Improving the Recognition of Females on the Autism Spectrum
Dr. Mandy is a clinical psychologist who discussed ways in which to improve the recognition of females on the autism spectrum at an Autism Community Training (ACT) research conference in April 2018. Check out the link below for videos of his talk where he discusses the history of autism, common myths about autism, the gender ratio in autism, and the female autism phenotype.
Dr. Mandy asserts that for every 4 males diagnosed with autism, 1 female with autism is diagnosed (i.e. 4:1 gender ratio). However, Dr. Mandy explains that it is not that there are less females with autism; it is actually that they are often under-diagnosed. For example, when it comes to females with autism there is a bias against receiving assessment in addition to a bias against meeting diagnostic criteria.
Some of this bias arises from differences between males and females with autism. For example, females with autism tend to:
Have higher social motivation (i.e. more motivated to participate in the social world than their male counterparts.
Have more typical and gender-stereotyped interests that are less ”strikingly unusual” (e.g. dolls, fashion); however, they are still pursued in a repetitive way with intense interest and attention to detail.
Demonstrate greater vulnerability to emotional difficulties (i.e. more likely to struggle with mental health difficulties). These difficulties in females are more likely to be internalized (e.g. anxiety) while in males they are more external (e.g. behaviour challenges).
Have greater capacity to ‘camouflage’ autistic difficulties (i.e. masking autism behaviours in social situations or compensation of autistic characteristics). For example, females may consciously decide to suppress stimming or mimic people they are with to try and behave similarly.
Thus, the myth that there are less females with autism and that females with autism are low functioning and have very intense symptoms is in fact because they are the only ones getting flagged and diagnosed; while the females with more subtle symptoms are getting missed.
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