Autism spectrum disorder (ASD), also known as autism, often goes unnoticed in women. ASD used to be considered a predominantly male issue, but recent research indicates that there are many women with ASD who aren’t diagnosed until adulthood. Since the assessment tools and traits are based on men, there’s much less understanding how ASD represents itself in females. For many people, it’s a relief to receive an autism diagnosis because it provides an explanation for past struggles, and opens the doors to helpful resources for the future. This is why researchers are finally delving into the unique traits that tend to appear in autistic females.
Intense interests
In order to diagnose ASD, the medical practitioner needs to receive proof of restricted and repetitive behaviors, as well as difficulties with social interaction and communication. However, the same behaviors can look different in young males and females through the lens of social norms. For example, children with autism tend to have intense interests in one particular subject. But since autistic girls tend to choose similar subjects as their peers (such as horses, famous singers, or fictional characters) the hyper-fixation doesn’t raise many eyebrows. They may also have a wider range of interests compared to men with autism.
Masking
Females are also more likely to mask signs of autism than males, according to a 2020 study. This is because they typically feel more motivated to socialize and fit in. This can lead them to learn or imitate socially-acceptable interactions through personal observation or movies. All of this effort can cause a lot of stress, anxiety, and burnout.
Internalized symptoms
When it comes to internalizing symptoms, boys tend to show more noticeable difficulties with behaviors like aggression or sitting still. Meanwhile, girls are more likely to deal with their feelings internally, which can lead to depression or anxiety. But on the outside, they may present themselves as shy and withdrawn, which is considered acceptable for little girls.
Better adapted to social situations
Women with undiagnosed autism learn to force themselves into societal norms. So they may seem to excel on the outside. But on the inside, they may feel something is wrong with them because they struggle with certain things that others don’t. For example, autistic adults may force themselves to make eye contact, even though it feels extremely uncomfortable. They may also have issues with understanding and reacting to social cues. And knowing they have these issues can make social interactions even more anxiety-inducing.
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Sensory sensitivity
Adults with ASD experience heightened senses that can become overwhelming. Small details others might be able to ignore, such as bright lights, can feel unbearable. Additionally, autistic females in particular can be extra sensitive to loud noise, strong smells, and fabric textures, according to a 2021 case series.
Coexisting conditions
Living with autism, and the challenges that come with it, can lead to the development of other disorders. Autistic females, especially the ones diagnosed as adults, are more likely to have coexisting conditions, says UCLA Health. This is perhaps because they didn’t get the care, support, and resources offered to other children diagnosed with ASD. This may also be a result of the stress of trying to mask their symptoms. Therefore, autistic women may also have ADHD, depression, anxiety, OCD, tic disorders like Turret’s syndrome, sleep disorders, and eating disorders.
Difficulty with self-regulation and executive function
Autistic adults tend to struggle with regulating their emotions as well as day-to-day functioning. ASD can complicate staying organized, making plans, or finishing tasks, especially if they are uninteresting to the person. Autism can also lead to difficulties with emotional regulation, and this is more so true for women. They may be more prone to heightened reactions and feelings of distress or discomfort.
Repetitive behaviors
Autism is often associated with repetitive behaviors that are self-stimulating and help self-regulation. Also known as “stimming,” these behaviors can include hand flapping, rocking, and repeating words or phrases aloud. They can also be more subtle or socially acceptable like pacing, hair-twirling, or picking at skin. Similarly, autistic people have difficulty changing their routines.
Diagnosing adult females with autism
If a person thinks they may have autism, they should ask their general health practitioner for a referal for an evaluation. Then they will meet with a psychologist, neuropsychologist, or psychiatrist who will ask questions about social and communication skills, sensory responses, behaviors, and interests. The health professional may also talk to family members to get a clearer picture before making a diagnosis.
Do not depend on online autism tests since they are generally unreliable and not tailored to diagnosing autism in women. Be sure to see a professional for a correct diagnosis, as well as resources (such as personal recommendations, support groups, referral to mental health professionals if applicable, and so on) that may help improve quality of life.
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