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holymackerel
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05 Jan 2021, 7:35 am

Has anyone actually bothered to check the ratio of level three autistics where it is not really in doubt? I hear a lot of people say women don't get diagnosed because of how the dsm is aimed at men and that women mask more frequently. I was just wondering if people have actually checked and it is not actually chromosome related. :shrug:



timf
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05 Jan 2021, 8:38 am

The best explanation of numerical disparities has been that behavior diagnoses tend to identify males more mostly because their behavior is more observable.

One would imagine that neurological variants would have an equal distribution. However, since female instances often present with internal more than external manifestations, their issues are often ignored.



wastubricine
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05 Jan 2021, 8:54 am

Could a more accurate female oriented test/detection/diagnostic method be developed, what do you think?



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05 Jan 2021, 10:21 am

wastubricine wrote:
Could a more accurate female oriented test/detection/diagnostic method be developed, what do you think?


Definitely possible, but it should also be kept in mind that some autistic women fit the same stereotypes as autistic men, and the possibility that some men's autism shows itself in a more "feminine" way mustn't be ignored, either. I suppose there could be two criteria, one that's like an average autistic man and another that's like an average autistic woman, and then those two could be used as options when diagnosing people. If someone ticks enough boxes from either criteria, they'd be on the spectrum, regardless of their gender.



holymackerel
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05 Jan 2021, 11:00 am

But surely that couldn't account for disparity in level 3 autistics. Where diagnosis would not go missed. I see a lot of people talking about this, but mostly they cite opinions. I just wondered if the ratio at level three is even or not so I know the opinion about it being related to diagnosis are true or not



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05 Jan 2021, 11:25 am

But what about men who mask? If I who know that I mask was to be assessed by the standards of assuming because I am a man I don't mask, it will very likely give difderent results.


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wastubricine
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05 Jan 2021, 11:32 am

Fireblossom wrote:
wastubricine wrote:
Could a more accurate female oriented test/detection/diagnostic method be developed, what do you think?


Definitely possible, but it should also be kept in mind that some autistic women fit the same stereotypes as autistic men, and the possibility that some men's autism shows itself in a more "feminine" way mustn't be ignored, either. I suppose there could be two criteria, one that's like an average autistic man and another that's like an average autistic woman, and then those two could be used as options when diagnosing people. If someone ticks enough boxes from either criteria, they'd be on the spectrum, regardless of their gender.


Good idea, catching them by subtype instead of mere gender, or rather regardless of gender.

How would you go about it?



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05 Jan 2021, 11:51 am

Mountain Goat wrote:
But what about men who mask? If I who know that I mask was to be assessed by the standards of assuming because I am a man I don't mask, it will very likely give difderent results.


True, it shouldn't be processed by gender, even if there are trends and patterns regarding sexes, one should always consider the outliers.



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06 Jan 2021, 1:50 am

holymackerel wrote:
Has anyone actually bothered to check the ratio of level three autistics

Almost certainly not because the levels of support concept is relatively new. Some people haven't been diagnosed with a level of support.

Quote:
I hear a lot of people say women don't get diagnosed because of how the dsm is aimed at men and that women mask more frequently. I was just wondering if people have actually checked and it is not actually chromosome related. :shrug:

Checked what, exactly? Also, I've never heard of anyone blaming chromosomes for differences between men's and women's rates of diagnoses.


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06 Jan 2021, 4:45 am

Doing a quick search I didn't find the actual studies but:

http://www.autism-help.org/points-gender-imbalance.htm

Quote:
Studies have found much higher prevalence in boys at the high-functioning end of the autism spectrum, while the ratios appear to be closer to 1:1 at the low-functioning end.


However - assuming this ratio to be true - I wouldn't automatically rely on it to mean that the ratio in high functioning autism also has to be 1:1. After all the cause of autism is partly unknown and not the same in every individual, the symptoms can vary widely and high functioning individuals do not necessarily have the exact same symptoms as low functioning individuals except milder. It's not one homogeneous condition.

Some other numbers that might help to gauge the true sex ratio:

https://www.spectrumnews.org/news/autis ... explained/
( https://pubmed.ncbi.nlm.nih.gov/28545751/ )

Quote:
In line with this idea, the 2017 study revealed that the sex ratio falls to 3.25 boys per girl when the analysis includes only the 20 studies in which researchers evaluated the participants for autism, rather than relying on previous diagnoses.


Quote:
Researchers have found a 3-to-1 ratio even when they have followed children from infancy and repeatedly screened them for autism, minimizing the possibility for biases in diagnosis and referral. The children in these studies have a family history of autism, however, so they may be fundamentally different from other children with the condition



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06 Jan 2021, 4:51 am

wastubricine wrote:
Fireblossom wrote:
wastubricine wrote:
Could a more accurate female oriented test/detection/diagnostic method be developed, what do you think?


Definitely possible, but it should also be kept in mind that some autistic women fit the same stereotypes as autistic men, and the possibility that some men's autism shows itself in a more "feminine" way mustn't be ignored, either. I suppose there could be two criteria, one that's like an average autistic man and another that's like an average autistic woman, and then those two could be used as options when diagnosing people. If someone ticks enough boxes from either criteria, they'd be on the spectrum, regardless of their gender.


Good idea, catching them by subtype instead of mere gender, or rather regardless of gender.

How would you go about it?


Don't know. I mean, if research was made on the subject, people would probably first interview already diagnosed autistic people -and that'd be where they would hit the first wall since majority of those already diagnosed would likely somewhat fit to one specific stereotype. So yeah, I'm not smart enough to solve this.



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06 Jan 2021, 6:45 am

I think that part of the differences are due to the general nature of men compared to the general nature of women because most women naturally want to gather together and talk while most men want to be a bit more solitary by their nature. (Hard to explain but women do tend to need lots of friends while men only need one or two).
These natural differences can explain why women are far more likely to mask to try to fit in while men are moee likely to just be themselves so anyone on the spectrum ay be easier to notice. I am an odd one because I am a man who masks and has done so from an early age. (I did not know what it was called but I knew that I was doing it, but I could not work out why other more popular kids were able to do it soo well! It did not occur to me that I was the only one who was masking. I thought everyone was because I was? It did not occur to me that I could think differently... BUT I was always told I was strange or unique or that I was an alien or something like that. In collage it was suggeted that they threw the baby out and I was the afterbirth. (My Mum assured me that I am not an afterbirth!)
But anyway... Sorry. I am going off subject.


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07 Jan 2021, 9:42 pm

Fireblossom wrote:
wastubricine wrote:
Could a more accurate female oriented test/detection/diagnostic method be developed, what do you think?


Definitely possible, but it should also be kept in mind that some autistic women fit the same stereotypes as autistic men, and the possibility that some men's autism shows itself in a more "feminine" way mustn't be ignored, either. I suppose there could be two criteria, one that's like an average autistic man and another that's like an average autistic woman, and then those two could be used as options when diagnosing people. If someone ticks enough boxes from either criteria, they'd be on the spectrum, regardless of their gender.


I agree with Fireblossom. People can't be pigeonholed into little pink and blue boxes.


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08 Jan 2021, 1:01 am

Honestly, this female autism thing has become nonsensical.

Fireblossom wrote:
wastubricine wrote:
Could a more accurate female oriented test/detection/diagnostic method be developed, what do you think?


Definitely possible, but it should also be kept in mind that some autistic women fit the same stereotypes as autistic men, and the possibility that some men's autism shows itself in a more "feminine" way mustn't be ignored, either.

No one should be evaluated for autism on the basis of stereotypes, so who fits which autism stereotypes is not relevant to diagnosis.

Quote:
I suppose there could be two criteria, one that's like an average autistic man and another that's like an average autistic woman, and then those two could be used as options when diagnosing people. If someone ticks enough boxes from either criteria, they'd be on the spectrum, regardless of their gender.
There's no such thing as an "average autistic" person at all because there are too many different possible combinations of traits that qualify for diagnosis.

Everyone has to fit the same diagnostic criteria to be diagnosed for autism, so there's nothing to be split into man and woman versions of diagnostic criteria. You'd just have two versions of the same criteria, possibly differing only by irrelevant gender stereotypes. There's no such thing as man autism and woman autism. If there's a group of people whose presentation differs so much from what's specified by autism criteria, either

A. they don't have autism, or
B. autism diagnostic criteria should be changed, and the new criteria should apply to everyone


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08 Jan 2021, 2:06 am

starkid wrote:
I've never heard of anyone blaming chromosomes for differences between men's and women's rates of diagnoses.


It's been hypothesised that females are somewhat protected from developing autism because we have XX chromosomes whereas males have XY. Possibly damage on the Y chromosome would be more likely to affect males.

Or there's another argument regarding exposure to excess androgens (that's male hormones such as testosterone) in the womb. I forget the details of the argument, but Simon Baron-Cohen is promoting this one (as it supports his extreme male brain idea).

I do believe that autism tends to present differently between men and women. On the current data, nobody has a conclusion on whether it is truly more prevalent in males or whether girls have just been going undiagnosed and thus skewing the figures.

I see no reason not to have separate diagnostic criteria for males and females if it truly presents differently - or at least broadening the criteria to include both. (In the same way that the medical profession are finally realising that heart attack symptoms tend to be different in males and females, such that females are more likely to get a delay in diagnosis or a misdiagnosis. It's important to study presentation in both sexes).



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08 Jan 2021, 3:20 am

doctors like the squeaking wheels better, as well

if you ain't complaining, you can't have it


-> like searching in the light; a Nasruddin story


Once, a man found Nasruddin searching for something on the ground outside his house under a lamp post.
On being asked, Nasruddin replied that he was looking for his key.
The man also joined in the search
and in due course asked Nasruddin: ”Where exactly did you drop it?”

Nasruddin answered: ”Over there, in the shadows.”
”Then why are you looking here?” the man asked.
”The light is better here” replied Nasruddin.