Oh Snap!

One of the first things you notice when looking for data on women with Asperger’s Syndrome is the great paucity of this information. Why has so little been written on this subject?

Today we know that autism spectrum disorders affect 1 in 100 children in Italy (in the United States, researches speak of a proportion equal to 1 in 68), and that the ratio between males and females is 1 in 4 (2012). While male prevalence of the condition has been verified, it is statistically impossible that there are no women on the spectrum. In this article you will know about autism in girls. So, keep your eyes on this blog.


Getting know on autism in girls

The lack of information about it is mainly due to two factors: High-functioning autism, or Asperger’s Syndrome, is more difficult to diagnose., as it is less evident than in conditions accompanied by evident cognitive impairment; secondly, women with this syndrome have a characteristic that in itself hinders the process of recognition and diagnosis: these women, in fact, often manifest a sense of identity that is not clearly defined and delineated, and have the ability to be strongly chameleonic , in particular before receiving the diagnosis (this, in fact, usually leads to an awareness that is reflected on the definition of one’s own identity). (Simone, 2016).

The face under the mask

A first characteristic of Asperger women is, therefore, the ability to blend in, adapting to the contexts and people with whom they interact. What would we find, though, if we imagined lifting the chameleon’s mask?

As for the physical appearance , Asperger girls and women tend to display comfortable clothing (mainly due to the sensory difficulties they may have), and appearances that are not too refined, as they usually prefer comfort and practicality (for example in haircuts), and do not spend large amounts of time on body care. In general, the features are often androgynous, while not excluding the female appearance, and youthful, showing fewer years than the real ones.


Is the personality facts on autism?


The personality is often eccentric (this may also occur in worn clothes); frequently these women perceive themselves as half female and half male, balancing the two roles, and may be more expressive than males on the spectrum. Many enjoy reading and film / TV, especially science fiction and children’s stories, seen as an escape from reality and a place of comfort when needed. From a cognitive point of view , women with AS may have particularly developed skills or talents, often they are musicians or artists. On the other hand, they may have difficulty holding a job or looking for one, and have trouble understanding verbal instructions.

Emotionally they are often immature and extremely sensitive, with a marked tendency to anxiety and mood swings, which can lead to depression. They show a marked intolerance to injustices and misunderstandings, as a result of which anger can arise. 


Asperger’s Syndrome can appear to be cold and distant


Often these women use control as a stress management strategy, tending to follow very strict rules and habits, and are more comfortable at home or in a protected environment. Finally, from a relationship standpoint , women with Asperger’s Syndrome can appear to be cold and distant, focused on themselves. They can be very direct in addressing others, and in some situations they can appear extremely clumsy (for example when they are attracted to a guy they tend to engage in behaviors that may seem bizarre, such as staring hard at the person, but it is an aspect that tends to be attenuates with age) (Simone, 2016).

Differences between men and women

There are some aspects that differentiate, in general, Asperger’s women from men with the same diagnosis. First, it is very important to be aware that the criteria for diagnosing this condition are based on male traits : for this reason they are often not recognized as women on the spectrum (they are often mistaken for bipolar or manic-depressive). 

However, we must not underestimate the mood symptoms that can be found in women and in individuals with Asperger’s Syndrome in general: due to sensory hypersensitivity and the social challenges they face, these people are often particularly predisposed to stress-related diseases. , such as anxiety, depression and chronic fatigue syndrome (Holliday Willey, 2012).


Is women tend to be more expressive?

Typically, women tend to be more expressive in their faces and gestures, and have a greater capacity for imitation; it may be that they are so good at imitating different types of personalities, and at “camouflaging” their social difficulties, that they are chameleonic (Lai et al., 2017). Like men, they can have very pronounced special interests, but these are often more practical in nature and are perceived as less bizarre than male ones.

Compared to men, they may be more prone to crying fits, even in public, due to emotional or sensory overstimulation . For this reason, and in general for support, they often love animals very much and have their own.

Finally, they are better at socializing than males, but not to the point of not experiencing difficulties in this area: often the risk is that they are considered more skilled than they actually are, and that this creates expectations about them and reduces the possibilities. that they are offered support.

Social mimicry

In the social sphere, women with Asperger’s learned very early on how to “ blend in ”, ie they learned how to pretend to be someone else. The time of school, which requires great social skills, is particularly challenging for girls with Asperger’s: to be able to cope with this difficulty many of them “wear a mask” or “pretend to be someone else” in specific social situations.

Some Asperger women have learned to “mask” their identity using the media as a source, imitating characters seen on TV, in magazines, reading body language books and novels. Some women have learned phrases and facial expressions from the official literature to be able to deal with unpleasant social situations, such as bullying.


Different facial expressions and modifying facial expressions


Despite having acquired compensatory strategies to adapt to different social situations, young women report a high cost linked to “masking” and “mimicking” their identity. While for neurotypical girls, in fact, producing different facial expressions and modifying facial expressions based on situations is part of an automatic and unconscious mechanism, for young AS women all this effort is often exhausting. Hiding one’s characteristics, pretending to be someone else, often has the result of confusing them with respect to their own identity, so much so as to question their belonging to the Asperger world.

” It’s very tiring trying to understand everything all the time, everything is more like a manual, you have to use one of those computers where you have to type every command” (translation from The Experiences of Late-diagnosed Women with Autism Spectrum Conditions.


Autism spectrum disorders

Historically, autism spectrum disorders have always been considered male disorders and, in part, still are. The same children and young people described in the 1940s by Hans Asperger – the Austrian pediatrician from whom Asperger’s syndrome takes its name , used for the first time by the psychiatrist Lorna Wing and “absorbed” in the DSM 5 of 2013 within the disorders of the autism spectrum – and even before that by Grunya Sukhareva they were mainly males with behaviors now considered typical of the spectrum, from adherence to very strict and restricted routines to (sometimes) extraordinary skills in very specific fields. Alongside, generally, in social contexts these children related to other people in a profoundly different way from their peers. Even in the studies conducted in the same years by psychiatrist Leo Kanner, who spoke of “early childhood autism”, we find mostly males described in a similar way.


 Stereotypes that they struggle to jump 


To date, much has changed in the knowledge about autism, from the scientific world as well as from the general public: the aspects of sensory perception are deepened, we know that between two autistics there can be even enormous differences, different experts press to unhinge labels and stereotypes that they struggle to jump – such as the idea that autistics are in no way empathic – and thanks to self-advocacy a door has opened to understanding about the differences of neurodiverse people and how they experience the world around them.

While all this changes, and very quickly, autistic girls, girls and women have long been talked about very little and in part it is still the case. Is it just a higher prevalence of autism among males?



Extricate oneself from this complex issue


The experience of clinicians and the personal testimonies of many autistic girls and women who share their own path – often long and frustrating – towards diagnosis show us that those who are looking for an answer for years because autism has passed in them are not rare. unnoticed , as if it were so different from the male one as to make them difficult to compare. It is no coincidence that we often hear about female autism, an absolutely unofficial “simplification” but which helps to extricate oneself from this complex issue that we have also used in the title of this article for practicality. It is not uncommon when reading about women on the spectrum to come across the term aspergirlsor similar, also used by some mental health professionals aware of the gender bias in the field of autism, which still plagues the diagnostic pathways of many people.


Does it make sense to talk about autism?


The issue is made even broader by the theme of gender identity: according to a study published in August 2020, autism (mentioned in the paper along with other psychiatric diagnoses / related to neurodevelopment) is three to six times more common. So does it make sense to talk about autism “in the feminine” or would it be more appropriate to look for a language suitable for the theme of gender medicine, but without reinforcing stereotypes? The question remains open and the dialogue / discussion about it is one that you can often cross if you follow self-advocacy pages / blogs / groups.

Undertake a formal diagnostic process


Returning to gender bias: as well told in the books of autistic authors such as Sarah Hendricks or Rudy Simone, who report their experience together with that of other women, in many cases we find ourselves facing stereotypes that are still difficult to abandon, which ” undertake a formal diagnostic process or delegitimize the long process of introspection that precedes the search for confirmations through clinical interviews:

“Look people in the eye, you can’t be autistic”

“You have friends and a job, you can’t be autistic”

“You have a partner, children and a satisfying life, you cannot be autistic”


Much information on neurobiology is lacking 


It is not uncommon for a woman seeking a diagnosis to receive such answers. To date, the neuropathology of autism is not known, much information on neurobiology is lacking and in particular there are no measurable biomarkers that allow the diagnosis, carried out by evaluating behaviors and difficulties considered symptomatic through clinical interviews – which may involve one or more family members for a look from the outside – and questionnaires such as the RAADS-R (Ritvo Autism Asperger’s Diagnostic Scale-Revised). This is how, sometimes only after years of misdiagnosis or bordering on the answer – such as OCD , bipolar disorder , anxiety and depression often comorbidities, the very consequences of autism-related difficulties – women come to clarity.


Developmental Disorders coordinated by Francesca


In recent years, scientific projects dedicated to autistic women and to clarify the gender differences in autism have been emerging , as well as several qualitative research on autism in women. Among these, a study in the Journal of Autism and Developmental Disorders coordinated by Francesca Happé, professor of cognitive neuroscience among the best known world experts on autism, which involved 18 autistic women to collect their experiences from diagnosis to management of daily life. Among the most recent projects we find FANN, Female Autism Network of the Netherlands, which works on specific topics: diagnosis, comorbidities, treatments, sexuality, parenting and general knowledge on the topic.


Retrace their experiences with a new and finally clarifying interpretation


Many women receive the diagnosis once they become mothers of children who are themselves autistic, because they gradually recognize themselves in the particularities of their children and retrace their experiences with a new and finally clarifying interpretation. Many still find themselves in the experience of other autistic women told in books, articles or blogs and undertake a process of evaluation as adults in search of answers. Others will never find them due to lack of support, specialists or dedicated diagnostic centers nearby; the interactive GapMap map developed by Stanford University on the United States shows, for example, how services dedicated to autism are not always homogeneously distributed throughout the territory.

Why such a difference?

Not too many years ago it was thought that in autism the ratio of males to females was close to 10: 1 but studies have narrowed it down to 4: 1. A 2017 review concludes that 3: 1 is the most correct ratio, but the picture may change again in the coming years. Many professionals including psychologist Tony Attwood – author of the best-known Asperger Syndrome manual – believe that there is still an important gender bias that leads many girls, girls and women to never receive a diagnosis that could ( as testimonies confirm ) their life.


Sensitive differences – We should know


Scientific studies have not yet been able to give clear answers in this regard and many theories and knowledge are based precisely on the clinical experience of specialists, who after decades of encounters with autistic women recognize patterns, behaviors, sensitive differences (compared to neurotypic women as well as to autistic men) which by their very nature lead to a delay in diagnosis or never to receive it. Among all the masking, the ability of many autistic women to blend in by copying the attitudes of others, hiding their autistic behaviors and going unnoticed. But often paying a huge price in terms of mental health, becoming social chameleons and sometimes ending up not “recognizing” their own identity anymore. Sometimes all this camouflage occurs in an unconscious and almost automatic way: learned to act to hide one’s particularities, that becomes the facade that presents itself to the world and that often falls only once you return to a safe environment, for example between the walls of home.


An important role in whether a girl will receive a diagnosis of autism


Research in this sense is increasingly active, and brings valuable insights. In February 2021, for example, a paper edited by Amy Pearson and Kieran Rose dedicated to masking was published in Autism in Adulthood in which it is reiterated that it is often the consequence of the prejudices and stigma of society towards autistic people and that it can play an important role in whether a girl / woman will receive (or not) a diagnosis of autism. Case study on 136 people


A small study conducted on 136 people and published in July in The Lancet Psichiatry showed that the compensatory strategies implemented by autistics to better manage complex situations, such as sociability, can have serious negative consequences on mental health and contribute to delay diagnosis. Forcibly laughing at jokes, avoiding stimming in public, or planning conversations and pleasantries well in advance comes at a cost, but in many cases it helps autistics to blend in better. Becoming, in what is often a painful recitation that drains the energies, almost indistinguishable from neurotypical people.


Effective diagnostic paths


The study authors point to the limitations that most of the participants involved were highly educated women diagnosed in adulthood , a limitation that actually gives us an insight into precisely that part of autism that we greatly need. know better. For more effective diagnostic paths, which do not lose women among the meshes of criteria designed for men or when, by now adults, they are now perfectly camouflaged and implement masking and compensatory mechanisms automatically, but always with enormous energy costs. Yet autism certainly does not disappear as we grow up and stories of people who receive a diagnosis, liberating and clarifying, even in old age are not rare. Even at 50, 60, 70 years old.


Specificity of interests

Most autism diagnoses are made by the age of six; according to Attwood, the “atypical” behaviors that lead parents to seek the advice of a professional are much more frequent in boys than in girls. Even the specificity of interests, often defined stereotyped, is more evident in them to neurotypical eyes or concerns topics that many families now associate with autism (means of transport such as trains or planes, numbers and sequences).


Privacy of one’s own room and learning it almost by heart

For girls and boys, always from clinical experience and testimonies, it is not uncommon for the attention to focus instead on animals or literature. Interests considered less atypical and that hardly attract parents or teachers in the same way, even if they have the same repetition and intensity: reading a book dozens of times in the privacy of one’s own room and learning it almost by heart is considered less “strange” than knowing how to rattle off all the train models of a certain historical period.

A large 2012 study of 15,000 twins confirmed that the “female” spectrum goes unnoticed more often: between a boy and a girl with comparable autistic traits, it is much more difficult for a girl to obtain a diagnosis of autism spectrum disorder if there are no other elements of note from an intellectual or behavioral point of view. 


Final word

This reflects a gender bias in the diagnosis , the authors proposed even then, or the better ability to compensate and adapt of autistic girls – who still experience difficulties very similar to those of children, for example in the sensory field.- and from an early age they are subject to the pressures of a society that wants the female gender to be kind, sociable and empathetic at all costs, eventually encouraging masking and the feeling of having to adapt at all costs to be “normal”. This can lead to the question of whether the difference is not attributable so much to a female phenotype , as to the social pressures and expectations that a child sometimes suffers from an early age. So, if you find any symptoms, call to doctor. So, guys if you need more info let’s know us via inbox or comment below the post. Thanks for reading.

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