The gender bias of Autism

When people think of autism there is a preconception of a man or a boy, possibly an Alan Turing or an Einstein type; someone who is extremely gifted at maths, has no empathy and has incredible talents.  When people think of autism, they see stereotypes, the faces they have been shown: by the media, by research papers, or even anecdotes from friends and families. But is this autism?

Though, these people do exist, it is not the norm. The stereotypes presented are misrepresentative for many, however this is especially true for a large group of individuals, who up until recently haven’t been recognised fully, these individuals are women.

Autism affects up to 1% of the population in the UK [1], and suggested ratios of males to females having autism are 1:3 [2]. However, in the past this was thought to be as low as 1:13[3]. This inability to identify autistic females, likely led to biased research and diagnostic criteria. So, now there is a catch up to be had, a time for research to look at autism from a new perspective, providing potentially life-changing evidence to women seeking answers about this condition. 

So what is autism (a very brief overview)?

A general overview of autism is someone who has difficulties with social skills, repetitive behaviours, sensitivity issues and could have issues with speech or could potentially be non-verbal[4]. However, though this list could be a general outline for many individuals on the spectrum, there is still a perceived notion of how these phenotypes (characteristics)  would present themselves, as we still show biased thinking, such as:

• Social Skills = no eye contact, direct, rude and no friends. 
• Repetitive Behaviours = OCD-like, meltdowns and tantrums if unable to keep with a routine.
• Sensitivity Issues = Loud noises, bright lights induce self soothing behaviours such as rocking.

Though these things can all be signs of autism, not all people present this way. Because of this lack of understand regarding the differing presentations of autism we have reduced our ability to identify and diagnose many on the spectrum, and this is especially true for females.

Due to this preconception, we have left many women in search for answers about who they are, with some undergoing identity crises, many women unable to be themselves, leading to mental health issues, eating disorders and in some tragic cases suicide. Until diagnosis for women is as easy and accurate as diagnosis for men, there will be a continuation of these struggles. 

Therefore, this platform hopes to develop an understanding and provide answers to these key questions: 

a)     What is autism?

b)     How does autism seem to affect women?

c)     Why is it harder to diagnose in women?

These themes, in essence, are wide ranging and complex. This will be a platform where both fact, opinion and anecdotes will be collated to produce a picture for the people searching for answers. 

Written by- Georgia Cronshaw

References:

1. Brugha TS, McManus S, Bankart J, Scott F, Purdon S, Smith J, et al. Epidemiology of autism spectrum disorders in adults in the community in England. Arch Gen Psychiatry. 2011 May;68(5):459–65.
2. Loomes R, Hull L, Mandy WPL. What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry. 2017 Jun;56(6):466–74.
3. Grandin T, Panek R. The autistic brain. London: Rider Books; 2014.
4. Wiggins LD, Rice CE, Barger B, Soke GN, Lee L-C, Moody E, et al. DSM-5 criteria for autism spectrum disorder maximizes diagnostic sensitivity and specificity in preschool children. Soc Psychiatry Psychiatr Epidemiol. 2019 Jun;54(6):693–701.