Hi, I’m Lady Nym and I’m pretty sure I’m an Aspie. I’m also very sure I’m female.
Is the combination of those two things surprising?
For a long time it was thought there were more boys with ASD than girls. The figure I’ve seen most often and the one quoted on the EarlyBird programme (the course I’m on for parents of young children with ASD) is that for every one female with autism there are four males.
So, autism is more common in boys?
Maybe. Maybe not.
I know at least as many women with autism as men (both with and without official diagnosis) but despite the fact I feel like a huge number of the people I know are on the spectrum, they form a relatively small sample. As I’m
obnoxiously quick to point out to other people: anecdotes do not count as scientific evidence.
But it’s not just my experience. A lot of professionals are also coming to the conclusion there are many more women with autism than was previously thought. They simply haven’t been recognised as such until now.
So, why? Why isn’t ASD in women picked up on as often as ASD in men?
For the same reason doctors used to tell women they should try not to think too much because it would divert the blood flow to their brain and away from their uterus (thus causing it to wither up): good old fashioned sexism.
Leo Kanner is often hailed as the man who ‘discovered’ autism. Out of the 11 children he studied in the cases he used to characterise autism, only 3 were girls. Later, came along Hans Asperger (it probably won’t come as a shock to you to learn he was influential in the study of Asperger’s/’high functioning ASD’) and his cases consisted of four boys; no girls.
I’m not criticising either man for their selection. They were entering uncharted territory and worked with what they had. However, it seems odd the people who carried on their studies apparently said, ‘Huh, these diagnostic criteria have largely been clarified through watching boys, and girls don’t seem to display them so that must mean girls don’t tend to be autistic,’ rather than, ‘Huh, these diagnostic criteria have largely been clarified through watching boys so maybe we should look at whether girls show different symptoms.’
It’s not surprising. I mean, it’s only recently that anyone seems to have become aware of the fact women tend to suffer from different symptoms when they’re having a fracking heart attack. A measly disorder that was long considered to be purely neurological is small fry compared to, you know…fracking heart attacks.
There is another aspect of our historically misogynistic society that plays a part in fewer girls being diagnosed with ASD. Girls are conditioned – from a very young age – to be compliant, attendant to others’ needs and generally passive.
A born leader of a boy is a bossy girl; a determined, strong boy is a bitchy girl; a focused boy is a selfish girl. And it works the other way (because sexism negatively affects everyone): a caring, thoughtful girl is a wet boy; a sweet, sensitive girl is an oversensitive boy; an artistic girl is a pussy of a boy.
We’re all shoehorned into these roles by society without anyone even realising it’s happening and people with Asperger’s are at least subconsciously aware of all this. One of the common characteristics of Aspie girls, especially, is a painful concern about what other people think.
We’re told autistic people don’t do empathy, don’t like socialising (or at least aren’t very good at it), and have lots of weird tics and stims (repetitive movements). Now, the first two are dubious anyway but I can at least see why it may appear that way in a lot of boys (and some girls) with ASD. However, for many girls on the spectrum who know they’re in some way different but are desperate to fit in, they may in fact try very hard to be more empathetic, better at listening, very good at socialising (even if it gives them terrible anxiety) and they’ll likely repress their stims or find more socially acceptable ones like hair twirling or finger tapping (rather than hand flapping or head shaking).
We expect people on the spectrum to have obsessions and/or collections: trains, historical dates, Star Trek, Pokemon, vacuum cleaners etc. Females on the spectrum are also prone to this but often make their obsessions and collections more ‘socially acceptable’ and stereotypically ‘girly’. They may be particularly obsessed with a particular band or with horses, they may collect make-up or handbags.
Not always, I should point out. The thing about ASD is no two people on the spectrum are the same (it’s almost like we’re people or something). Autistic girls can collect Magic the Gathering cards or obsess over maths, too, but there is a tendency towards less ‘obviously autistic’ interests in ‘high functioning’ autistic women.
I could write a list of specifically female autistic traits but other people in a better position to do so have beaten me to it so if you’re interested check out Tania Marshall’s list here and the post on Everyday Asperger’s here.
So, for a long time many girls on the spectrum have slipped under the radar. They often know there’s something different about them. They often sense they don’t quite fit in and feel like they’re faking it. They probably struggle with social communication and have anxiety but hide it as best they can. If they have actually sought help they may have been misdiagnosed with something else like a personality disorder or depression (though, there’s a chance they will also have depression…just in case you thought things were in any way simple!).
Does it matter, then? When girls and women on the spectrum have been ‘passing’ as neurotypical for so long anyway, do they – or anyone else – even need to know they’re autistic? Does it benefit anyone?
For one thing, it’s nice to know why you feel so different and removed from the world. I have spent my whole life just not quite fitting in and not quite ‘getting…it’. The realisation this is probably because I’m autistic is quite comforting. There is a reason; I’m not just crazy (and now I have a pass to watch Firefly over and over again endlessly…right?).
Also, it’s nice to figure out why you do some of the things you do. Ah, that’s why I feel so horribly overwhelmed and uncomfortable and even angry when there’s a lot of noise. That’s why I’m just so utterly crap at organising paperwork and why I have such anxiety over making phone calls etc.
On a more serious/medical note, being autistic means women are more likely to suffer from anxiety, depression, OCD, eating disorders and a whole host of things. I don’t know about anyone else but I think it’s kind of important people know this and know if they’re at higher risk.
They are also more at risk of finding themselves in abusive relationships (this can mean emotionally, physically, sexually or financially abusive). Again, sort of important information.
With appropriate support in place, girls on the spectrum are more likely to leave school with better grades rather than getting overwhelmed and anxious and not reaching their full potential. Colleges and universities also offer support for autistic students and employers are legally obliged to make certain allowances.
On a less official level there’s also support available from fellow Aspies online.
Knowing about how female Aspies present is also beneficial to boys on the spectrum because, strangely enough, we’re not all perfect cliches who fit neatly into boxes and many boys who exhibit some of these typically more female traits also don’t get a diagnosis. If female autistic traits become more widely recognised simply as ‘autistic traits’ it will help boys on the spectrum who don’t present in such a typical way (like Tyger).
My suspicion is there’s probably a fairly even number of autistic females and males. It’s taken me getting on for 30 years to realise I might be autistic. I’m willing to bet there are many, many other girls and women out there who have no idea but feel out of place in a neurotypical world.