Gender Bias (against females) in Diagnosing Autism

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Yes, I believe the ratio is dropping all the time, I think I read something on the NAS once that put it about 1:1.5. There probably are some enlightened clinicians out there, but the trouble is they are a scarcity. It's as bad having stereotypes about autistics generally as it is believing that it's a male condition.

I thought this was taken as fact, the gender bias of diagnosis. Obviously not.

Has there been any follow up yet, I saw NAS mention a 2011 paper but have not found any details.

I was misdiagnosed myself, by a woman no less.

Well it kind of is, but I think the studies don't get enough publicity and it's getting clinicians in the field to act appropriately.

What were you misdiagnosed with?

Sorry that was a humour failure on my part.

It's a long convoluted story, here's the short version: After months of waiting I had an AS assessment, it lasted all of 15 minutes and, much later, I realised the consultant knew very little about the subject. Ultimately I was told that there was no basis for a diagnosis to be confirmed. I should take the tablets that were being offered for depression and find my own help for other issues that were seen to be the cause of my problems.

Wow. I can't believe that any clinician thinks you could know someone has any ASC, let-alone a high-functioning one, after 15 minutes. Some of these people should be struck off. I presume you are getting a 2nd opinion at some point? You are entitled to one on the NHS and if that was a private one, then it would count as your 1st opinion on the NHS if you ask for referral for ASC assessment.

This is all NHS experience. I had been quite doctor shy up until this point in my life. This put me off again, I accepted the assessment, I did not know any better, and continued my life full of frustration for another 3 or 4 years. The letter with the 'judgement' was mis-dated when added to my records and then was used against me when I later applied for a job that needed a health assessment. The practice received the letter in December but filed it with the following years date rather than the one at the head of the letter.

Fast Forward >>

During 2 years working with teenagers with behavioural issues I started to do more research, parts of the puzzle clearly fitted together, I went back to speak with my doctor. Following a 6 month wait to see the consultant psychotherapist I was referred to an ASC unit for assessment. After another 8 months waiting time I received a letter saying that the out of area assessments had been cut due to lack of funding. I was offered another assessment at the local Mental Health Unit where I had been seen previously. This I declined.

So it's now in the region of 8 or 9 years since I first discovered the spectrum and the idea that I'm probably on it. I think I'm okay with that, I know there is no support available for me. My main issue now is that my father, who is obviously on the spectrum too, has recently been diagnosed with dementia. I'm concerned that if my self diagnosis was out in the open, and additionally whether a formal diagnosis, would aid or alter his treatment.

Thats what I hate about the NHS, its a postcode lottery. There is just no consistency to the level and professionalism of the services offered.

I'm lucky that in south yorkshire we have an excellent Autism/Aspergers centre in sheffield that is linked to a corresponding research centre at the university. I was able to get my diagnosis within a couple of months of applying, from a real expert in Autism.

You would think that in London things would be better funded/more professional, but It sounds like that is not the case

Don't give up though, you could be right that they need to understand the inherent autism in your family to better understand your fathers dementia.

Sorry for going off topic by the way

You may have seen a different clinician if you had gone to the same clinic.

It's also always worth getting errors on file corrected, I always challenge them even if they refuse to change them, my objection and correspondence is noted alongside.

Also, as it's now the new CCGs, the rules on how things are run has changed and they are trying to pay much more attention to NHS NICE Guidelines and Strategic Guidance (which is compulsory).

I understand if you are worried about what a diagnosis may mean for you in other areas, (although I'm unclear as to why, perhaps you fear they would put your dad in a home if they felt you were unable to care for him) but you could check that out with Citizen's Advice, The NAS etc. before you commit to an assessment.

To answer your question Fnord, the racists would have to choose to quit being racist. Employers would have to choose to see value in a person with AS. If poverty is to be eliminated people would have to want to change their views about it and actually help those who are in poverty. The solution to homelessness is for people to choose to take a homeless person into their home. They would have to want and choose to feed, clothe and help them get on their feet.

The solution would be to change other people's minds. How can a person change a person's mind if this said person does not want to change their mind. Therein lies the conundrum.

Fnord "alleges" there is a problem, like I say, even in the face of scientific studies which is usually the only thing that gets him excited, to the point he will defend someone (as seen on other threads) even if they are appallingly wrong, purely because they have a certificate from a university that says they are good at learning and retaining information. Hmmn, I wonder if you tested all people waving certificates if they would all prove to be wondrously intelligent, or if there would be a reasonable cross-section of intelligence - exactly as there is in the general population (excluding people with learning disabilities/intellectual impairment).

Quite clearly no one person has the answer, as Fnord should be well aware, and as I pointed out to Thetroll...sorry I mean Thelibrarian, I'm not some world crusader that has the power to change the status quo (although I am doing my own little part locally where I live).

You're quite right cubedemon6073, this is a societal problem and until those in power start educating people and enforcing how things are done by clinicians, (as grahamguitarman said, it's a postcode lottery in the UK) so that there is a specific minimum they have to abide by, this issue will continue. How do you change stereotypes? You educate people, you raise awareness, you do the right research that you disseminate to those that need it, you include clinical presentation of both genders in the research and in the diagnostic manual criteria.

I'm glad that Dr Gould is talking about it in the UK, the information is included on a major national autism website and I hope that the information goes world-wide to break those stereotypes.

I realise that but I can be a stubborn fool sometimes.
The mistake was corrected but by this time the necessary certificate had been marked as a fail, this too was corrected but then I had to sit a tribunal with the board of directors after just starting a new job. One of the directors was sleeping with the office manager who then gossiped my confidential information to the rest of the staff.


I have read your previous posts on this subject which I found very helpful. Thank you.
For the reasons above I'm reasonably reluctant to have any more potentially damaging information recorded.


With regard to my dad's treatment, I have been reading up on the possible correlation between ASC's and Parkinson's, associated with basal ganglia and dopamine production in the brain. I have not found any evidence yet regarding alternative treatments. He has chosen to donate his brain and spine to medical research so ultimately I feel I should mention this at some point soon. Additionally my mother has OCD and anxiety issues, we are a fairly dysfunctional family, so discussing these things does not come easily.

Thanks for your concern and Graham Guitarman too.

I don't want to derail your thread any further.

Whirlingmind, I have dealt with Fnord so I know where you're coming from and I know what you're talking about. I do believe people waving certificates can have biases as well. Just because one is a professional or an expert does not mean their logic is sound or they're correct. If one claims that x is correct because a person who is an expert says so, they're committing the fallacy of appeal to authority.




I tried to be a world crusader and it was foolish on my part. One has to have enough resources to do this. We can only do what our resources and time allow.



To me, therein lies an underlying problem. First, I do believe in educating people, raising issues and doing the right research and everything else you believe. Everything thing you say is logical and sound. The issue I see is willful ignorance. There are those who don't care for the education, awareness, research dissemination and clinical presentation. There are people who are ignorant and wish to remain ignorant. How can one solve this problem? Figuratively, how can one lead a horse to water and get the horse to drink? This is the real problem that I see and I do not see any solutions for this. As a person who is an INTP personality type this saddens me deeply.



I am glad he is doing this. He and major national autism website chooses to see the issue and problem at hand. This does give me some hope.

Now forgive me for a little tease here, but the irony was too delicious (and I have a mischievous sense of humour)

Tut, tut Cube, Dr Gould is a woman! Stop stereotyping!

And yes, slowly but surely, hopefully there will be a sea change (although I'm sure we'd all rather it was quicker!)

There definitely is a huge bias in young males that think they might have ASC, but this is mostly cultural beliefs as when these males do Aspie Quiz they often end up as neurotypical, In fact, there is a huge correlation between a high proportion of young male respondents and males getting low scores.

Using repetitive behaviors as a diagnostic criteria is also highly flawed, since the interpretation of "repetetive" behaviors spans many traits that are poorly correlated.

So it is a two-factor thing. Males are believed to more often be autistic, and the diagnostic criteria can easily be misinterpreted so females are missed.

oops how embarrassing. I should've looked this person's name up to determine the gender. For whatever reason, I equated the name Gould as being a man's name.

Well, this is a mistake on my part. Even I can have biases as well.

This brings up some questions on my part. If I can have a form of gender bias towards a person's name then can others have it as well. If I and others can have this bias towards a person's name then I have to question what other gender biases do we have that we may not know about?

Sorry about that. I still feel embarrassed. IMHO, she is doing a wonderful thing for those on the spectrum.

I see what you are getting at here, but the problem isn't about online self diagnosis - its about the disparity in official diagnosis. there can't be gender bias in a self administered test since the individual is in control of the situation. its when your diagnosis is dependant on other people providing the answers that you become vulnerable to that persons prejudices.