTLY what my parents did with me and made me do as a child, which was itself very gendered (my parents both prided themselves on being feminists and couldn't see how their expectations of me were different than those for my brothers). There was a ton of forced and repeated social interaction as a child for me, including scripts that I could check in with, to help me navigate different situations (interacting with very culturally different sides of the family and with specific age-related social expectations (both in terms of my age, as well as the age of the person I was talking to). As a result I expressed many fewer stereotypical Aspie traits than my brother.

2) I felt a shameful level of dislike/annoyance for boys with autism characteristics. Because of my knee-jerk response to them and my shame around it, I tried to figure out where it was coming from and realized that it was because I saw them as "getting away with" the same stuff that I was NOT allowed to, the stuff I'd get punished or excluded or shamed for. (Note: my parents didn't do much of the negative reinforcement, but it was prevalent in others). I knew I was able to suppress behaving like them, I knew how much effort it was, I knew it was part of my social responsibility, and I hated seeing them getting a free pass just because of gender.

When I've confessed this to a male friend who has received an adult diagnosis, he told me he really wished that his parents had done the kind of intensive social stuff mine did. That's helped me be less judgmental, but it can still very hard for me, especially when it's someone acting entitled. Another part of it is that I've rarely experienced sexual harassment (indeed, I seem to be luckier than many female friends of mine) but every time I have, it's been from an aspie/autistic boy/man who seems to prioritize his own sexual feelings/"rights" over my autonomy and dignity and, because he's "special" and "can't help it", I've been told I'm the problem or the one who has to deal with it. (I tend to wear tighter clothing and low-cut shirts for sensory reasons.)



Additionally, I think there is a perhaps a teeny bit of science behind some language/socialization delay stuff in boys (though gendered socialization/expectations appear by 6 months, so who can say) and parents/others don't interact with their sons in the same intensely social ways as they do with their daughters. The value of a daughter is tied up much more heavily in her social skills (rather than intelligence/strength/earning potential) and there is a ton more expectation that she will have good social skills. This means that from the earliest possible ages, females are socialized and expected to socialize. This can include very subtle stuff, like engaging her more while she is feeding as an infant. For this reason, I think girls do have an advantage in coming across as more NT than they are. The downside of this is that our struggles are even more likely to be seen as moral and individual choices to fail (because they occur at higher levels (in more complex social situations, for example) even though they come from the same underlying brain differences).

I am very suspicious of accepting the assumption that autism appears much less frequently in women. All that tells me is that diagnostic criteria for brain stuff is clumsy and sexist, treatment is in the very very early stages of moving from an "art" to a science, and we live in a male-oriented world where "diseases" are first defined by how they manifest in (wealthier, white) males.

In fact, most cultures expect girls to be more socially savvy, more talkative and more interactive at young age - so I don't buy it that girls are that underdiagnosed as often claimed, it makes no sense.

All that tells me is that diagnostic criteria for brain stuff is clumsy and sexist, treatment is in the very very early stages of moving from an "art" to a science, and we live in a male-oriented world where "diseases" are first defined by how they manifest in (wealthier, white) males.

I guess there are many different factors, but I don't think that I behaved -being in a female body- so much differently than now, that this would explain as only reason the different behaviour psychiatrists have towards me now...

That's verry merry berry interesting, cyberdad.

I'll have to dig up some literature on language impairments in autistic girls or girls in general (boys have higher language delay/impairment prevalence than girls in general).

Temple Grandin was this kind of girl growing up, and me too, so I always related bester to her eggsperiences than I did to other autistic authors. Most authors, I don't relate to at all, and also not much to complete guide to asperger syndrome that many people say was story of their life when they read it.

What age was your daughter's traits most severe? For me, it was age three to four at preschool. I was happy at home, but daily disaster at preschool, and teachers didn't understand what was going on and brought it up with my parents, who saw the calm happy me at home, and no one understood why I didn't talk or interact with people or even play at preschool, I think I was too sensory overloaded to do anything there but walk in circles, thankfully I got out of there at four to stay with old lady babysitter while parents were at work.

That was the earlier point I was making to Verdandi. You are high functioning and most of the girls who these empirical studies propose are being missed in diagnosis are high functioning.

What we can establish from the data is that there is a disproportionate number of girls diagnosed who are either on the severest end of the spectrum (with associated cognitive impairment) or on the top end of the spectrum (Aspies). Girls like my daughter who show classical symptoms of autism but are cognitively above average when compared to NTs are very very rare where I live. I recently spoke to my daughter's school psychologist and she concurred saying that HFA girls (diagnosed with autism) in mainstream schools make up about 1 in 500 of autistic children in these schools. According to her 99.99% of the autistic girls in mainstream school were diagnosed with Aspergers. In stark contrast most of the boys were diagnosed with autism.

I don't know the reasons for these statistics but it certainly is very interesting.